Skip to main content Accessibility help
×
Home
Hostname: page-component-ffbbcc459-gmk6f Total loading time: 0.275 Render date: 2022-03-07T09:45:54.019Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

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*
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: Erin.Conway@acu.edu.au.

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.

Type
Review Article
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, 497511.CrossRefGoogle ScholarPubMed
Alzheimer's Association (2014). 2014 Alzheimer's disease facts and figures. Alzheimer's and Dementia, 10, e47e92.CrossRefGoogle 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, 4955.CrossRefGoogle ScholarPubMed
Balfour, A. (2014). Developing therapeutic couple work in dementia care–the living together with dementia project. Psychoanalytic Psychotherapy, 28, 304320.CrossRefGoogle 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, 329334.CrossRefGoogle ScholarPubMed
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, 779806.CrossRefGoogle ScholarPubMed
Boylstein, C. and Hayes, J. (2012). Reconstructing marital closeness while caring for a spouse with Alzheimer's. Journal of Family Issues, 33, 584612.CrossRefGoogle Scholar
Brodaty, H. and Cumming, A. (2010). Dementia services in Australia. International Journal of Geriatric Psychiatry, 25, 887995.CrossRefGoogle ScholarPubMed
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, 148158.CrossRefGoogle ScholarPubMed
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, 1426.CrossRefGoogle ScholarPubMed
Davies, J. C. (2011). Preserving the ‘‘us identity’’ through marriage commitment while living with early-stage dementia. Dementia, 10, 217234.CrossRefGoogle 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, 149154.CrossRefGoogle ScholarPubMed
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, 3143.CrossRefGoogle ScholarPubMed
Epstein, C., Auclair, U. and Mittelman, M. (2007). Couples counseling in Alzheimer's disease. Clinical Gerontologist, 30, 2135.CrossRefGoogle 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, 423428.CrossRefGoogle ScholarPubMed
Fitzpatrick, K. E. and Vacha-Haase, T. (2010). Marital satisfaction and resilience in caregivers of spouses with dementia. Clinical Gerontologist, 33, 165180.CrossRefGoogle 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.CrossRefGoogle ScholarPubMed
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, 950960.CrossRefGoogle ScholarPubMed
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, 110.CrossRefGoogle ScholarPubMed
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, 4859.CrossRefGoogle Scholar
Hellström, I., Nolan, M. and Lundh, U. (2007). Sustaining ‘couplehood’: spouses' strategies for living positively with dementia. Dementia (14713012), 6, 383409.CrossRefGoogle 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, 237254.CrossRefGoogle ScholarPubMed
Jones, C. and Moyle, W. (2016). Sexuality & dementia: an eLearning resource to improve knowledge and attitudes of aged-care staff. Educational Gerontology, 42, 563571.CrossRefGoogle 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, 12431272.CrossRefGoogle 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, 136141.CrossRefGoogle ScholarPubMed
Litwin, H., Stoeckel, K. J. and Roll, A. (2014). Relationship status and depressive symptoms among older co-resident caregivers. Aging & Mental Health, 18, 225231.CrossRefGoogle ScholarPubMed
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 ScholarPubMed
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, 4854.CrossRefGoogle Scholar
Molyneaux, V. J., Butchard, S., Simpson, J. and Murray, C. (2012). The co-construction of couplehood in dementia. Dementia, 11, 483502.CrossRefGoogle Scholar
Moon, H. and Adams, K. B. (2013). The effectiveness of dyadic interventions for people with dementia and their caregivers. Dementia, 12, 821839.CrossRefGoogle ScholarPubMed
O'Shaughnessy, M. O., Lee, K. and Lintern, T. (2010). Changes in the couple relationship in dementia care: spouse carers' experiences. Dementia (14713012), 9, 237258.CrossRefGoogle 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, 20312044.CrossRefGoogle ScholarPubMed
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, 769778.CrossRefGoogle ScholarPubMed
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, 2744.CrossRefGoogle 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, 583593.CrossRefGoogle ScholarPubMed
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, 4752.CrossRefGoogle ScholarPubMed
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, 463473.CrossRefGoogle ScholarPubMed
Williams, C. (2011). Marriage and mental health: when a spouse has Alzheimer's disease. Archives of Psychiatric Nursing, 25, 220222.CrossRefGoogle ScholarPubMed
6
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

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

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

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

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

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

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *