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Ho HT, Jia R, Habibi N, Stern C, Carter G, Santin O, Stone J, Valenzuela C, Aromataris E. Experiences of informal caregivers of people with dementia in low- and middle-income countries: a systematic review protocol. JBI Evid Synth 2024:02174543-990000000-00284. [PMID: 38477072 DOI: 10.11124/jbies-23-00470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE This review aims to synthesize the experiences of informal caregivers of people with dementia in low- and middle-income countries (LMICs). INTRODUCTION Globally, the burden of dementia is increasing disproportionately in LMICs. Informal caregivers play a vital role and face multiple challenges in LMICs. Caregivers often lack awareness and skills to provide adequate care for people living with dementia. Many LMICs have limited resources and caregivers lack support services. Understanding their experiences and perceptions may improve interventions, helping caregivers to better support those living with dementia. INCLUSION CRITERIA Studies from all settings in LMICs will be considered. Qualitative data from qualitative or mixed methods studies that explore caregivers' experiences and perceptions will be included in this review. Participants are informal caregivers of people diagnosed with dementia at any stage, regardless of age, gender, or their relationship with people living with dementia. METHODS This review will follow the JBI methodology for a qualitative systematic reviews, with meta-aggregation as the synthesis method. The review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A 3-step search strategy will be used to locate published and unpublished studies in MEDLINE, CINAHL, Embase, PsycINFO, AgeLine, LILACS, African Index Medicus, ProQuest Dissertations and Theses, Open Dissertations, Web of Science Core Collection, and Google Scholar. There will be no date or language limitations. All studies will be screened against the inclusion criteria and data will be extracted and critically appraised for methodological quality by 2 independent reviewers using JBI tools. Confidence in the final synthesized findings will be assessed using the ConQual approach. REVIEW REGISTRATION NUMBER PROSPERO CRD42023453814.
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Affiliation(s)
- Hien Thi Ho
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
- School of Nursing and Midwifery, Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK
| | - Romy Jia
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Nahal Habibi
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Cindy Stern
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Gillian Carter
- School of Nursing and Midwifery, Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK
| | - Olinda Santin
- School of Nursing and Midwifery, Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK
| | - Jennifer Stone
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Chelsea Valenzuela
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Edoardo Aromataris
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Masterson-Algar P, Egan K, Flynn G, Hughes G, Spector A, Stott J, Windle G. Hard to Reach and Hidden: Improving the Identification of Young Dementia Carers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7103. [PMID: 38063533 PMCID: PMC10871087 DOI: 10.3390/ijerph20237103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/01/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023]
Abstract
Young dementia carers (YDCs) rarely receive appropriate training and support. Their visibility and identification remain dangerously low, and, consequently, support initiatives being developed are failing to reach them. This study explored the success (or failure) of YDC identification pathways as well as the barriers and enablers to their implementation. An explorative qualitative approach was followed, drawing on the experiences of parents of YDCs, dementia researchers, professionals in the field of dementia/young carers, and young adult carers. Data collection involved semi-structured interviews (n = 17) and a participatory 2-h workshop to discuss and critique preliminary themes as well as explore strategies to increase the visibility and identification of YDCs. Five themes were identified: a "whole-family approach" (as a pathway to identification), "not a carer" (self/family identification), a postcode lottery (high variability of support services), tailored support that is "fit for purpose", and the "power" of peer support. Recommendations on potential initiatives and actions that can help raise awareness and increase the identification success of YDCs are proposed. Our findings support the need for a broad and holistic approach to the identification of YDCs that runs alongside the development of support initiatives that are accessible and relatable. The support itself will play a role in improving subsequent identification or hindering it if not "fit for purpose".
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Affiliation(s)
- Patricia Masterson-Algar
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK; (G.F.); (G.H.); (G.W.)
| | - Kieren Egan
- Department of Computer and Information Science, University of Strathclyde, Glasgow G11 XH, UK;
| | - Greg Flynn
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK; (G.F.); (G.H.); (G.W.)
| | - Gwenllian Hughes
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK; (G.F.); (G.H.); (G.W.)
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK; (A.S.); (J.S.)
| | - Joshua Stott
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK; (A.S.); (J.S.)
| | - Gill Windle
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK; (G.F.); (G.H.); (G.W.)
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Hochgraeber I, Köhler K, Stöcker H, Holle B. The dyadic relationship of family carers and people living with dementia - an umbrella review. Aging Ment Health 2023; 27:1965-1974. [PMID: 37390842 DOI: 10.1080/13607863.2023.2215191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/11/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVES The dyadic relationship of people living with dementia and their family carers is highly relevant when considering the stability of home-based care arrangements. There is a solid body of research that covers issues related to dyadic relationships. However, a synthesis of qualitative research is missing. Therefore, the aim of this review is to give an overview of the dyadic relationship, with the leading research question of what influences the dyadic relationship and how it can be maintained during the trajectory of the disease. METHODS We performed an umbrella review of qualitative literature on the basis of thematic synthesis and used the SoCA-Dem theory as a theoretical framework. Literature searches in the databases PubMed (MEDLINE), CINAHL, Scopus, and PsycInfo were performed from July to September 2020, additional papers were included until September 2022. We searched without timeframe restrictions and considered publications in English or German. RESULTS After a systematic database search, resulting in 1325 records, we included 12 reviews. Five analytical themes and 11 subthemes were identified. The analytical themes were 'change in the relationship', 'activities to maintain the relationship', 'continued togetherness', 'home as a place for enacting relationship', and 'influencing factors'. CONCLUSION The dyadic relationship is a complex and multifaceted phenomenon. It is characterized by family carers' attempts to continue togetherness using different strategies and is mainly influenced by the quality of the premorbid relationship and the mindset of the family carer.
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Affiliation(s)
- Iris Hochgraeber
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Kerstin Köhler
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
| | - Hannah Stöcker
- Faculty of Health, School of Psychology, Witten/Herdecke University, Witten, Germany
| | - Bernhard Holle
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Witten, Germany
- Faculty of Health, School of Nursing Science, Witten/Herdecke University, Witten, Germany
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Megido MJ, Celdrán M, Ferrer A, Roca M, Pujol-Ribera E, Zabaleta-Del-Olmo E. Grandchildren of grandparents with Alzheimer's disease: Exploratory study of the impact of the disease on their relationships. DEMENTIA 2023; 22:838-853. [PMID: 36916529 DOI: 10.1177/14713012231162882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
The aim of this study was to describe the perception of changes that Alzheimer's disease in grandparents has made to the relationship with their grandchildren of between 6 and 13. Qualitative methodology was used. Semi-structured interviews were carried out with 25 grandchildren living in Catalonia, Spain. Participants reported a change in roles from being the care receiver to being the caregiver, changes in the activities that they did together and a positive impact on the grandparent's emotional wellbeing. In the physical sphere, sleeping problems were reported in grandchildren that cohabited with their grandparents. The feelings they described include fear of not being recognized by their grandparents and sadness, as well as satisfaction resulting from their affection and participating in caring. These findings suggest the need to provide information and resources for grandchildren and their families to enable them to deal with the disease.
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Affiliation(s)
- Maria Jesus Megido
- Direcció Atenció Primària Metropolitana Sud. ICS. Departament de Salut. Generalitat de Catalunya.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Montserrat Celdrán
- Department of Cognition, Development and Educational Psychology, 16724Universidad de Barcelona, Barcelona, Spain
| | - Assumpta Ferrer
- Primary Healthcare Centre El Pla, 37494ICS, Sant Feliu de Llobregat, Spain
| | - Montserrat Roca
- Campus Bellvitge Escola d'infermeria, 73071Universidad de Barcelona, Barcelona, Spain
| | - Enriqueta Pujol-Ribera
- 203271Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Edurne Zabaleta-Del-Olmo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain.,Nursing Department, Faculty of Nursing, Universitat de Girona, Girona, Spain
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Masterson-Algar P, Egan K, Flynn G, Hughes G, Spector A, Stott J, Windle G. iSupport for Young Carers: An Adaptation of an e-Health Intervention for Young Dementia Carers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:127. [PMID: 36612450 PMCID: PMC9819145 DOI: 10.3390/ijerph20010127] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Young dementia carers need to be recognised and supported in their role. They need help to understand the illness, what changes are expected and how it can affect their family member. Many support services, partly due to the COVID pandemic, have moved online and have been shown to be acceptable as they are low cost and reduce access barriers. iSupport is an evidence-informed e-health training programme developed by the World Health Organization (WHO) to support adult dementia carers. This paper reports on the co-design of an adapted version of iSupport for young carers. A theoretically driven co-design approach, drawing on the lived experiences of young dementia carers and experts who work with this target group was followed. As a result of this study iSupport for Young Carers was created. It is the first e-health intervention of its kind and aims to support the mental health, knowledge and skills of young dementia carers. In turn, it could improve the quality of the support that service providers can offer, and this can result in increased levels of identification of these young people. The work presented also provides opportunities for other countries and demographic groups to translate and adapt iSupport for Young Carers to their specific cultural context.
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Affiliation(s)
| | - Kieren Egan
- Department of Computer and Information Science, University of Strathclyde, Glasgow G11 XH, UK
| | - Greg Flynn
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK
| | - Gwenllian Hughes
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK
| | - Aimee Spector
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - Joshua Stott
- Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - Gill Windle
- School of Medical and Health Sciences, Bangor University, Bangor LL57 2EF, UK
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Roberto KA, Savla J. Extended Family Caregivers for Persons Living With Dementia. JOURNAL OF FAMILY NURSING 2022; 28:396-407. [PMID: 35960005 PMCID: PMC10112257 DOI: 10.1177/10748407221115455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Despite changes in the structure of contemporary families, little is known about extended family members-siblings, grandchildren, nieces/nephews, stepkin-who are primary caregivers for a relative living with dementia. Information about these caregivers is needed to help ensure their needs are understood by providers in health care and social service settings. The focus of this research was on the care situations of extended family caregivers and the impact of caregiving on their health and well-being. In Study 1, data from the National Study of Caregiving were used to describe the experiences of 107 extended family caregivers. In Study 2, case study techniques elicited additional information about the experiences of 10 extended family caregivers. Collectively, these caregivers provide care with little or no formal support and occasional help from a small informal network. Caregiving affected their physical and emotional health, depending on the strength of the relationship between the caregiver and the person living with dementia and the type of care provided. Findings contribute new knowledge about extended family caregivers and highlight the important role extended family dementia caregivers play and the challenges they face.
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The mental and physical health of young carers: a systematic review. THE LANCET PUBLIC HEALTH 2022; 7:e787-e796. [DOI: 10.1016/s2468-2667(22)00161-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 12/14/2022] Open
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Venters S, Jones CJ. The experiences of grandchildren who provide care for a grandparent with dementia: A systematic review. DEMENTIA 2020; 20:2205-2230. [PMID: 33372548 PMCID: PMC8369917 DOI: 10.1177/1471301220980243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Much of the research exploring the experiences of family caregivers of people with dementia has focussed on spouses and adult children. It is hypothesised that other family members at different life stages and with different family roles may experience and perceive the caregiving role differently. The objective of the current review was to explore the experiences of grandchildren who provide care to a grandparent with dementia. A systematic search of four databases identified 12 studies which met the inclusion criteria. An assessment of quality was completed for each of the included studies. Grandchildren described dementia-related changes, changes to their role and relationship with their grandparent, multiple impacts of caregiving, influences of other family relationships on caregiving and positive aspects of caregiving. Many of the included studies met most of the quality criteria for the respective methodological design; however, there was some variation in quality and sample across included studies. The review indicates that assessments and interventions to incorporate grandchildren and the wider family system may help to support family carers to continue to provide care for grandparents with dementia. The research and clinical implications and limitations of the review are also considered.
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Affiliation(s)
- Sophie Venters
- Department of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Christina J Jones
- Department of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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