Dementia carer education and patient behaviour disturbance

Author(s): OBoyle, C. A., Coakley, D., Lawlor, B. A.

Journal/Book: Int J Geriat Psychiat. 1999; 14: Baffins Lane Chichester, W Sussex PO19 1UD, England. John Wiley & Sons Ltd. 302-306.

Abstract: Objective. To evaluate the impact of a dementia Carer Education Programme on carer quality of life (QoL), burden, and well-being. Design. Single group before-after intervention study. The group was subdivided by perceived status post-programme for intragroup analysis. Setting. Hospital memory clinic. Participants. Convenience sample of 32 dementia carers. Intervention. Eight weekly 2 h education and support sessions run by a psychogeriatric clinical team. Measures. Pre-programme and 6 months post-programme data were obtained. Measures included individually perceived QoL, burden, well-being, managing problem behaviour, appraisal of social support, knowledge of dementia, and perception of the programme. Patients were characterized in terms of cognition, behaviour disturbance and functional status. Results. Twelve carers reported their situation post-programme as 'better', 12 as 'worse', and four as 'no change'. There were no significant baseline differences. For 'better/no change' carers the only significant change over time was increased knowledge about dementia. For 'worse' carers knowledge also increased, but there was evidence of poorer QoL, increased burden, a poorer appraisal of social support, and increased patient behaviour disturbance. Only patient behaviour disturbance significantly discriminated 'no change/better' from 'worse' carers (F=4.08, p = 0.055). Conclusions. The programme increased carers' knowledge about dementia, but had no significant impact on QoL, burden, or well-being. Increased patient behaviour disturbance appeared to be a major factor when the carer's situation worsened over time. Despite high carer satisfaction the efficacy of a group-based education approach to the management of behaviour disturbance in dementia appears limited. More intensive or individually tailored interventions may be necessary alternatives.

Note: Article Coen RF, St James Hosp, Mercers Inst Res Ageing, Dublin 8, IRELAND

Keyword(s): dementia; education; carer burden; behaviour disturbance; quality of life; RANDOMIZED CONTROLLED TRIAL; ALZHEIMERS-DISEASE; CAREGIVERS; SUPPORT; BURDEN; INTERVENTIONS; RELIABILITY; VALIDITY; EFFICACY; SCALE

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