Managing behavioural and psychological symptoms in community dwelling older people with dementia: 1. A systematic review of the effectiveness of interventions Alzheimer's disease caregiving information and skills. Part II: family caregiver issues and concerns. Alzheimer's disease caregiving information and skills, part III: group process issues and concerns. Does a ‘Singing Together Group’ improve the quality of life of people with a dementia and their carers? A pilot evaluation study
Background Two-thirds of people living with dementia live at home in the UK and many experience distressing behavioural and psychological symptoms . This systematic review evaluates the effectiveness of non-pharmacological interventions for behavioural and psychological symptoms among community-dwelling people living with dementia . Methods This two-stage review undertook an initial mapping of the literature followed by a systematic review of relevant r and omised controlled trials . We search ed electronic data bases for pertinent studies reporting outcomes from interventions from January 2000 to March 2015 and up date d search es in October 2016 . We included studies that considered behavioural and psychological symptom management for older people living with dementia who live at home and excluded studies conducted in long-term care setting s. This paper presents findings from a narrative synthesis of 48 r and omised controlled trials evaluating interventions for people living with dementia alone , family carers alone and patient-carer dyads . Results We retrieved 17,871 de-duplicated records and screened them for potential inclusion . Evidence from 48 r and omised controlled trials suggests that family carer training and educational programmes that target problem behaviours and potential triggers can improve outcomes . Nurses and occupational therapists appear to help people with dementia with behavioural and psychological symptoms , but professional comparisons are lacking and there is no shared language about or underst and ing of behavioural and psychological symptoms amongst professionals , or between professionals and family carers . Conclusions Future research should focus on the effectiveness of components of multi-faceted programmes and their cost effectiveness and include qualitative data to better target interventions for behavioural and psychological symptoms . It is important to consider family carer readiness to use non-pharmacological strategies and to develop a shared language about the inherent needs and communications of behavioural and psychological symptoms In recent years research ers have carried out an increasing number of clinical trials with family caregivers of the elderly . The results of these interventions have suggested that caregiver skill-building interventions may be more effective than information/support interventions . Although research ers have given considerable attention to the information and support needed by family caregivers , less is known about how this information and support translates into caregiver skills or into changes in behavior . This is the second in a series of three articles on a study in which research ers used qualitative methods to analyze summaries from the group component of a larger caregiver clinical trial . In this article we describe caregiver issues and concerns in five major areas : ( a ) . dealing with change , ( b ) . managing competing responsibilities and stressors , ( c ) . providing a broad spectrum of care , ( d ) . finding and using re sources , and ( e ) . experiencing emotional and physical responses to care . We identify specific skills needed by caregivers in addressing these caregiving issues and concerns , and we compare and contrast skilled with less skilled caregivers . Further work is needed concerning the focus and methods of future caregiver skill-based interventions In this descriptive study we examined content and processes in a group-based component of an ongoing clinical trial with family caregivers of persons with dementia . The purpose was to identify issues arising from the group processes that could be used to inform future skill-building caregiver groups . Summaries from two types of intervention groups , a caregiver skill-building ( CSB ) treatment intervention and an information and support only ( ISO ) control intervention were examined , along with data collected during a group leader debriefing session . Three major categories of process information were identified : ( a ) group member behaviors that support group processes necessary for skill development , ( b ) group leader behaviors that support group processes necessary for skill development , and ( c ) the phases of learning in caregiver ( CG ) skill development . Subcategories and specific content in each of these areas are identified in this article , and a list of member and leader behaviors that might support future skill development in groups is presented Ten people with dementia ( PWD ) and their family carers participated in a Singing Together Group for 10 weeks and measures of mood , quality of life , PWD 's behavioural and psychological problems , activities of daily living and cognitive status were measured at pre , post and 10-week follow-up . Engagement levels were monitored during the sessions and care partners asked to rate each session . Additional qualitative information was obtained through interview pre-post and at follow-up and subjected to thematic analysis . The results showed that PWD were deteriorating slowly over the course of the study on all measures but that they and their carers ’ quality of life remained relatively stable . Engagement levels during the group were very high and attendance excellent . Qualitative data gave strong support to the group having promoted wellbeing of all participants and Nolan 's ‘ Senses Framework ’ was used to explore this further . Future research directions are suggested
Background People living with dementia often develop distressing behavioural and psychological symptoms ( BPSD ) that can affect their quality of life and the capacity of family carers and staff providing support at home .
This systematic review of qualitative studies considers the views and experiences of people living with dementia and care providers about these symptoms and what helps to reduce their impact .