How do caregivers successfully cope with behavioral and psychological symptoms of dementia? A web-based, preliminary analysis using a hybrid approach.

Abstract

Objectives: There has been no systematic analysis of coping strategies for behavioral and psychological symptoms of dementia (BPSD) using large-scale cumulative data. We preliminarily examined the characteristics of successful and unsuccessful coping strategies for BPSD.

Design: We employed a deductive and inductive analysis (hybrid approach) of the data derived from "Ninchisho Chienowa-net," a web-based system that collects caregivers' coping strategies for BPSD. Antecedent control procedure and consequence manipulation in applied behavior analysis (ABA) were used as theory-driven codes for deductive classification.

Cases: We targeted 1049 cases except "others" among BPSD's categories submitted from January 2016 to January 2019, and finally, 1027 were selected.

Measurements: Subsequently, nine sub-codes of coping strategies were inductively generated through a trial classification in the first BPSD category, applying these to remaining categories.

Results: Success frequencies varied significantly across coping strategy sub-codes: strategies "assisting the person in performing other activities," "addressing setting events," "listening to the person and accepting her/his challenges," and "multi-coping strategies" had higher success frequencies than expected. Conversely, "explaining reality" and "inhibiting BPSD" had higher failure frequencies than expected. As for the BPSD category "problems due to forgetting," "prompting the person to do an appropriate behavior" was more successful than other coping strategies.

Conclusions: This investigation systematically elucidated the efficacy of various coping strategies, delineating successful ones from those that were not. The discerned patterns across all categories of BPSD and within each individual category will provide valuable insights for caregivers.