Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-22T02:27:01.099Z Has data issue: false hasContentIssue false
  • English
  • Français

Is it all bleak? A systematic review of factors contributing to relationship change in dementia

Published online by Cambridge University Press:  18 April 2018

Erin R. Conway ,
Brittany Watson ,
Gemma Tatangelo  and
Marita McCabe
Erin R. Conway*
Affiliation:
School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
Brittany Watson
Affiliation:
Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
Gemma Tatangelo
Affiliation:
Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
Marita McCabe
Affiliation:
Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
*
Correspondence should be addressed to: Erin R. Conway, School of Allied Health, Australian Catholic University, Brisbane, QLD 4014, Australia. Phone: +617 36237852. Email: [email protected].
Get access

Abstract

Background:

The care of community-dwelling people with dementia often occurs in the context of pre-existing family relationships. The presence of dementia can result in changes to the quality of those relationships. The purpose of this systematic review is to identify factors that enhance or challenge the quality of spousal or offspring relationships in the context of dementia.

Methods:

Both qualitative and quantitative studies were included in a systematic review of the literature. Thematic analysis of results was conducted that examined factors related to the relationship quality of community dwelling people with dementia and their spousal or offspring carer. Meta-analysis was not possible due to the heterogeneity of the included studies.

Results:

Four themes were extracted from seven qualitative studies: connection to the carer role; identity of the people with dementia; current efforts to maintain relationship connection; and the dyads response to dementia. Each of these four themes incorporated positive and negative facets that impacted on relationship quality. An analysis of nine quantitative and one mixed methods studies identified four domains: influence of dementia characteristics; connection within the dyad; relationship response to stress and carer burden; and carer demographic factors.

Conclusions:

The findings of this review highlight relationship factors that are important for supporting relationship quality for the people with dementia and the carer individually, as well as for the dyad together. These findings extend an existing framework of relationship quality in dementia. Implications for interventions to enhance relationship quality in the dementia context are discussed.

Keywords

relationship qualitydementiadementia caregivingcommunity-dwellinginformal care
Type
Review Article
Information
International Psychogeriatrics , Volume 30 , Special Issue 11: Social Aspects of Dementia and Dementia Practice , November 2018 , pp. 1619 - 1637
Copyright
Copyright © International Psychogeriatric Association 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ablitt, A., Jones, G. V. and Muers, J. (2009). Living with dementia: a systematic review of the influence of relationship factors. Aging & Mental Health, 13, 497–511.Google Scholar
Alzheimer's Association (2014). 2014 Alzheimer's disease facts and figures. Alzheimer's and Dementia, 10, e47–e92.Google Scholar
Ascher, E. A., Sturm, V. E., Seider, B. H., Holley, S. R., Miller, B. L. and Levenson, R. W. (2010). Relationship satisfaction and emotional language in frontotemporal dementia and Alzheimer disease patients and spousal caregivers. Alzheimer Disease & Associated Disorders, 24, 49–55.Google Scholar
Balfour, A. (2014). Developing therapeutic couple work in dementia care–the living together with dementia project. Psychoanalytic Psychotherapy, 28, 304–320.Google Scholar
Bauer, M. J., Maddox, M. K., Kirk, L. N., Burns, T. and Kuskowski, M. A. (2001). Progressive dementia: personal and relational impact on caregiving wives. American Journal of Alzheimer's Disease & Other Dementias, 16, 329–334.Google Scholar
Beeson, R., Horton-Deutsch, S., Farran, C. and Neundorfer, M. (2000). Loneliness and depression in caregivers of persons with Alzheimer's disease or related disorders. Issues in Mental Health Nursing, 21, 779–806.Google Scholar
Boylstein, C. and Hayes, J. (2012). Reconstructing marital closeness while caring for a spouse with Alzheimer's. Journal of Family Issues, 33, 584–612.Google Scholar
Brodaty, H. and Cumming, A. (2010). Dementia services in Australia. International Journal of Geriatric Psychiatry, 25, 887–995.Google Scholar
Clare, L. et al. (2012). Marital relationship quality in early-stage dementia: perspectives from people with dementia and their spouses. Alzheimer Disease & Associated Disorders, 26, 148–158.Google Scholar
Critical Appraisal Skills Programme (CASP) (2014). CASP Qualitative Checklist. Oxford, UK: CASP.Google Scholar
D'Aoust, R. F., Brewster, G. and Rowe, M. A. (2015). Depression in informal caregivers of persons with dementia. International Journal of Older People Nursing, 10, 14–26.Google Scholar
Davies, J. C. (2011). Preserving the ‘‘us identity’’ through marriage commitment while living with early-stage dementia. Dementia, 10, 217–234.Google Scholar
de Vugt, M. E. et al. (2003). Behavioural disturbances in dementia patients and quality of the marital relationship. International Journal of Geriatric Psychiatry, 18, 149–154.Google Scholar
Dickinson, C., Dow, J., Gibson, G., Hayes, L., Robalino, S. and Robinson, L. (2016). Psychosocial intervention for carers of people with dementia: what components are most effective and when? A systematic review of systematic reviews. International Psychogeriatrics, 29, 31–43.Google Scholar
Epstein, C., Auclair, U. and Mittelman, M. (2007). Couples counseling in Alzheimer's disease. Clinical Gerontologist, 30, 21–35.Google Scholar
Etters, L., Goodall, D. and Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: a review of the literature. Journal of the American Academy of Nurse Practitioners, 20, 423–428.Google Scholar
Fitzpatrick, K. E. and Vacha-Haase, T. (2010). Marital satisfaction and resilience in caregivers of spouses with dementia. Clinical Gerontologist, 33, 165–180.Google Scholar
Graff, M. J. L., Vernooij-Dassen, M. J. M., Thijssen, M., Dekker, J., Hoefnagels, W. H. L. and Rikkert, M. G. M. O. (2006). Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial. BMJ, 333, 1196.Google Scholar
Harris, S. M., Adams, M. S., Zubatsky, M. and White, M. (2011). A caregiver perspective of how Alzheimer's disease and related disorders affect couple intimacy. Aging & Mental Health, 15, 950–960.Google Scholar
Häusler, A., Sánchez, A., Gellert, P., Deeken, F., Rapp, M. A. and Nordheim, J. (2016). Perceived stress and quality of life in dementia patients and their caregiving spouses: does dyadic coping matter? International Psychogeriatrics, 28, 1–10.Google Scholar
Hayes, J., Boylstein, C. and Zimmerman, M. K. (2009). Living and loving with dementia: negotiating spousal and caregiver identity through narrative. Journal of Aging Studies, 23, 48–59.Google Scholar
Hellström, I., Nolan, M. and Lundh, U. (2007). Sustaining ‘couplehood’: spouses' strategies for living positively with dementia. Dementia (14713012), 6, 383–409.Google Scholar
Ingersoll-Dayton, B., Spencer, B., Kwak, M., Scherrer, K., Allen, R. S. and Campbell, R. (2013). The couples life story approach: a dyadic intervention for dementia. Journal of Gerontological Social Work, 56, 237–254.Google Scholar
Jones, C. and Moyle, W. (2016). Sexuality & dementia: an eLearning resource to improve knowledge and attitudes of aged-care staff. Educational Gerontology, 42, 563–571.Google Scholar
La Fontaine, J. and Oyebode, J. R. (2014). Family relationships and dementia: a synthesis of qualitative research including the person with dementia. Ageing and Society, 34, 1243–1272.Google Scholar
Leach, M. J., Andrew, F. and Taherah, Z. (2014). Improving the health and well-being of community-dwelling caregivers of dementia sufferers: study protocol of a randomized controlled trial of structured meditation training. The Journal of Alternative and Complementary Medicine, 20, 136–141.Google Scholar
Litwin, H., Stoeckel, K. J. and Roll, A. (2014). Relationship status and depressive symptoms among older co-resident caregivers. Aging & Mental Health, 18, 225–231.Google Scholar
Livingston, G. et al. (2013). Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial. BMJ, 347, f6276.Google Scholar
Michon, A., Weber, K., Rudhard-Thomazic, V. and Giannakopoulos, P. (2005). Dynamic process of family burden in dementia caregiving: a new field for psychotherapeutic interventions. Psychogeriatrics, 5, 48–54.Google Scholar
Molyneaux, V. J., Butchard, S., Simpson, J. and Murray, C. (2012). The co-construction of couplehood in dementia. Dementia, 11, 483–502.Google Scholar
Moon, H. and Adams, K. B. (2013). The effectiveness of dyadic interventions for people with dementia and their caregivers. Dementia, 12, 821–839.Google Scholar
O'Shaughnessy, M. O., Lee, K. and Lintern, T. (2010). Changes in the couple relationship in dementia care: spouse carers' experiences. Dementia (14713012), 9, 237–258.Google Scholar
Prick, A.-E., de Lange, J., Twisk, J. and Pot, A. M. (2015). The effects of a multi-component dyadic intervention on the psychological distress of family caregivers providing care to people with dementia: a randomized controlled trial. International Psychogeriatrics, 27, 2031–2044.Google Scholar
Quinn, C., Clare, L., Pearce, A. and van Dijkhuizen, M. (2008). The experience of providing care in the early stages of dementia: an interpretative phenomenological analysis. Aging & Mental Health, 12, 769–778.Google Scholar
Rankin, E. D., Haut, M. W. and Keefover, R. W. (2001). Current marital functioning as a mediating factor in depression among spouse caregivers in dementia. Clinical Gerontologist, 23, 27–44.Google Scholar
Rausch, A., Caljouw, M. A. A. and van der Ploeg, E. S. (2016). Keeping the person with dementia and the informal caregiver together: a systematic review of psychosocial interventions. International Psychogeriatrics, 29, 583–593.Google Scholar
Simonelli, C. et al. (2008). The influence of caregiver burden on sexual intimacy and marital satisfaction in couples with an Alzheimer spouse. International Journal of Clinical Practice, 62, 47–52.Google Scholar
The Joanna Briggs Institute (2016). Joanna Briggs Institute Reviews' Manual: 2016 Edition. Australia: The Joanna Briggs Institute.Google Scholar
Wadham, O., Simpson, J., Rust, J. and Murray, C. (2016). Couples' shared experiences of dementia: a meta-synthesis of the impact upon relationships and couplehood. Aging & Mental Health, 20, 463–473.Google Scholar
Williams, C. (2011). Marriage and mental health: when a spouse has Alzheimer's disease. Archives of Psychiatric Nursing, 25, 220–222.Google Scholar