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Carer Involvement in Rehabilitation for People Living With Dementia: A Systematic Review
Cheng-Ya Lee1, Yun-Hee Jeon1, Karen Watson1
1Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Aims:
To examine the role and impact of carer involvement in rehabilitation for community-dwelling individuals with dementia, focusing on cognitive stimulation therapy, cognitive rehabilitation, cognitive training, cognitive behavioural therapy, and exercise.
Design:
A systematic review and synthesis without meta-analysis.
Data Sources:
Five electronic databases, reference lists, and citations were searched (2017-2024), targeting primary research that reported results concerning one or more of those five focused rehabilitation interventions for people with dementia and their carers.
Methods:
Results were synthesised using narrative approaches. The Cochrane Risk of Bias Tool and the Mixed Methods Appraisal Tool were used to appraise the quality of included studies.
Results:
Forty-one studies (12 main trials, 22 pilot studies, and 7 sub-studies) were included. While the patterns between carer involvement level and types of rehabilitation were observed, their relationship to intervention effectiveness was unclear. High carer involvement in cognitive stimulation therapy and exercise was associated with improved cognition and quality of life for people with dementia and better health-related quality of life for carers. Pilot studies showed mixed but generally positive trends, with increased depressive symptoms in carers needing further investigation. Qualitative findings highlighted social interaction and improved caregiving knowledge as key enablers to positive experiences, whereas lack of motivation was the main barrier to rehabilitation engagement.
Conclusion:
This review identified several patterns between the level of carer involvement and intervention types. However, the mechanism underlying different involvement levels and rehabilitation success remains unclear. More rigorous research is needed to determine the relationship between carer involvement and the effects of rehabilitation interventions on supporting the independence of people with dementia.
Impact:
This review enhanced the understanding of carers' roles and impacts in supporting dementia rehabilitation and possible links to optimal health outcomes.
Reporting Method:
Synthesis Without Meta-analysis (SWiM) reporting guideline.
Patient Or Public Contribution:
No patient/public contribution.
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