Effective psychosocial intervention for family caregivers lengthens time elapsed before nursing home placement of individuals with dementia: a five-year follow-up study.
BACKGROUND
This study was designed to determine the effectiveness of a psychosocial intervention for family caregivers in delaying nursing home placement of individuals with dementia.


METHODS
The participants comprised 153 family caregivers of persons with dementia who underwent intervention and 155 family caregivers who did not. The intervention consisted of five weekly counselling sessions and a three-month conversation group. All patients with dementia underwent a standardized assessment of cognitive and functional ability. The degree of burden and the subjective health of family caregivers were assessed. Participation continued until the patient moved to a nursing home or died, or until five years of living at home had passed.


RESULTS
There were significant delays (6 months) in nursing home placement, and a longer time at home for persons with dementia with adult children as caregivers in the intervention group compared to the control group at follow-up (p = 0.004). A greater delay of institutionalization was found where intervention-group caregivers were daughters (p = 0.028). The proportional hazards regression showed factors associated with nursing home placement to be the family caregiver's influence on intervention (OR = 1.55, p = 0.019), caregiver gender (OR = 0.66, p = 0.033) and the patient's severity of dementia (OR = 1.45, p = 0.002).


CONCLUSIONS
Family caregiver intervention for adult children was significantly associated with prolonged time to nursing home placement.
Andrén
Signe
S
Department of Health Sciences, Lund University and Malmö University Hospital, Malmö, Sweden. signe.andren@med.lu.se
Elmståhl
Sölve
S
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D032721:Adult Children / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003376:Counseling / Q000379:methods; D003704:Dementia / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006701:Home Nursing / Q000523:psychology; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family / Q000523:psychology; D009735:Nursing Homes / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D013997:Time Factors