Adelaida Zabalegui1, Jan P H Hamers2, Staffan Karlsson3, Helena Leino-Kilpi4, Anna Renom-Guiteras5, Kai Saks6, Maria Soto7, Caroline Sutcliffe8, Esther Cabrera9. 1. Nursing Hospital Clínic de Barcelona, Spain. Electronic address: azabaleg@clinic.ub.es. 2. Care of Older People at Maastricht University, The Netherlands. 3. Lund University, Sweden. 4. University of Turku, Finland; Hospital District of Southwest, Finland. 5. Witten/Herdecke University, Germany. 6. University of Tartu, Estonia. 7. Alzheimer Acute Care Unit, Gérontopôle Toulouse, Department of Geriatric Medicine University Hospital, France. 8. Manchester University, UK. 9. School of Health Sciences at Fundació Tecnocampus Mataró-Maresme Tecnocampus, Spain.
Abstract
OBJECTIVE: To identify effective interventions which improve quality of care for people with dementia (PwD) living at home. METHODS: MEDLINE-(via PubMed), CINAHL, PsycINFO and ISI Web of Science databases were searched. INCLUSION CRITERIA: (1) randomized controlled trials; (2) published in English-language, peer-reviewed journals between 1990 and 2012; (3) evaluated strategies to improve quality of care for PwD cared at home; and (4) participants older than 65. RESULTS: 23 studies met inclusion criteria. All the studies aimed to improve PwD quality of care and most of them focused on PwD caregivers. Psychoeducational programs are the most frequently assessed interventions and multicomponent interventions produced the most promising results. CONCLUSION: Due to the great variety of interventions describing specific samples and contexts, comparison of practice effectiveness is difficult. However, cognitive rehabilitation in PwD is effective when applied at an early stage of the disease. Case managers have demonstrated to reduce PwD institutionalization and the use of other community services. The studies were limited by sample heterogeneity, short follow-up or insufficiently detailed description. PRACTICE IMPLICATIONS: To improve PwD homecare, health professionals should educate and support caregivers. Before specific interventional recommendations can be made, further research addressing the limitations of current studies is needed.
OBJECTIVE: To identify effective interventions which improve quality of care for people with dementia (PwD) living at home. METHODS: MEDLINE-(via PubMed), CINAHL, PsycINFO and ISI Web of Science databases were searched. INCLUSION CRITERIA: (1) randomized controlled trials; (2) published in English-language, peer-reviewed journals between 1990 and 2012; (3) evaluated strategies to improve quality of care for PwD cared at home; and (4) participants older than 65. RESULTS: 23 studies met inclusion criteria. All the studies aimed to improve PwD quality of care and most of them focused on PwD caregivers. Psychoeducational programs are the most frequently assessed interventions and multicomponent interventions produced the most promising results. CONCLUSION: Due to the great variety of interventions describing specific samples and contexts, comparison of practice effectiveness is difficult. However, cognitive rehabilitation in PwD is effective when applied at an early stage of the disease. Case managers have demonstrated to reduce PwD institutionalization and the use of other community services. The studies were limited by sample heterogeneity, short follow-up or insufficiently detailed description. PRACTICE IMPLICATIONS: To improve PwD homecare, health professionals should educate and support caregivers. Before specific interventional recommendations can be made, further research addressing the limitations of current studies is needed.
Authors: K J Gilhooly; M L M Gilhooly; M P Sullivan; A McIntyre; L Wilson; E Harding; R Woodbridge; S Crutch Journal: BMC Geriatr Date: 2016-05-18 Impact factor: 3.921
Authors: Connie Lethin; Helena Leino-Kilpi; Brenda Roe; Maria Martin Soto; Kai Saks; Astrid Stephan; Sandra Zwakhalen; Adelaida Zabalegui; Staffan Karlsson Journal: BMC Geriatr Date: 2016-01-29 Impact factor: 3.921