Premium
[P4–564]: A SYSTEMATIC REVIEW OF THE MANAGEMENT OF MEDICINES BY PEOPLE LIVING WITH DEMENTIA IN THEIR OWN HOMES AND THEIR FAMILY CARERS: ISSUES FACED AND STRATEGIES ADOPTED
Author(s) -
Sharmeen Taniya,
Lim Rosemary
Publication year - 2017
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.07.727
Subject(s) - feeling , dementia , coping (psychology) , medicine , qualitative research , nursing , psychology , psychiatry , social psychology , sociology , disease , pathology , social science
factors associatedwith QoL, well-being and life satisfaction in dementia. Articles had to provide quantitative data and include 75% people with dementia of any type or severity. Results from intervention studies were excluded. Correlational estimated effect size was employed. Results:We included 213 individual studies reported in 307 articles that reported QoL (N1⁄4205), well-being (N1⁄45) and life satisfaction (N1⁄43) outcomes. Meta-analysis was possible for 198 QoL studies taken from 272 articles. Separate analyses were conducted for each method of assessing QoL: self-rating by the person with dementia, informant rating by a family carer or health care professional, and proxy rating by a family carer or health care professional. A further analysis focused on factors associated with differences between parallel selfand informant ratings. Longitudinal studies were examined separately to identify baseline predictors at follow-up. Demographic and disease characteristics were largely unrelated to QoL. Many factors were significantly associated but effect sizes were often small or negligible, with only a few moderate associations. Factors reflecting relationships, social engagement and functional ability were associated with better QoL. Factors indicative of poorer physical and mental health were associated with poorer QoL, as were factors indicative of poorer carer well-being. Longitudinal evidence about predictors of QoL was limited. There was considerable between-study heterogeneity. Conclusions:Efforts to improve QoL could focus on supporting relationships, social engagement and everyday functioning, addressing poor physical and mental health, and ensuring high-quality care. However, longitudinal evidence is needed to clarify causal relationships and identify ways of maintaining or improving QoL over time. The pattern of numerous predominantly small associations with QoL suggests a need to reconsider approaches to understanding and assessing living well with dementia.