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Interventions for Care Partners of Adults with Dementia: A Systematic Review
PURPOSE: It is estimated that 8.5 million people are informal care partners for people with dementia (Friedman et al., 2015), which is a challenging role associated with emotional strain, anxiety and depression, increased care partner burden, poorer quality of life (QoL), financial strain, and lack of support (Hellis & Mukaetova-Ladinska, 2023). It is important for occupational therapy practitioners (OTPs) to use the most effective interventions that can be implemented to preserve informal care partners’ health, wellbeing, and quality of life (QoL) (Hellis & Mukaetova-Ladinska, 2023). The purpose of this systematic review is to determine which interventions within the scope of OT practice best support the QoL of care partners of adults with dementia.
DESIGN: We completed a systematic review that focused on interventions within the scope of OT practice to improve QoL of care partners. We included articles published in English from 2013 to 2023. We limited the articles to those which were levels of evidence I – III and had a primary outcome measure of QoL for informal/unpaid care partners. We used the U.S. Preventative Services Task Force levels of certainty and grade definitions to describe the strength of the evidence.
METHOD: We reviewed 136 articles from three different databases. Of 136 articles found, nine studies met the inclusion criteria and were included in the review. Each article was reviewed by at least two reviewers to assess its eligibility.
RESULTS: We themed the articles by intervention type: activity programs, skills training, coping strategies, and psychosocially based interventions. There was strong evidence to support activity program interventions that resulted in a decrease in care partner burden and depressive symptoms. There was strong evidence to support care partner coping strategies that resulted in improvements in QoL, decreased depressive symptoms, and increased mental health in care partners. There was moderate evidence to support skills training interventions that resulted in increased carer satisfaction and decreased or no differences in depressive symptoms. There was moderate evidence to support the use of psychosocial-based interventions, results showed decreased care partner distress, increased self-efficacy, overall well-being, and QoL.
CONCLUSION: Occupational therapy practitioners play a valued role in advocating for and implementing therapy interventions in order to promote positive QoL for informal care partners. Based on the strong evidence of articles evaluating activity programs and coping strategies to improve QoL of care partners we believe these intervention strategies could be provided on a routine basis. Based on the moderate evidence of articles evaluating skills training programs and psychosocial based interventions we believe these intervention strategies could be provided on a routine basis. Further research should be conducted to determine the most effective frequency, duration, and time period during which these interventions would be best implemented. These evidence-based intervention strategies have potential to serve as a powerful influence in occupational therapy practice to enhance QoL of informal care partners of adults with dementia.
Friedman, E. M., Shih, R. A., Langa, K. M., & Hurd, M. D. (2015). US prevalence and
predictors of informal caregiving for dementia. Health Affairs, 34(10), 1637-1641. doi: 10.1377/hlthaff.2015.0510
Hellis, E., & Mukaetova-Ladinska, E. B. (2023). Informal Caregiving and Alzheimer’s Disease: The Psychological Effect. Medicina, 59(1). https://doi.org/10.3390/medicina59010048
Stall, N. M., Kim, Sanghun, J. K., Hardacre, K. A., Shah, P. S., Straus, S. E., Bronskill, S. E., Lix, L. M., Bell, C. M., & Rochon, P. A. (2019). Association of the informal caregiver distress with health outcomes of community-dwelling dementia care recipients: A systematic review. Journal of the American Geriatrics Society, 67, 609-617. https://doi.org/10.1111/jgs.15690
care partners of adults with dementia, dementia, adults, interventions, occupational therapy
Homan, Makenzie Kay; Ourada, Azia Marie; Rieber, Reannon Taylor; and Tynan, Grace Delaney, "Interventions for Care Partners of Adults with Dementia: A Systematic Review" (2023). Student Systematic Reviews: Occupational Therapy. 9.