Key Intervention Categories to Provide Person-Centered Dementia Care: A Systematic Review of Person-Centered Interventions.

Wiebke Mohr,Bernhard Michalowsky,Moritz Platen,Martina Roes,David Edvardsson,Anika Rädke,Wolfgang Hoffmann,Adel Afi,Franka Mühlichen

doi:10.3233/jad-210647

Abstract

Background:Person-centered care (PCC) is an important concept in many countries’ national guidelines and dementia plans. Key intervention categories, i.e., a taxonomy of person-centered (PC)-interventions, to provide person-centered dementia care, are difficult to identify from literature.Objective:This systematic review aimed to identify and categorize published PC-interventions into key intervention categories to guide the provision of person-centered dementia care.Methods:Conduct of this systematic review followed Cochrane guidelines. A search of the dimensions ‘Dementia’, ‘Person-Centered Care’, and ‘Intervention’ combined was performed in PubMed, EMBASE, and Web of Science. Study selection was based on 2-stage screening against eligibility criteria, limited to controlled study designs. Information about interventions and outcomes was extracted into an “Effects Table”. The identified PC-interventions were categorized in intervention categories to provide person-centered dementia care.Results:Searches identified 1,806 records. 19 studies were included. These covered a range of psychosocial interventions, oftentimes multi-component interventions, which followed heterogeneous approaches. Studies were conducted in long-term care/hospital settings. Nine key intervention categories were identified: social contact, physical activities, cognitive training, sensory enhancement, daily living assistance, life history oriented emotional support, training and support for professional caregivers, environmental adjustments, and care organization.Conclusion:Our findings provide a current overview of published PC-interventions in dementia, which followed heterogeneous approaches under the PCC-concept. The heterogeneity made it challenging to identify a well-defined concept of PCC and common key intervention categories. An effectiveness-evaluation of “PC” - including “relationship-centered”-interventions may be valuable, to assess whether an explicit focus on relationships around PCC-interventions yields an added benefit.PROSPERO-ID: CRD42021225084.

Highlights

With aging populations, dementia increasingly represents a challenge for public health and health care systems worldwide [1]
Despite the recent approval of aducanumab for Alzheimer’s disease by the U.S Food and Drug Administration [4], no curative treatment for all people living with dementia (PlwD) exists
Many countries include a Person-centered care (PCC)-approach in their national guidelines and dementia plans [7,8,9,10,11,12,13]

Summary

Introduction

Dementia increasingly represents a challenge for public health and health care systems worldwide [1]. The concept is covered by a multiplicity of terms in the literature, dependent on the context in which care is provided It challenges the traditional clinician-centered or disease-focused medical model to a model of care, which is customized to each person [14]. Objective: This systematic review aimed to identify and categorize published PC-interventions into key intervention categories to guide the provision of person-centered dementia care. The identified PC-interventions were categorized in intervention categories to provide person-centered dementia care. Conclusion: Our findings provide a current overview of published PC-interventions in dementia, which followed heterogeneous approaches under the PCC-concept. The heterogeneity made it challenging to identify a well-defined concept of PCC and common key intervention categories. An effectiveness-evaluation of “PC”, including “relationship-centered”-interventions may be valuable, to assess whether an explicit focus on relationships around PCC-interventions yields an added benefit

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