The effect of caregiver support interventions for informal caregivers or community-dwelling frail elderly: a systematic review

Author(s): Lopez-Hartmann, M., Wens, J., Verhoeven, V., and Remmen, R.

Published In: International Journal of Integrated Care, 12: 1-14

Study Aim/Purpose: The aim of the review was to summarize research on the effectiveness of caregiver interventions targeting informal caregivers of frail elderly living in the community. 

Summary of Methods: In September 2010, the authors conducted a systematic search in Medline, sychINFO, Ovid Nursing Database, Cinahl, Embase, Cochrane Central Register of Controlled Trials, and British Nursing Index of reviews and original effectiveness studies published in English, French, German or Dutch. The authors selected a subset of articles based on a methodological quality assessment of the studies using the Scottish Intercollegiate Guidelines Network’s methodology checklists. 

Summary of Key Results (related to studies of effectiveness): A total of 14 articles (four literature reviews and 10 primary research studies) were included in the review. The authors found that, overall, while the effect of caregiver support interventions is small and inconsistent between studies, there is evidence that respite care can be helpful in reducing depression, burden, and anger. In addition, interventions targeted at the individual caregiver level can be beneficial in reducing or stabilizing depression, burden, stress, and role strain. There is some evidence that group support for caregivers has a positive effect on their coping ability, knowledge, social support, and in reducing depression. Finally, the limited research on technology-based interventions provided evidence that types of interventions can reduce caregiver burden, depression, anxiety and stress and improve caregivers’ coping ability. 

Limitations of Studies Reviewed (as cited by the author): The authors recognized that their primary search term “frail elderly” might not have captured all relevant articles since the term is a new concept in the literature. They also suggest that their review’s focus on quantitative studies should have been broadened to include qualitative studies to examine such topics as how the intervention is experienced by the population it is targeted to serve. 

Authors’ Discussion/Conclusions: The authors recommend that future research on caregiver support interventions pay attention to the influence of caregivers’ characteristics and context on the outcomes. With regard to study design, they suggest that randomized controlled trials might not be the best method for evaluating caregiver support interventions. Instead, they suggest research examining the economic savings of caregiver interventions, and studies using qualitative methods should be considered. They also emphasize the importance of integrated programming that combines multiple supports, such as respite and one-on-one caregiver support services. They also recommend that the intervention be tailored to the individual caregiver’s physical, psychological, and social needs and that future research examine the long-term effect of such integrated and tailored caregiver support services.