Running head: EFFECTIVENESS OF DEMENTIA INTEVENTIONS 1

Effectiveness of Dementia Interventions

Student’s Name

Institutional Affiliation
EFFECTIVENESS OF DEMENTIA INTEVENTIONS 2

Executive Summary
The objective of this review is to recognize, appraise, and synthesize coexisting proof about the

effectiveness of interventions o the health and wellbeing of family carers of individuals with

dementia who have shifted into residential care. In particular, the objectives are to evaluate the

effectiveness of interventions on any of these family carer results after placement in residential

care: anxiety, burden, stress, guilt, depression, grief and loss, satisfaction, and quality of life with

the individual care with dementia.

EFFECTIVENESS OF DEMENTIA INTEVENTIONS 3

Introduction

Dementia is a condition which is associated with damage of the brain. The cases 0f this

condition has become rampant nowadays. Family members are solely responsible of the patients.

Treatments are carried out in the home. The chances of dementia are said to increase randomly

by 2050 with a huge number. The process of taking care of the patients cost the family members

their career and time wastage because thorough attention is required to take care of the patient.

Taking care of the patient with dementia condition is very costly. Many people provide free

labor to the patients of which the cost of taking care of the patient is very high per year. People

with dementia are kept in homes where they are taken care of in order to cut the charges which

can be inflated if a healthy practitioner is in charge.

In previous years the interpretation of dementia condition has led to stress and depression

to the caretakers. People are motivated in order to take care of the patients and not to take it as a

form of slavery. Creating awareness on the significance of taking care of dementia patient has

been put in the fore front. The care taking process is seen as encouraging lethargy because many

of some people might overdo it. The role is supposed to be regulated that a person involved is

supposed to use reasonable amount of time. The condition of dementia is not supposed to be an

excuse to interfere with normal day working hours for the relatives. Research has shown that the

condition has led to the patients not fit for working and thus the patients should be taken care of.

There several activities which the patient have been involved in. The activities are said to be

very supportive and contributes much the care taking roles. The roles include equipping the

patients with skills, creating a rapport, involving them in public work and even involving them

in mental gymnastics. The level of output is used to gauge the effectiveness of different methods

used. Different methods portray different delivery methods and thus varying length of outcomes.
EFFECTIVENESS OF DEMENTIA INTEVENTIONS 4

Evaluation is used to consider the effectiveness of a method. The more effective method is said

to be the best to use while the moderate method is rarely used because their effectiveness is also

low.

There has been a dilemma to which elements should be used. Reviews which shows the

best elements have been conducted and this does not show a clear definition of the element to be

preferred. Recommendations are yet to be made about the best element which should be

endorsed worldwide (Brodaty et al., 2003). Heart disorders and cancer effects have been

concluded using systematic reviews method. The method is subjected to all stereotypes accorded

to those diseases. Literature in Autism is also analyzed through systematic reviews unlike the

dementia condition. The systematic reviews which are carried out earlier about the condition of

dementia are still subjected to reviews in a systematic way to examine whether they will produce

different results.

The method is used to suggest the future plans to be used to curb the condition and to identify

what should be considered in future while carrying out research.

Methods

Search strategy

The search strategy was launched by the information professional in integration with the

research group. The searches were carried out in wide range of databases stretching health and

the social sciences: CINAHL, MEDLINE, EMBASE, PsycInfo, ASSIA: Applied Social Sciences

Index and Abstracts, Scopus, Web of Science, Social Services Abstracts, Sociological Abstracts,

SCIE: Social Care Online, E-journals, Cochrane Database of Systematic Reviews and DARE.

The search items were collected into four facets: the illness (demetia), the population (carers of

individuals with demetia), intervention, and health and welfare. The terminologies were
EFFECTIVENESS OF DEMENTIA INTEVENTIONS 5

integrated with thesaurus terms and were truncated as suitable. The suitable search filters were

utilized to obtain reviews and meta-analysis. The variant spellings of phrases were also looked

upon. In addition, there was no language restrains that were set in the search strategy.

The other sources of details were probated using a hand search; including bibliographies

of associated review papers, conference proceedings, reference lists of main papers, and the

outcomes of principal journals in the field and NICE and SCIE guideline and policy reports.

Inclusion and exclusion criteria

Study design

In the study, there was inclusion of the systematic reviews and meta-analyses. The

benchmark for inclusion as a systematic review was a statement of review, a reported search

strategy of two or more databases with the search terms asserted, and the articulated inclusion

and exclusion criteria.

Participants

The caregivers of individuals with demetia who resided in the community were the only

category of people recognized as the participants of the study. the terminology ‘caregiver’ was

interpreted as informal carers of persons with demetia. The reviews that assessed caregivers of

various conditions were excluded expect they presented their findings disjointedly for carers of

people with demetia. The participants were recruited via social media, community centers, and

GP practices. The individuals were randomly allocated to one of the three arms; wait‐list

control* (control), an eight‐week intervention consisting of counselling (single intervention) and

EFFECTIVENESS OF DEMENTIA INTEVENTIONS 6

an eight‐week multicomponent intervention consisting of counselling, information provision and

behavioral management (multiple interventions).

Interventions

The intervention studied ought to have been directed towards the informal caregivers of

individuals with dementia and try to increase their awareness, hone their skills as well as the

coping strategies and offer the much-needed support. The interventions could constitute the

psychotherapy, cognitive behavioral therapy (CBT), counselling, family therapy,

anxiety/depression management, education, stress management, or psychoeducation, health

education and social support (Gaugler et al., 2010). The formal approaches designed to support

the carers were excluded in the study.

Outcomes

The reviews were included if they assessed; i) psychological outcomes such as depression

or anxiety, ii) health and iii) well-being. The current review will consider studies that include any

of the following family carer outcomes as measured by a validated measurement tool:

General health questionnaire-12 (GHQ-12). It is a 12-item measure of psychological impairment

designed to recognize the short run changes instead of personality (Bramble et al., 2009). The

Likert scoring method was utilized in this study, and the item wording imply they all scored in

the similar direction. Every item is scored from 0-3 (likely range 0-36), with higher scores

constituting ore serious problems. In addition, the Quality of life (QoL) Visual Analogue Scale

(VAS)-it was quantified on a ten-centimeter horizontal line with participants placing a cross

when they had faith their present Qol to be. The scores stem vary from 0 to 11. Moreover,

Warwick-Edinburgh Mental Well-being Scale- the WEMWBS scale is a 14 item measure of

EFFECTIVENESS OF DEMENTIA INTEVENTIONS 7

wellbeing. The scores range from 1 to 5(possible range 14-70) are no items are reversed. The low

scores imply low perceived wellbeing.

Procedure

Initial assessment

The entire titles and abstracts were independently examined via two reviewers. The

comprehensive paper copies of likely pertinent reviews were then obtained and examined for

inclusion by the duo reviewers independently. The conflicts about the first examination were

discussion whereby a third reviewer (LR) provided timely resolutions.

Data extraction and synthesis

The data extraction was embarked by the duo reviewers independently (CD and GG). A

customized data extraction form was utilized to extract the subsequent information: year, review

authors, search strategy, inclusion/ exclusion criteria, methods, results and conclusions. The

included reviews were integrated into a narrative synopsis where the results were group once

found necessary by the type of intervention.

Quality assessment

Duo review authors (CD and LH) examined the methodological quality of the added

reviews independently through ‘Assessment of Multiple Systematic Reviews’ (AMSTAR)

measurement tool. The AMSTAR tool recognizes eleven items which might influence quality. A

score of 5-8 showed moderate quality, 0-4 indicated low quality, and 9-11 implied high quality.

The conflicts were solved by in-depth discussion or a third author (LR).

Results

The results of the study of the effectiveness of interventions of dementia patients were

detailed. According to the Chisquare tests of independence, the technological interventions

EFFECTIVENESS OF DEMENTIA INTEVENTIONS 8

improve the quality of life and wellbeing (p=0.264). the null hypothesis is rejected which implies

that there is a significant relationship between technological interventions and quality of life and

wellbeing.

According to the Chisquare tests of independence, the psychological interventions

improve the quality of life and wellbeing (p=0.239). The null hypothesis is rejected which

implies that there is a significant relationship between psychological interventions and quality of

life and wellbeing.

Brodaty et al. (2003) added thirty studies (n=2,040) in the assessment of psychosocial

interventions. They documented substantial benefits in carer psychological distress (22 trials; ES

= 0.31; 95% CI: 0.13-0.50). The findings of the results are that there was no statically significant

relationship in carer burden, with statistically significant small to moderate effect sizes

showcased for the acquaintance and parenthood of the carer (Brodaty et al., 2003)

Pusey and Ricahrds (2010) explored the method of delivery group-based (n=14) or

individually- based (n=9). They deduced the evidence of the effectiveness of both Group-Based

interventions and personally-based was fairly weak as a result of the inherent methodological

weaknesses of the added studies (Pusey & Ricahrds, 2010).

In the only high quality review, Vernooji-Dassen et al. (2011) pooled data from various

studies on cognitive reframing for caregivers. A proof of beneficial effect of cognitive reframing

existed on psychological morbidity and specifically anxiety of the carer. (standardised mean

difference (SMD) -0.21; 95% confidence interval (CI) -0.39 to -0.04), depression (SMD -0.66;

95% CI -1.27 to -0.05), and subjective stress (SMD -0.23; 95% CI -0.43 to -0.04 (Vernooji-

Dassen et al., 2011).

Discussion
EFFECTIVENESS OF DEMENTIA INTEVENTIONS 9

Dementia is an umbrella term that envelops a gathering of conditions that continuously

decrease the cerebrum's capacity to work. Despite the fact that dementia results from physical

changes in the mind, the impacts of dementia are essentially mental in nature, as they include

dynamic changes in mental (or 'psychological') capacities, for example, memory, dialect,

consideration, fixation, visual discernment, arranging and critical thinking. Here and there these

progressions are additionally connected with development related challenges, for example, issue

with achieving, strolling or gulping (Karmel et al., 2012). The aftereffect of these progressions is

to lessen the individual's commonsense capacity to oversee regular exercises. This frequently

happens at once in life when individuals are likewise encountering different changes in

wellbeing, way of life and social commitment.

Dementia has a significant mental effect, influencing individuals' feeling of character,

how they carry on, their state of mind, and their general prosperity, and all parts of their

associations with others and their capacity to oversee ordinary exercises. The effect of dementia

isn't kept to individuals who specifically encounter the condition. It likewise majorly affects their

families and companions, and at last dementia contacts everybody in the public arena. As

mindfulness and comprehension of the individual and social effect of dementia has expanded,

there has been a developing enthusiasm for the job that therapists can play in its aversion,

treatment and the executives, and in supporting individuals to live well with dementia.

Conclusion

This paper explains the evidence-base of interventions for carers of individuals for

careers of individuals with dementia. Whereas effectiveness is significant, it is also relevant to

take into account how realistic interventions are and the experiences of people who engaged in.

Generally, even though individual aspects were well documented, insights into legacy
EFFECTIVENESS OF DEMENTIA INTEVENTIONS 10

necessitates further attention and requires to be looked at more particularly and even beyond the

life trajectory of the patient. Hence, further research may entail making exploration of legacy

elements a key, prioritized aim of the research. Finally, more perspectives from individuals

suffering from dementia are required instead from the relatives and staff.

References

Bramble, M., Moyle, W., & McAllister, M. (2009). Seeking connection: family care experiences

following long‐term dementia care placement. Journal of clinical nursing, 18(22), 3118-

3125.

Brodaty, H., Green, A. and Koschera, A.(2003). Meta-analysis of psychosocial interventions for

caregivers of people with dementia. Journal of the American Geriatrics Society, 51, 657-

664.

Gaugler, J. E., Mittelman, M. S., Hepburn, K., & Newcomer, R. (2010). Clinically significant

changes in burden and depression among dementia caregivers following nursing home

admission. BMC medicine, 8(1), 85.

Karmel, R., Gibson, D., Anderson, P., Wells, Y., & Duckett, S. (2012). Care trajectories through

community and residential aged care services: disease effects. Ageing & Society, 32(8),

1428-1445.

Pusey, H. and Richards, D. (2001). A systematic review of the effectiveness of psychosocial

interventions for carers of people with dementia. Aging & Mental Health, 5, 107-119.

Schulz R, Belle SH, Czaja SJ, McGinnis KA, Stevens A, Zhang S. Long-term care placement of

dementia patients and caregiver health and well-being. JAMA 2004;292(8):961–7

EFFECTIVENESS OF DEMENTIA INTEVENTIONS 11

Ve rnooij-Dassen, M., Draskovic, I., McCleery, J. and Downs, M.(2011). Cognitive reframing

for carers of people with dementia. Cochrane Database of Systematic Reviews,

CD005318.
EFFECTIVENESS OF DEMENTIA INTEVENTIONS 12

Appendix

Case Processing Summary

Cases

Valid Missing Total

N Percent N Percent N Percent

id_number * QoL 300 100.0% 0 0.0% 300 100.0%

id_number * GHQ_12 300 100.0% 0 0.0% 300 100.0%

id_number * 300 100.0% 0 0.0% 300 100.0%

WEMWBS

sex * QoL 300 100.0% 0 0.0% 300 100.0%

sex * GHQ_12 300 100.0% 0 0.0% 300 100.0%

sex * WEMWBS 300 100.0% 0 0.0% 300 100.0%

group * QoL 300 100.0% 0 0.0% 300 100.0%

group * GHQ_12 300 100.0% 0 0.0% 300 100.0%

group * WEMWBS 300 100.0% 0 0.0% 300 100.0%

Chi-Square Tests
Asymptotic
Significance (2-
Value df sided)
Pearson Chi-Square 71400.000a 71162 .264
Likelihood Ratio 3213.712 71162 1.000
Linear-by-Linear Association 215.972 1 .000
N of Valid Cases 300
EFFECTIVENESS OF DEMENTIA INTEVENTIONS 13

a. 71700 cells (100.0%) have expected count less than 5. The minimum
expected count is .00.

Symmetric Measures
Approximate
Value Significance
Nominal by Nominal Phi 15.427 .264
Cramer's V 1.000 .264
N of Valid Cases 300

Symmetric Measures
Approximate
Value Significance
Nominal by Nominal Phi 16.462 .250
Cramer's V 1.000 .250
N of Valid Cases 300

Chi-Square Tests
Asymptotic
Significance (2-
Value df sided)
Pearson Chi-Square 65700.000a 65481 .272
Likelihood Ratio 3109.319 65481 1.000
Linear-by-Linear Association 191.747 1 .000
N of Valid Cases 300
a. 66000 cells (100.0%) have expected count less than 5. The minimum
expected count is .00.

Symmetric Measures
Approximate
Value Significance
Nominal by Nominal Phi 14.799 .272
Cramer's V 1.000 .272
N of Valid Cases 300
EFFECTIVENESS OF DEMENTIA INTEVENTIONS 14

Chi-Square Tests
Asymptotic
Significance (2-
Value df sided)
Pearson Chi-Square 271.977a 238 .064
Likelihood Ratio 362.517 238 .000
Linear-by-Linear Association 169.524 1 .000
N of Valid Cases 300
a. 478 cells (100.0%) have expected count less than 5. The minimum
expected count is .39.

Chi-Square Tests
Asymptotic
Significance (2-
Value df sided)
Pearson Chi-Square 287.179a 271 .239
Likelihood Ratio 383.428 271 .000
Linear-by-Linear Association 162.382 1 .000
N of Valid Cases 300
a. 544 cells (100.0%) have expected count less than 5. The minimum
expected count is .39.

Symmetric Measures
Approximate
Value Significance
Nominal by Nominal Phi .978 .239
Cramer's V .978 .239
N of Valid Cases 300
EFFECTIVENESS OF DEMENTIA INTEVENTIONS 15

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EFFECTIVENESS OF DEMENTIA INTEVENTIONS 17