Multicomponent interventions are effective in helping alleviate burdens of family caregivers

Abrahams R, Liu K, Bissett M, Fahey P, Cheung K, Bye R, Chaudhary K, Chu L. Effectiveness of interventions for co-residing family caregivers of people with dementia: Systematic review and meta-analysis Australian Occupational Therapy Journal. 2018; 65(3): 208-224.

Review question

•       How effective are multicomponent interventions seeking to alleviate the burden experienced by family caregivers living with older adults?

Background

•       People living with dementia often require assistance to complete daily tasks, especially as the disease progresses. This assistance often comes from family members who live with the older adults and who must perform a primary caregiving role.

•       Many studies have demonstrated that caregiving roles have a significant impact on the health and quality of life of family caregivers, who often place their own health needs secondary to their loved one’sneeds

•       It has been reported that as many as 39% of family caregivers experience depression. Many family caregivers may also experience disruptions to their social support network, spending less time with friends and experiencing strains in family relationships.

•       The aim of this systematic review is to examine the effects of multicomponent interventions seeking to alleviate the burden experienced by family caregivers co-residing with older adults.

How the review was done

•       Review authors conducted a detailed literature search in seven databases.

•       Search terms included: dementia, Alzheimer, caregiver, spouse, partner, family, multicomponent, multidimensional, burden, depress, health and support.

•       Only studies published in English were eligible for inclusion.

•       Of the 358 studies identified from the search, 22 were included in this review.

•       The work was partly supported by the Western Sydney University School of Science and Health Research Grant in Australia.

What the researchers found

•       The multicomponent interventions identified involved a range of different strategies.

•       The most common intervention components fell under the categories of education and skills training, counselling, and support groups. Less common components included stress management, exercise and health promotion, computerized telephone support systems, and modifications to the home environment.

•       Significant effective results were found for all four outcomes of burden, depression, disruptions in health, and disruptions in social support. Two of six studies on caregiver burden had significant positive results, 10 of 15 studies had statistically significant positive results for depression, four of six studies had significant positive effects on family caregiver’s health, and one study had significant positive effects on family caregiver’s level of social support.

•       Review authors could not determine what strategies used in the interventions offered the best outcomes. However, counselling, support group, education, stress and mood management, and telephone support appeared to be important strategies of an effective multicomponent intervention.

Conclusion

•       This review demonstrated that multicomponent interventions are likely to be beneficial to caregivers who experience burden, depression, and disruptions to their health and social support.

•       Being able to manage the burden of caregiving may delay the need for older adults to move to formal assisted-living facilities.