A preliminary study of the effects of early intervention with people with dementia and their families in a memory clinic

A brief individualized intervention comprising of information about diagnosis and prognosis, reinforcement of coping strategies, crisis prevention advice and memory management programmes was offered to newly diagnosed people with dementia and their families, prior to referral to the services of their local psychogeriatric community support team. The control group received diagnosis and written advice and were referred directly to their local psychogeriatric community support team. At 18-month follow-up, improvements were found in the memory scores of the experimental group. Carer wellbeing was worse in the control group and this was associated with an increased likelihood of the breakdown of home care. We suggest that psychosocial variables may be important at the time of diagnosis and note an interesting relationship between memory ability in people with dementia and carer strain. Our results can only be fully understood in the context of methodological improvements. These are outlined, for the purpose o...

[1]  S. Orbell,et al.  Factors Associated With Informal Carers’ Preference Not To Be Involved In Caring , 1993 .

[2]  A. Eye,et al.  Efficacy of interventions with caregivers: a reanalysis. , 1991, The Gerontologist.

[3]  K. Shulman,et al.  Factors determining the decision to institutionalize dementing individuals: a prospective study. , 1993, The Gerontologist.

[4]  D. Gold,et al.  When Home Caregiving Ends: A Longitudinal Study of Outcomes for Caregivers of Relatives with Dementia , 1995, Journal of the American Geriatrics Society.

[5]  A. N. Exton-smith,et al.  Further evidence of preserved memory function in Alzheimer's disease , 1991 .

[6]  B. Rovner,et al.  Factors contributing to nursing home admission because of disruptive behaviour , 1996 .

[7]  R. Woods,et al.  Effect of Family Relationships on Psychogeriatric Patients , 1984, Journal of the Royal Society of Medicine.

[8]  Lena Borell,et al.  Supporting everyday activities in dementia: An intervention study , 1993 .

[9]  M P Quayhagen,et al.  Differential effects of family-based strategies on Alzheimer's disease. , 1989, The Gerontologist.

[10]  Robert Howard,et al.  Insight in Alzheimer's disease , 1996 .

[11]  N. Moffat Everyday cognition in adulthood and late life: Home-based cognitive rehabilitation with the elderly , 1989 .

[12]  A. Felling,et al.  HOME CARE FOR DEMENTIA PATIENTS , 1995, Journal of the American Geriatrics Society.

[13]  R. Woods,et al.  Positive Approaches to Dementia Care , 1995 .

[14]  J. Stevens Applied Multivariate Statistics for the Social Sciences , 1986 .

[15]  H. Brodaty,et al.  Effect of a training programme to reduce stress in carers of patients with dementia. , 1989, BMJ.

[16]  H. Brodaty Low Diagnostic Yield in a Memory Disorders Clinic , 1990, International Psychogeriatrics.

[17]  D. Griffith Better for the Break , 1994 .

[18]  S H Ferris,et al.  A family intervention to delay nursing home placement of patients with Alzheimer disease. A randomized controlled trial. , 1996, JAMA.

[19]  R. Snaith,et al.  The Hospital Anxiety and Depression Scale , 1983 .

[20]  J. O'Brien,et al.  Demographic and clinical features of patients attending a memory clinic , 1993 .

[21]  Bill Jerrom,et al.  Stress on relative caregivers of dementia sufferers, and predictors of the breakdown of community care , 1993 .

[22]  B. Reiss,et al.  Does early intervention reduce the number of elderly people with dementia admitted to institutions for long term care? , 1991, BMJ.

[23]  L. George,et al.  Predictors of Institutionalization Among Caregivers of Patients With Alzheimer's Disease , 1986, Journal of the American Geriatrics Society.

[24]  J. Lindesay,et al.  A survey of memory clinics in the british isles , 1995 .

[25]  Nick Warner,et al.  Breaking the bad news: What do psychiatrists tell patients with dementia about their illness? , 1994, International journal of geriatric psychiatry.

[26]  S. Zarit,et al.  Memory training for severe memory loss: effects on senile dementia patients and their families. , 1982, The Gerontologist.

[27]  J. Lavoie,et al.  Living with an Impaired Elderly Person: The Informal Caregiver's Physical and Mental Health , 1995, Journal of aging and health.

[28]  H. Brodaty,et al.  THE PRINCE HENRY HOSPITAL DEMENTIA CAREGIVERS’ TRAINING PROGRAMME , 1997, International journal of geriatric psychiatry.

[29]  Anthony F Jorm Disability in dementia: assessment, prevention, and rehabilitation. , 1994, Disability and rehabilitation.

[30]  H. Brodaty,et al.  Quasi‐experimental evaluation of an educational model for dementia caregivers , 1994 .

[31]  G. Livingston,et al.  Behavioural complications of dementia—can they be treated? , 1995 .

[32]  R. Woods,et al.  The role of memory clinics and psychosocial intervention in the early stages of dementia , 1997, International journal of geriatric psychiatry.

[33]  M. Luszcz,et al.  Enhancing memory performance in Alzheimer's disease: acquisition assistance and cue effectiveness. , 1993, Journal of clinical and experimental neuropsychology.

[34]  R. Woods Specificity of learning in Reality-Orientation sessions: a single-case study. , 1983, Behaviour research and therapy.

[35]  I G Hanley,et al.  Memory aids in reality orientation: a single-case study. , 1984, Behaviour research and therapy.

[36]  C. Camp,et al.  Spaced-retrieval: a memory intervention for dementia of the Alzheimer's type (DAT) , 1990 .

[37]  M. Philpot,et al.  A memory clinic for the early diagnosis of dementia , 1987 .

[38]  B. Knight,et al.  A meta-analytic review of interventions for caregiver distress: recommendations for future research. , 1993, The Gerontologist.

[39]  A. Kurz,et al.  Predictors of nursing home placement in patients with alzheimer's disease , 1993 .

[40]  Jacob Cohen,et al.  A comprehensive support program: effect on depression in spouse-caregivers of AD patients. , 1995, The Gerontologist.

[41]  S. Orbell,et al.  Measuring the outcome of psychosocial intervention for family caregivers of dementia sufferers: A factor analytic study , 1997 .

[42]  S. Zarit Do we need another "stress and caregiving" study? , 1989, The Gerontologist.