Life Review Intervention Delivered by Family Caregivers of People Living with Dementia Improves Depression: A Mixed-Methods Study.

Abstract

Background and objectives: The prevalence of depression in people living with dementia is 40% in the United States. However, since pharmacological treatments tend to produce undesirable side effects, we developed a nonpharmacological, innovative depression intervention, Caregiver-Provided Life Review (C-PLR) for people living with dementia with mild depressive symptoms. We trained family caregivers in interview skills of the evidence-based depression intervention, life review, and caregivers conducted the intervention with people living with dementia at home. This paper reports the intervention outcomes and implementation recommendations.

Research design and methods: This 8-week pre- and postintervention study used a mixed-methods design with 45 caregiver-people living with dementia dyads (N = 90). We recruited participants across the United States and measured people living with dementia's depressive symptoms (primary outcome), life satisfaction, caregiver burden, rewards, and dyads' relationship quality (secondary outcomes) quantitatively, and interviewed caregivers about their intervention experience qualitatively.

Results: Caregivers were 58 years old on average, married, college-educated, working, female, and in good/excellent health while people living with dementia were on average 81 years old, widowed, retired, female, and in poor/fair health. Their depressive symptoms significantly improved after intervention (p < .001), as did caregiving rewards (p = .029), and relationship quality (p = .041). Caregiver burden did not change (p = .519). Caregivers' interviews supported the quantitative results. The results of fidelity check-in calls confirmed high adherence to the C-PLR protocol. Caregivers confirmed the feasibility of virtual training and confidence in conducting life reviews.

Discussion and implications: Training family caregivers to conduct life reviews may be an acceptable and cost-effective way to improve depressive symptoms among people living with dementia while improving caregiver experiences. C-PLR seems to be an easy and convenient depression intervention for people living with dementia in terms of delivery method, delivery setting, delivery schedule, and delivery cost, and thus, has the potential to reach a wide range of participants.