Abstract
During the transition of people with dementia from home to nursing home, family carers often feel insufficiently prepared and burdened, and people with dementia often show behavioral and neuropsychiatric symptoms.
A systematic review was conducted according to the Cochrane Handbook for Intervention Reviews and the protocol registered in PROSPERO. Reporting follows the PRISMA statement. MEDLINE, CENTRAL, PsycINFO, CINAHL, OTseeker, and PEDro, were searched, additionally Google Scholar and ALOIS. The Cochrane Risk of Bias tool was used for critical appraisal. The development and evaluation of interventions were appraised according to recommendations of the UK Medical Research Council on complex interventions. Findings were synthesized narratively.
The search yielded 1,278 records. Five studies were included, all performed in the US. The interventions identified were individual and family counseling via telephone or ad hoc, addressing solely the informal carers. Data on efficacy were inconsistent. Significant effects were found concerning less depressive symptoms, burden, feeling of guilt, emotional distress, overload, and influence on interactions with staff. Other outcomes, i.e. stress, adaptation to placement, role overload, role captivity, were not statistically significantly affected. The risk of bias across studies varied from moderate to low. Only two studies tested the feasibility of the intervention before full scale evaluation, none evaluated the implementation process.
We identified a small number of studies with heterogeneous outcomes; evidence regarding the effectiveness of psychosocial interventions is thus insufficient. Reporting on the feasibility and the implementation process of interventions should be guaranteed, since it is crucial to evaluate the transferability across care settings.