Dementia and communication comorbidities within the context of caregiver support systems: a scoping review

在照护者支持系统背景下,痴呆症和沟通共病:一项范围界定综述

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Abstract

BACKGROUND: Dementia is a growing global health concern affecting millions of people worldwide. Communication difficulties are a hallmark feature that pose challenges for both people with living dementia (PLWD) and caregivers. These challenges encompass spoken and unspoken communication and can lead to social isolation and diminished quality of life. Caregivers also face significant burdens owing to communication difficulties, stress, and burnout. AIMS: This review aimed to explore the existing literature on dementia and communication comorbidities within the context of caregiver support systems. By synthesising current evidence, this review aimed to identify gaps in knowledge, highlight effective interventions, and inform future research and clinical practice aimed at improving the communication experiences of individuals with dementia and supporting their caregivers. METHODS: The review methodology was guided by the PRISMA-ScR framework. A search strategy using relevant keywords was developed, and searches were conducted using PubMed and EMBASE without any limitations. Two independent reviewers screened the titles and abstracts and full texts using predetermined eligibility criteria. Data extraction was conducted by two reviewers and disagreements were resolved through discussion. The extracted data were grouped based on common themes and narratively synthesised. RESULTS: A total of 228 articles were screened at the title and abstract levels, and 120 full-text articles were assessed for eligibility. 23 eligible studies were included in the narrative synthesis. Most of these studies were conducted in the United States of America (47.8%) and Europe (43.5%). The studies used various designs, with an almost equal number of cohort studies (30%), qualitative studies (26%), and experimental studies (26%). The key themes identified were as follows: adult day service use reducing caregiver burden, educational interventions reducing caregiver burden, supportive technologies, caregiver counselling, perspectives of informal caregivers and PLWD, perceptions of staff caregivers. Only one study addressed hearing loss as a communication comorbidity. CONCLUSION: The findings highlight the potential value of adult day-care services, caregiver counselling, educational interventions, and supportive technologies in dementia care. Future research that focuses on specific interventions tailored to dementia and communication comorbidity needs and integrating them into care plans can reduce the caregiver burden.

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