Caregivers Of People With Dementia Research Articles

Professional and family caregivers' attitudes towards involuntary treatment in community-dwelling people with dementia.

AimsThe aim of this study was to gain insight into professional and family caregivers’ attitudes towards involuntary treatment in community‐dwelling people with dementia (PwD).BackgroundThe number of PwD with complex care needs living at home is increasing rapidly. In some situations, caregivers provide care against the will of PwD, referred to as involuntary treatment, which includes non‐consensual care, psychotropic medication and physical restraints.DesignA cross‐sectional study.MethodsA total of 228 professional (nursing staff, general practitioners (GPs) and other healthcare professionals such as physical therapists and psychologists) and 77 family caregivers of PwD completed the Maastricht Attitude Questionnaire—Home Care. This questionnaire measures attitudes towards involuntary treatment and perceived restrictiveness of and experienced discomfort in using involuntary treatment. Data were collected in the Netherlands between June and November 2016.ResultsFamily caregivers and GPs had more positive attitudes towards involuntary treatment than nursing staff and other healthcare professionals, indicating that they are more accepting of involuntary treatment. A more positive attitude was associated with higher perceived caregiver burden and being a family caregiver. Family caregivers and GPs found the use of involuntary treatment less restrictive and indicated feeling more comfortable when using these measures.ConclusionIt is important to account for the differences in attitudes and foster dialogue among professional and family caregivers to find common ground about alternatives to involuntary treatment. These results will inform the development of an intervention that aims to prevent involuntary treatment in home care.

Prevalence and Risk Factors of Abusive Behaviors in the Caregivers of People with Dementia in Korea.

ObjectiveWe investigated the prevalence and risk factors of physically abusive behaviors (PhAB) and psychologically abusive behaviors (PsAB) towards people with dementia (PWD) in family caregivers, and compared their prevalences between East Asian and Western countries. MethodsWe estimated the prevalence and risk factors of PhAB and PsAB in 467 Korean pairs of community-dwelling PWD and their primary family caregivers. We evaluated abusive behaviors using the Modified Conflict Tactics Scale. In addition, we compared the prevalence of abusive behaviors between Asian and Western countries through a meta-analysis on 12 studies including the current one. ResultsMore than a half of the caregivers reported PsAB and about one out of seven caregivers admitted PhAB within past three months. PsAB and PhAB were slightly more prevalent in East Asian countries than in Western countries. Non-Alzheimer type and moderate to severe behavioral and psychological symptoms of dementia were associated with the risk of PhAB but not with the risk of PsAB. Severe care burden and low income were associated with the risk of PhAB and PsAB. ConclusionPhAB and PsAB were as prevalent in the family caregivers of PWD in Asian countries including Korea as in Western countries. Prevention strategies should be implemented according to the type of abusive behaviors.

Unmet needs of family dementia caregivers of persons with dementia : Primary medical care

Results of current research studies revealed that providing informal care for people with dementia (PwD) is associated with caregivers' burden and avariety of health impairments. In order to provide optimal support for family caregivers of PwD, general practitioners and specialists should be able to identify caregivers' unmet needs in primary care. The present article provides an overview of unmet needs of family caregivers that are relevant for general practitioners as well as specialists in neurology, psychiatry, psychotherapy and psychosomatics. The present overview is based on current reviews on unmet needs of caregivers of PwD and on results of the general practitioner-based, cluster-randomized controlled intervention trial DelpHi-MV (Life- and person-centred help in Mecklenburg-Western Pomerania, Germany; Identifier: NCT01401582). The article provides an overview of unmet needs of family caregivers for PwD, especially in the domains of social integration, psychological and physical health, legal and financial issues, as well as available and valid measurements. The article illustrates the importance and the possibilities for general practitioners and specialists to identify caregivers' unmet needs. The question to what extent unmet needs' assessments for family caregivers of PwD could be implemented and financed in routine care is still under debate.

The Effectiveness of Mindfulness- and Acceptance-Based Interventions for Informal Caregivers of People With Dementia: A Meta-Analysis.

The application of mindfulness- and acceptance-based interventions (MABIs) for informal caregivers of people with dementia (PwD) is relatively novel, and the current state of the evidence base is unclear. This meta-analysis examined the effectiveness of MABIs on reducing symptoms of depression and burden in informal caregivers of PwD. The quality of included studies was evaluated and moderator variables explored. A literature search of six electronic databases (PsycARTICLES, PsycINFO, MEDLINE Complete, SCOPUS, Web of Science, and ProQuest) was conducted from the first available date to 20 December 2016. Inclusion criteria involved studies that quantitatively investigated the impact of MABIs on depression and/or burden in informal caregivers of PwD. Twelve studies, providing data on 321 caregivers, were included. Most used mindfulness-based stress reduction and were conducted in the United States. The average attrition among participants was 15.83%. The pre-post effect of MABIs was large for depression and moderate for burden. These effects were largely maintained at follow-up. Significant heterogeneity of effect sizes was observed, with no significant moderators identified. Study quality varied from very poor to moderately good. The low attrition and moderate to large effects suggest that MABIs are acceptable and beneficial for informal caregivers of PwD. The lack of significant moderators could advocate services using more cost-effective forms of MABIs. Further higher-quality research is needed to improve the robustness of the evidence base and enable a meta-analysis to thoroughly examine and quantify moderator variables.

Effectiveness of an online social support intervention for caregivers of people with dementia: the study protocol of a randomised controlled trial

BackgroundCaregivers of people with dementia (PwD) face burden, feelings of loneliness, and social isolation. Previous studies have shown promising effects of online e-health interventions. Using social media may facilitate support for dementia caregiver networks. In an iterative step-wise approach, a social support tool entitled “Inlife” was developed. This paper describes the design of a study evaluating the effects of Inlife and its process characteristics.MethodsA mixed-method, randomised controlled trial with 122 caregivers of PwD will be conducted. Participants will be assigned to either the Inlife social support intervention or a waiting-list control group. After 16 weeks, the control group will obtain access to the Inlife environment. Data will be collected at baseline (T0) and at 8-week (T1), 16-week (T2) and 42-week follow up (T3). The 16-week follow-up assessment (T2) is the primary endpoint to evaluate the results on the primary and secondary outcomes, measured by self-reported questionnaires. The primary outcomes include feelings of caregiver competence and perceived social support. The secondary outcomes include received support, feelings of loneliness, psychological complaints (e.g., anxiety, stress), and quality of life. A process evaluation, including semi-structured interviews, will be conducted to examine the internal and external validity of the intervention.DiscussionUsing a mixed-method design, our study will provide valuable insights into the usability, effectiveness, and factors related to implementation of the Inlife intervention. Our study results will indicate whether Inlife could be a valuable social support resource in future routine dementia care.Trial registrationDutch trial register, NTR6131. Registered on 20 October 2016.

Mindfulness-Based Intervention for Stress Reduction of Family Caregivers of People with Dementia: A Systematic Review and Meta-Analysis

Caring for people with dementia (PWD) poses a lot of challenges to family caregivers. Mindfulness-based intervention (MBI) is a newly adopted psychosocial intervention through an integration of the mind and body to reduce stress of the participants (caregivers). This study aims to determine whether and to what extent MBI for family caregivers of PWD can reduce their stress. Electronic databases including MEDLINE, CINAHL, Cochrane Library, PsycINFO, EMBASE, and the Web of Science were searched for relevant studies published between 1990 and 2016. All randomized controlled trials (RCTs) and quasi-experimental studies evaluating the effects of MBI on reducing stress in family caregivers of PWD were eligible for inclusion in this review. Five studies were included. Of these, three trials involving 144 participants were eligible for the meta-analysis. The analysis showed that stress levels dropped significantly after the MBI. The findings showed a significantly more favorable effect of MBI with the standardized mean difference with a moderate aggregated effect size of 0.57 (95% CI [0.23, 0.92], overall effect Z = 3.25 at p = 0.001). This effect was only found immediately after the MBI but not in the follow-up sessions. In conclusion, the available evidence suggests that MBI seems to be effective at reducing stress among family caregivers of PWD. However, it should be noted that the number of studies involved was small (n = 5), as were the sample sizes, and no sustained effect was found. Multi-center RCTs of the effects of MBI involving larger and more diverse samples of family caregivers of PWD are recommended before any clear conclusion can be reached.

Assessing Grief of Family Caregivers of People with Dementia: Validation of the Chinese Version of the Marwit-Meuser Caregiver Grief Inventory.

Grief in dementia caregiving is underexplored in research studies in the Chinese context, yet social workers often work with caregivers of people with dementia (PWD) and who experience grief. Having a valid assessment tool can help social workers better identify the grief of caregivers and facilitate caregivers' articulation of grief. This article describes a study aimed to validate the Marwit-Meuser Caregiver Grief Inventory-Short Form (C-MM-CGI-SF) among Hong Kong Chinese caregivers of PWD. One hundred and twenty caregivers participated in this study. They were recruited from day care centers and a memory clinic. The short version of MM-CGI was translated into Chinese, and participants were asked to complete a questionnaire that included this scale and other scales validating it. Reliability and validity were examined. C-MM-CGI-SF was found to be a reliable and valid measure in the Hong Kong context. Its construct validity was demonstrated by the positive correlations with caregiving strain and depression, and negative correlations with presence of meaning and life satisfaction. The discriminant validity was supported by showing that spousal caregivers' grief level was significantly higher than that of nonspousal caregivers. Authors recommend social workers using the C-MM-CGI-SF to assess the grief of Chinese caregivers caring for people suffering from dementia.

Effectiveness of Cognitive Behavioral Therapy for Caregivers of People with Dementia: A Systematic Review and Meta-Analysis.

Background and PurposeCaregivers endure tremendous physical, emotional, and financial burdens while caring for people with dementia. The current study aimed to estimate the effectiveness of cognitive behavioral therapy (CBT) for caregivers of people with dementia (CGPWD).MethodsStudies in the MEDLINE, EMBASE, Cochrane Library, Web of Science, and SCOPUS databases were screened. Studies with a randomized controlled design and which produced CBT outcomes for CGPWD were included in this study, and we investigated these outcomes.ResultsThe screening of abstracts of 263 studies resulted in 12 randomized controlled trials being included in this study. The mean age of the CGPWD ranged from 51.5 to 66.2 years. The caregiver role was most frequently adopted by a female spouse or daughter. CBT for the CGPWD resulted in positive effects on various conditions, including depression, anxiety, stress, and dysfunctional thoughts. Depression was the most commonly evaluated condition, and the Center for Epidemiologic Studies Depression Scale (CES-D) was most frequently used as an inventory for depressive symptoms. The mean differences between the baseline and postintervention CES-D scores were compared between the CBT-intervention and control groups. The CES-D score decreased significantly more in the CBT-intervention group than in the control group. The difference in pooled mean differences between the two groups was −4.98.ConclusionsCBT is an efficient intervention tool for reducing the various emotional burdens experienced by CGPWD. This meta-analysis found that CBT significantly improved the depressive symptoms of CGPWD.

A COMMUNITY-BASED APPROACH TO ADDRESSING CAREGIVER STRAIN IN INDIGENOUS CAREGIVERS OF PEOPLE WITH DEMENTIA

A COMMUNITY-BASED APPROACH TO ADDRESSING CAREGIVER STRAIN IN INDIGENOUS CAREGIVERS OF PEOPLE WITH DEMENTIA

A COMMUNITY-BASED APPROACH TO ADDRESSING CAREGIVER STRAIN IN INDIGENOUS CAREGIVERS OF PEOPLE WITH DEMENTIA

A COMMUNITY-BASED APPROACH TO ADDRESSING CAREGIVER STRAIN IN INDIGENOUS CAREGIVERS OF PEOPLE WITH DEMENTIA

Burnout in Professional Caregivers and Quality of Life in Institutionalized Center Residents

Starting from previous studies in professional caregivers of people with dementia and other diseases in institutionalized centers of different regions, the aim of this study was to compare burnout levels that workers present depending on the center, to create a caregiver profile with high professional accomplishment and to describe the quality of life that residents perceive Murcia and Barcelona. The instruments used were the Maslach Burnout Inventory (MBI), the Professional Caregiver Survey developed ad hoc and the Brief Questionnaire of Quality of Life (CUBRECAVI in Spanish) on residents. The results show, on the one hand, that levels of professional accomplishment may be paradoxically higher in the case of catastrophe and, on the other hand, the 98.2% of users are satisfied with the residence in which is located and 81.8% with the manner in which occupy the time. The conclusions that are extrapolated from the study shed light on the current situation of workers and residents and the influence that an earthquake can have on them.

Changes in Levels of Burnout in a Comparative Study in Professional Caregivers After a Situation of Post-Traumatic Stress

Following a previous study on professional caregivers of people with dementia and other diseases in residential, was decided to compare two residential centers of two different regions, Murcia and Barcelona. Based on the results of which 13.3% of the global sample had a high emotional exhaustion, 54.8% a high level of depersonalization and 10% a reduced sense of personal accomplishment, we proceed to an analysis of current levels in the three dimensions to study their evolution. Similarly, we assess whether in the town of Lorca (Murcia), these levels have been affected by the earthquake on May 11, 2011, for which it has conducted an evaluation of possible symptoms of Post-Traumatic Stress Disorder (PTSD). We proceeded to the administration of the same tests of the latest research (Scale Maslach Burnout Inventory -MBI- and an ad hoc survey conducted for professional caregivers) and the Scale SA-45 which is the short form from the original SCL-90, and the Severity of Symptoms Scale of Posttraumatic Stress Disorder. The results show differences between the two populations in different variables and they shed light on the consequences and impact of a traumatic event in the sample.

Coping strategies and anxiety in caregivers of people with Alzheimer's disease: The LASER-AD study

Background Caregivers of people with dementia (CGPD) frequently have anxiety symptoms but little is known about the relationship of anxiety with coping strategies. Method 126 people with Alzheimer's disease (AD) and their family caregivers living in the community were recruited from local psychiatric services, the voluntary sector and care homes. Sampling was designed to ensure that the sample was epidemiologically representative in terms of dementia severity, gender and care setting. We used the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and the Brief COPE to measure coping strategies. Results Use of dysfunctional coping strategies (Wald = 7.3, p = 0.007) and HADS depression caseness (Wald = 14.0, p < 0.001) were the only factors that predicted HADS anxiety caseness on logistic regression. Limitations Anxious caregivers may be more likely to report their coping strategies negatively; these results do not clarify direction of causality. Conclusions Dysfunctional coping strategies and depression appear to be the most important factors predicting caregiver anxiety. Addressing coping strategies may be a helpful intervention for managing caregiver anxiety.