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Peter A S, Prabhu MM, Tolson D, Nayak BS, Bhandary RP, V B, Devi ES. Effectiveness of interventions to prevent abuse in people living with dementia in community settings: A systematic review. DEMENTIA 2024:14713012241260476. [PMID: 38901056 DOI: 10.1177/14713012241260476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
OBJECTIVES This review examined the evidence for interventions to prevent the abuse of people living with dementia in the community. METHODS The articles were retrieved from 2000 to 2023 from six databases, including MEDLINE via PubMed, CINAHL Plus via EBSCO, EMBASE, ProQuest Medical Library, Web of Science, and Scopus. The research articles that focused on finding the effectiveness of interventions for preventing abuse of people living with dementia in community settings were included in this review. The review included randomized controlled trials and pre-test post-test trials only. The quality appraisal of the eligible studies was done using ROB 2 and ROBINS II. The findings were tabulated and narratively synthesised. RESULTS Out of 1831 articles, only three were included in this review. Only two RCTs were included in this efficacy review. Both the studies showed that the interventions were not effective in reducing abuse. The studies utilised family caregiver interventions like psychological interventions and online supportive education. The review identified psychological interventions with some evidence. Another study was a quasi-experimental study that used dialectical behaviour therapy as an intervention to reduce abuse occurrence. The study showed low evidence and focused only on reporting of elder abuse as an outcome. CONCLUSION This review found very few studies and was not able to draw a conclusion on the effectiveness of interventions for abuse in people living with dementia. Given the paucity of research, there is a clear need to identify how to overcome the challenges faced in elder abuse research and further refine the development of approaches to reduce elder abuse among people living with dementia in community settings.
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Affiliation(s)
- Seelia Peter A
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka,India 576104
| | - M Mukhyaprana Prabhu
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
| | - Debbie Tolson
- Alzheimer's Scotland Centre for Policy and Practice, University of West of Scotland, UK; School of Health and Life Sciences, University of West of Scotland, UK
| | - Baby S Nayak
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
| | - Rajeshkrishna P Bhandary
- Department of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
| | - Binil V
- Department of Psychiatric (Mental Health) Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
| | - Elsa Sanatombi Devi
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
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Dorey JM, Pongan E, Padovan C, Chaillet A, Herrmann M, Krolak-Salmon P, Rouch I. Prodromal or mild Alzheimer's disease: Influence of neuropsychiatric symptoms and premordid personality on caregivers' burden. Int J Geriatr Psychiatry 2024; 39:e6114. [PMID: 38858800 DOI: 10.1002/gps.6114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 05/29/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVE In Alzheimer's disease (AD), the burden on caregivers is influenced by various factors, including the stage of disease progression and neuropsychiatric symptoms (NPS). To date, there has been limited research examining how patient's premorbid personality could affect this burden. The objective of this study was to investigate the impact of both premorbid personality and NPS in individuals with prodromal to mild AD on their caregivers' burden. METHOD One hundred eighty participants with prodromal or mild AD drown from the PACO (in French: Personnalité Alzheimer COmportement) cohort were included. Personality was assessed by the Revised NEO Personality Inventory (NEO-PI-R). Neuropsychiatric symptoms were measured with the short version of the Neuropsychiatric Inventory (NPI-Q), and caregiver burden was evaluated with the Zarit burden scale. Relationships between personality, Neuro-Psychiatric Inventory (NPI) scores, and caregiver burden were determined using multivariate linear regressions controlled for age, sex, educational level, and Mini Mental State Examination. RESULTS The total NPI score was related to increased burden (beta = 0.45; p < 0.001). High level of neuroticism (beta = 0.254; p = 0.003) et low level of conscientiousness (beta = - 0.233; p = 0.005) were associated higher burden. Extraversion (beta = -0.185; p = 0.027) and conscientiousness (beta = -0.35; p = 0.006) were negatively associated with burden. In contrast, neuroticism, openness and agreeableness were not correlated with burden. When adjusted on total NPI score, the relationship between extraversion and conscientiousness didn't persist. CONCLUSION Our results suggest that premorbid personality of patients with prodromal to mild Alzheimer influence caregivers's burden, with a protective effect of a high level of extraversion and conscientiousness.
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Affiliation(s)
- J M Dorey
- Department of Aging Psychiatry, Hospital Le Vinatier, Bron, France
- Clinical and Research Memory Center of Lyon, Hospices Civils de Lyon, Hôpital des Charpennes, Villeurbanne, France
- Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier - Neurocampus, INSERM U1028 - CNRS UMR5292 - PsyR2 - Lyon 1 University, Bron Cedex, France
| | - E Pongan
- Clinical and Research Memory Center of Lyon, Hospices Civils de Lyon, Hôpital des Charpennes, Villeurbanne, France
- Memory Clinical and Research Center of Saint Etienne (CMRR), Neurology Unit, Hospital of Saint Etienne, Saint Etienne, France
| | - C Padovan
- Department of Aging Psychiatry, Hospital Le Vinatier, Bron, France
| | - A Chaillet
- Department of Aging Psychiatry, Hospital Le Vinatier, Bron, France
| | - M Herrmann
- Department of Aging Psychiatry, Hospital Le Vinatier, Bron, France
| | - P Krolak-Salmon
- Clinical and Research Memory Center of Lyon, Hospices Civils de Lyon, Hôpital des Charpennes, Villeurbanne, France
| | - I Rouch
- Memory Clinical and Research Center of Saint Etienne (CMRR), Neurology Unit, Hospital of Saint Etienne, Saint Etienne, France
- INSERM, U1219, Bordeaux Population Health Center, University of Bordeaux, Bordeaux, France
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Malhotra C, Chaudhry I, Shah SU, Østbye T, Malhotra R. Trajectories of negative and positive experiences of caregiving for older adults with severe dementia: application of group-based multi-trajectory modelling. BMC Geriatr 2024; 24:172. [PMID: 38373922 PMCID: PMC10875866 DOI: 10.1186/s12877-024-04777-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 02/04/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Family caregivers of older adults with severe dementia have negative and positive experiences over the course of caregiving. We aimed to delineate joint trajectories (patterns over time) for negative and positive experiences, identify risk factors associated with membership of joint trajectories, and ascertain the association between joint trajectories and caregivers' outcomes after the death of the older adult. METHODS Two hundred fifteen family caregivers of older adults with severe dementia in Singapore were surveyed every 4 months for 2 years, and 6 months after the death of the older adult. Using group-based multi trajectory modelling, we delineated joint trajectories for positive (Gain in Alzheimer Care Instrument) and negative (sub-scales of modified Caregiver Reaction Assessment) experiences of caregiving. RESULTS We identified four joint trajectories - "very high positive, low negative" (23% of caregivers), "high positive, moderate negative" (28%), "very high positive, moderate negative" (28%), and "high positive, high negative" (21%). Caregivers of older adults with more behavioural symptoms, and who did not receive strong emotional support from family were more likely to have "high positive, moderate negative" or "very high positive, moderate negative" trajectory. Compared to caregivers with "very high positive, low negative" trajectory, caregivers with "very high positive, moderate negative" or "high positive, high negative" trajectories expressed greater grief and distress, with the latter also having lower spiritual well-being and quality of life at 6 months after the death of the older adult. CONCLUSION The caregiving experiences for older adults with severe dementia vary between caregivers but remain stable over time. Modifiable risk factors identified for trajectories involving negative experiences of caregiving may be targeted in future interventions to improve the experience of caregiving and caregiver quality of life and distress after the death of the older adult. TRIAL REGISTRATION http://www. CLINICALTRIALS gov (NCT03382223).
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Grants
- HSR-GEoL16Dec002 Health Services Research Grant, Ministry of Health, Singapore
- HSR-GEoL16Dec002 Health Services Research Grant, Ministry of Health, Singapore
- HSR-GEoL16Dec002 Health Services Research Grant, Ministry of Health, Singapore
- HSR-GEoL16Dec002 Health Services Research Grant, Ministry of Health, Singapore
- HSR-GEoL16Dec002 Health Services Research Grant, Ministry of Health, Singapore
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Affiliation(s)
- Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
| | - Isha Chaudhry
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Shimoni Urvish Shah
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Truls Østbye
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Rahul Malhotra
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
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Kim EY, Chang SO. Exploring carer resilience in the context of dementia: a meta-synthesis. BMC Geriatr 2022; 22:806. [PMID: 36266630 PMCID: PMC9585856 DOI: 10.1186/s12877-022-03516-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
AIMS The aim of this literature review is to integrate the results of qualitative research on the resilience experiences of family carers of people with dementia (PWD). DESIGN A qualitative meta-synthesis study was conducted. METHODS The meta-ethnography method of Noblit and Hare (1988) was used. We searched five electronic bibliographic databases (PubMed, EMBASE, CINAHL, PsycINFO and Web of Science) using the keywords "caregivers", "family caregivers", "spouse caregivers", "qualitative research", "resilience, psychological" and "dementia." The inclusion criteria of the literature search found studies that explored the resilience experience of family carers of PWD, were qualitative, were published in English, and had participants 18 years of age or older. RESULTS Eleven studies, 1 from Australia, 4 from USA and 6 from UK, were included in the analysis. Through the process, three themes emerged: 'Seeing the life of a carer as one's duty', 'Setting boundaries in life', 'Moving forward toward a developing life.' These themes illustrated how family carers of PWD overcome the adversities they encounter. CONCLUSION This meta-synthesis showed how family carers of PWD adapt to and overcome the difficult situations they are confronted with as carers. This review suggests an important direction for enhancing the resilience of family carers of PWD.
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Affiliation(s)
- Eun Young Kim
- Department of Nursing, Soonchunhyang University, Cheonan, Republic of Korea
| | - Sung Ok Chang
- College of Nursing, and BK21 FOUR R&E Center for Learning Health Systems, Korea University, 145, Anam-ro, Seongbuk-gu, 02841, Seoul, Republic of Korea.
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Boluarte-Carbajal A, Paredes-Angeles R, Tafur-Mendoza AA. Psychometric Properties of the Zarit Burden Interview in Informal Caregivers of Persons With Intellectual Disabilities. Front Psychol 2022; 13:792805. [PMID: 35356334 PMCID: PMC8959923 DOI: 10.3389/fpsyg.2022.792805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/28/2022] [Indexed: 11/24/2022] Open
Abstract
Intellectual disability leads to a loss of autonomy and a high level of dependence, requiring support from another person permanently. Therefore, it is necessary to incorporate the assessment of caregiver burden in healthcare actions, to avoid putting the health of caregivers and patients at risk. In this sense, the study aimed to analyze the internal structure of the Zarit Burden Interview (ZBI) in a sample of caregivers of people with intellectual disabilities, to provide convergent and discriminant evidence with a measure of the risk of maltreatment, and to estimate the reliability of the scores from the Classical Test Theory and the Rasch Measurement Theory. The study was instrumental. The sample consisted of 287 Peruvian informal primary caregivers of persons diagnosed with intellectual disabilities. To collect validity evidence, the internal structure (confirmatory factor analysis, CFA) and the relationship with other variables (convergent and discriminant evidence) were used, while reliability was estimated through the omega coefficient and Rasch analysis. The internal structure of the ZBI corroborated a unidimensional structure. In terms of convergent and discriminant evidence, the scale presents adequate evidence. Reliability levels were also good. Previously, the psychometric properties of the ZBI have not been studied in caregivers of people with intellectual disabilities, and it represents the first study of the scale in Peru. The results obtained will allow the use of this scale to design actions in the work with caregivers and studies to understand the psychology of the caregiver.
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Affiliation(s)
| | - Rubí Paredes-Angeles
- Grupo de Estudios Avances en Medición Psicológica, Universidad Nacional Mayor de San Marcos, Lima, Peru.,Instituto Peruano de Orientación Psicológica, Lima, Peru
| | - Arnold Alejandro Tafur-Mendoza
- Grupo de Estudios Avances en Medición Psicológica, Universidad Nacional Mayor de San Marcos, Lima, Peru.,Research Center (CIUP), Universidad del Pacífico, Lima, Peru
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Abuse in Patients with Spinal Cord Injury During the COVID-19 Pandemic. ARCHIVES OF NEUROSCIENCE 2022. [DOI: 10.5812/ans.121167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: One of the chronic diseases with various challenges for patients and caregivers is spinal cord injury (SCI). The spread and prevalence of coronavirus disease 2019 (COVID-19) have been an influential risk factor for abuse. Objectives: The aim of this study was to assess the rate of abuse in patients with SCI during the COVID-19 pandemic. Methods: This cross-sectional descriptive study population was all SCI cases in Ilam, Iran. Researcher-made forms and questionnaires with confirmed validity and reliability, including the demographic characteristics, form and perceived abuse researcher-made questionnaire for people with SCI, were used. The perceived abuse questionnaire for patients with SCI was a researcher-made questionnaire designed based on library studies, interviews with patients, and determination of abuse instances. This instrument consists of 20 questions answered as yes (score 1) or no (score 0). After data collection, statistical analyzes were performed using the SPSS software version 16. Results: According to our results, the mean ± SD of the perceived abuse score by caregivers and patients was 8.48 ± 2.31 and 42.45% during the COVID-19 pandemic, respectively. Moreover, the mean ± SD of the age of patients was 62.86 ± 19.15 years, and the patient abuse increased with elevation in age (P = 0, F = 27.42). The possible abuse score was 0 - 20 divided into three categories of low (20, 20.4%), moderate (76, 76.5%), and high (2, 2%). The perceived abuse score was significantly higher among women and patients with a history of more than 10 years of SCI. Abuse prevalence did not have a significant relationship with income and marital status. Regarding age and abuse, our results showed a rise in perceived abuse scores with an increase in age. Conclusions: The present study showed that it is necessary to take measures to prevent abuse in patients with SCI. Moreover, the prevalence of abuse related to COVID-19 in patients with SCI was high. Therefore, preventive actions need to be proposed in this field.
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Schaffler-Schaden D, Krutter S, Seymer A, Eßl-Maurer R, Flamm M, Osterbrink J. Caring for a Relative with Dementia: Determinants and Gender Differences of Caregiver Burden in the Rural Setting. Brain Sci 2021; 11:brainsci11111511. [PMID: 34827510 PMCID: PMC8615550 DOI: 10.3390/brainsci11111511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Dementia is a progressive disease that puts substantial strain on caregivers. Many persons with dementia (PwDs) receive care from a relative. Since male and female caregivers experience different issues related to stress, it is important to meet their different needs to prevent the early nursing home placement of PwDs. This study investigated the multifactorial aspects of caregiver burden and explored gender differences in caregiver burden in a rural setting. This was a cross sectional study that administered anonymous questionnaires to family caregivers of PwDs. Caregiver burden was assessed using the Burden Scale for Family Caregivers-short version. A path model was used to determine the multivariate associations between the variables. To reflect the multifaceted aspects of caregiver burden, we used Pearlin's model with its four dimensions. A total of 113 family caregivers responded to our survey. The overall burden of caregivers was moderate. According to the path model, gender differences were predictors of caregiver burden. The behaviour of the person with dementia and cohabitation had direct effects on caregiver burden. Our results suggest that the experiences of men and women caring for a PwD are different and highlight the need for tailored support in dementia care.
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Affiliation(s)
- Dagmar Schaffler-Schaden
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, 5020 Salzburg, Austria;
- Correspondence:
| | - Simon Krutter
- Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; (S.K.); (R.E.-M.); (J.O.)
| | - Alexander Seymer
- Department of Sociology, Paris Lodron University, 5020 Salzburg, Austria;
| | - Roland Eßl-Maurer
- Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; (S.K.); (R.E.-M.); (J.O.)
| | - Maria Flamm
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, 5020 Salzburg, Austria;
| | - Jürgen Osterbrink
- Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; (S.K.); (R.E.-M.); (J.O.)
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Sardella A, Lenzo V, Alibrandi A, Catalano A, Corica F, Quattropani MC, Basile G. A Clinical Bridge between Family Caregivers and Older Adults: The Contribution of Patients' Frailty and Optimism on Caregiver Burden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073406. [PMID: 33806026 PMCID: PMC8037634 DOI: 10.3390/ijerph18073406] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 01/02/2023]
Abstract
The association between caregiver burden and the physical frailty of older adults has been the object of previous studies. The contribution of patients’ dispositional optimism on caregiver burden is a poorly investigated topic. The present study aimed at investigating whether older adults’ multidimensional frailty and optimism might contribute to the burden of their family caregivers. The Caregiver Burden Inventory was used to measure the care-related burden of caregivers. The multidimensional frailty status of each patient was evaluated by calculating a frailty index, and the revised Life Orientation Test was used to evaluate patients’ dispositional optimism. The study involved eighty family caregivers (mean age 64.28 ± 8.6) and eighty older patients (mean age 80.45 ± 7.13). Our results showed that higher frailty status and lower levels of optimism among patients were significantly associated with higher levels of overall burden and higher burden related to the restriction of personal time among caregivers. Patients’ frailty was additionally associated with caregivers’ greater feelings of failure, physical stress, role conflicts, and embarrassment. Understanding the close connection between patient-related factors and the burden of caregivers appears to be an actual challenge with significant clinical, social, and public health implications.
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Affiliation(s)
- Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (A.S.); (M.C.Q.)
| | - Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, “Dante Alighieri” University for Foreigners of Reggio Calabria, 89125 Reggio Calabria, Italy;
| | - Angela Alibrandi
- Unit of Statistical and Mathematical Science, Department of Economics, University of Messina, 98123 Messina, Italy;
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, School and Unit of Geriatrics, University of Messina, 98125 Messina, Italy; (A.C.); (F.C.)
| | - Francesco Corica
- Department of Clinical and Experimental Medicine, School and Unit of Geriatrics, University of Messina, 98125 Messina, Italy; (A.C.); (F.C.)
| | - Maria C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (A.S.); (M.C.Q.)
| | - Giorgio Basile
- Department of Clinical and Experimental Medicine, School and Unit of Geriatrics, University of Messina, 98125 Messina, Italy; (A.C.); (F.C.)
- Correspondence:
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