Interventions with family caregivers for people with dementia: efficacy problems and potential solution

Family members are increasingly caring for relatives with dementia at home. It is well recognized that this is a stressful experience for carers. Treatment approaches that aim to alleviate this stress were introduced in the 1970s and later research began to evaluate their efficacy. Early studies using subjective ratings of satisfaction and usefulness demonstrated encouraging results. However, later studies using standardized measures of distress and burden, have not been able to demonstrate efficacy in a convincing way. There have been some positive significant changes; however, most findings have been poor, inconsistent and equivocal. This may be accounted for by the poor methodological rigour diluting the positive potential benefits of interventions for carers. This paper suggests that in order for the efficacy research to evolve, there needs to be a change in direction. It is vital that instead of repeating 'more of the same' studies, researchers need to prioritize the use of theoretically driven interventions and research design. This factor alone could provide the framework to influence the methodological issues that potentially dilute the demonstration of treatment efficacy. Without clearer evidence from research, guidance for practitioners about treatment for carers is ambiguous.