title: Exploring psychosocial interventions for people with dementia that enhance personhood and relate to legacy- an integrative review.
abstract: BACKGROUND
  Epidemiological predictions suggest that dementia will continue to rise and that this will have social and economic ramifications. Effective interventions, beyond pharmacological management are needed. Psychosocial interventions have largely been investigated in relation to carers of people with dementia, or with regards to their ability to manage dementia symptoms, improve cognition, and reduce challenging behaviour. However, since dementia is a life-limiting illness and people with dementia are at risk of having their personhood compromised, psychosocial interventions should seek to enhance personhood, and offer the potential for the person to leave a legacy.
  
  
  METHODS
  An integrative review was carried out to identify, assess, appraise and synthesise studies featuring interventions, which relate to both personhood and legacy. Search strategies were developed in key databases: MEDLINE; PsycINFO; Embase; Joanna Briggs Institute; CINAHL; Cochrane Database of Systematic Reviews; ASSIA. Grey literature was also identified through free-text searches.
  
  
  RESULTS
  Thirty six articles were included in the final review, these were tabulated and were assessed based on how the intervention related to personhood and legacy. Classification resulted in three themes being identified: Offering aspects of legacy; Acknowledging the person behind the patient; Facilitating meaningful engagement. Generally, personhood aspects of interventions were well reported, but further research is required to explore legacy potential of psychosocial interventions for people with dementia.
  
  
  CONCLUSIONS
  The integrative review provides an overview and exploration of an under-researched area, and provides directions for future research, which will help expand the evidence base and ultimately help improve patient care for people with dementia and their families.
authors.affiliation: Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, School of Health Sciences, The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, England, UK. Bridget.Johnston@nottingham.ac.uk.
authors.forename: Bridget
authors.initials: B
authors.lastname: Johnston
authors.affiliation: Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, School of Health Sciences, The University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, England, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Narayanasamy
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology* / Q000628:therapy*; D017028:Caregivers / Q000523:psychology; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D010043:Outcome and Process Assessment, Health Care; D028723:Personhood; D000067250:Psychiatric Rehabilitation
keywords: Alzheimer’s disease; Cognitive impairment; Dementia; Dignity; Integrative review; Legacy; Personhood