Background: With the aging of the global population, the prevalence and incidence of Alzheimer’s disease or related dementia are increasing. Most mild or moderate dementia clients are taken care of at home by informal caregivers, which leave a heavy burden to the caregivers. Researchers have found out that with good intervention services and programmes for the caregivers, their burden, emotional distress and even the care recipients’ symptoms and institutionalization rates would be improved. Objectives: This project is to review these researches to evaluate whether the interventions are effective and/ or cost-effective and how the decision-makers could use the results for evidence-based policy. Methods: A literature search was performed on randomized controlled trials in education, information/ support intervention programmes published from October 2005 to July 2012. Electronic databases (EBSCO, PubMed and CNKI) were searched until July 2012. The Consolidated Standards of Reporting Trials (CONSORT) checklist for reporting randomized controlled trials was used as the guideline to evaluate the quality of identified papers. Results: 16 papers (15 studies) were included in this review and classified into three groups, as home-based, individual-based and group-based interventions. This review found that the intervention programmes had various outcomes and showed some evidence of effectiveness. Most of the papers had good quality. The home-based programmes showed cost-effectiveness in the identified studies. Conclusion: There was some evidence that the home- and group-based interventions were effective and the home-based interventions could be cost-effective. Further studies are recommended and a meta-analysis on the studies and more researches on economic analysis are needed. A community-based long-term dementia management should be built up for better outcomes. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

Purpose: This review evaluates the impact of intervention studies for informal dementia caregivers. Methods: Meta-analytic methods were used to integrate the findings of 14 intervention studies evaluating the cognitive behaviour therapy for caregivers. Meta-regression and analysis of variance were used to evaluate the impact of caregiver and intervention characteristics on the outcomes. Results: Significant effects sizes were found for the impact of CBT on depression, burden, and mental health difficulties, g* = -0.55, 95% CI [-0.92, -0.19], g *= -0.37, 95% CI [-0.57, - 0.17], and g* = -0.54, 95% CI [-0.78, -0.30], respectively. CBT facilitated more adaptive coping, with significant effects on caregiver adaptive coping and dysfunctional thoughts, g* = 0.48, 95% CI (0.02, 0.24) and g* = -1.33, 95% CI (-2.22, -0.44). The impact of CBT on caregiver outcomes was associated with the nature of the study control condition, and the intervention delivery, timing and specificity to dementia type. Caregiver ethnicity and gender were not predictive of the CBT outcome. Implications: Overall, caregiver interventions are efficacious in alleviating caregiver distress and facilitating more adaptive coping responses, with prominent effects established for CBT. Future research needs to consider CBT as part of multi-intervention approach tailored to the needs of caregivers across the disease progression. Further improvements are needed, with greater consideration of the impact of the intervention design in alleviating caregiver distress.

Bakgrund: Att vårda en familjemedlem i hemmet påverkar sannolikt anhörigvårdaren både emotionellt och socialt (Andrén & Elmståhl, 2008). Familjefokuserad omvårdnad är en teori som belyser betydelsen av att uppmärksamma hur en familj påverkas när någon drabbas av sjukdom (Benzein, Hagberg & Saveman, 2012). Syfte: Belysa upplevelser av att vara anhörigvårdare till en person med demenssjukdom som bor hemma. Metod: En systematisk litteraturstudie där vetenskapliga artiklar eftersöktes i databaserna Cinahl, PubMed och PsycInfo. Söktermer som användes i samtliga databaser var ”caregiver”, ”dementia” och ”experience”. De artiklar som vara relevanta utefter litteraturstudiens syfte granskandes efter granskningsmall. Nio artiklar uppnådde hög- eller medel kvalité och ingår i studiens resultat. Resultat: Efter analys av data skapades tre teman. Dessa var “rollen som anhörig”, “acceptans” och “förlust”, vardera tema har  två underliggande kategorier. Resultatet från denna studie visar att anhörigvårdares upplevelser av att hantera, reagera och acceptera vårdandet är en utmaning som upplevs olika.  Vårdandet är ett åtagande som upplevs som meningsfullt men kräver även mycket tid och energi. Slutsatser: Anhörigvårdares upplevelser är inte konstant, utan förändras utefter sjukdomens förlopp och den anhörigas välmående. Vårdandet kan upplevas som ensamt och utmanande, därför har sjuksköterskor ett ansvar över att underlätta samt uppmärksamma anhörigvårdares vårdsituation. För att underlätta bör sjuksköterskan intressera sig och uppmuntra över anhörigvårdarens upplevelser.

No description available.

Within a hospice environment, informal caregiving at the end of life can be a physically, psychologically, psychosocially and spiritually challenging experience, where the health and well-being of informal caregivers directly impacts the quality of end-of-life care of the resident. Inspired by a personal experience within palliative care, this practicum project focuses on how the design of an independent hospice facility can support the needs of informal caregivers in the delivery of palliative care. This holistic approach to palliative design integrates the overarching principles of healthy anticipatory grieving and patient-focused, family-centered end-of-life care, alongside the fundamental strategies of quality built environments and the tenets of biophilic design. Located on Waterfront Drive in the northeast corner of the Winnipeg Exchange District, the design of Exchange Hospice includes the adaptive reuse and partial new construction of an independent hospice facility. Exchange Hospice capitalizes on the healing potential of nature through direct, indirect, and symbolic connections to the natural environment.

The growth of grandparent caregivers has significantly increased in recent years, and therefore, more research is needed in this area. This particular qualitative study explored the feelings and experiences of permanent grandparent caregivers between the ages of 58 and 71. Data was collected using a semi structured interview format from four separate couple grandparents and one single grandmother. Although the study was limited due to the small sample size, the findings showed that despite some rewards, grandparent caregivers experienced a number of emotional issues. In analyzing the written transcripts, several themes emerged, included: feelings of loss; anger and frustration, disappointment and guilt; fears and concerns; isolation and lack of supports and, positive aspects. There were also several variations on these themes. The need for grandparent caregivers to be able to access services, and especially support groups for themselves, was evident.

Thesis (Ph. D.)--State University of New York at Binghamton, School of Nursing, 2007. / Includes bibliographical references.

Thesis (Ph. D.)--University of Nevada, Reno, 2006. / "August, 2006." Includes bibliographical references (leaves 67-70). Online version available on the World Wide Web.

Thesis (Ph. D.)--Oregon State University, 2008. / Printout. Includes bibliographical references (leaves 102-113). Also available on the World Wide Web.