Date Presented 4/1/2017
This thematic synthesis revealed effective strategies found to improve the quality of life for persons with Alzheimer’s disease, reduce caregiver burden by implementing caregiver training, enhance functional performance through environmental modifications, and support engagement in occupations.
Primary Author and Speaker: Beth Ann Walker
Additional Authors and Speakers: Jaye Allen, Megan A. Koch, Carolyn Sprehe, Kimberly T. Webber
PURPOSE: The purpose of this thematic synthesis was to explore the evidence on effective strategies to enhance and support quality of life for individuals with Alzheimer’s disease and their caregivers.
BACKGROUND: The incidence of Alzheimer’s disease has significantly increased due to the recent surge in the older adult population, medical advancements, and increased lifespan. The Centers for Disease Control and Prevention (2015) defined Alzheimer’s disease as a neurological progressive form of dementia leading to the inability to make decisions, perform activities of daily living, and recognize loved ones. Individuals with Alzheimer’s disease are not the only ones impacted by the disease; caregivers are as well. Occupational therapists are trained to identify and support everyday occupations to improve the quality of life and independence of individuals with Alzheimer’s (Dooley & Hinojosa, 2004). Occupational therapy (OT) can reduce stress on caregivers by developing new skills and strengthening family relationships to enable the caregiver’s self-efficacy (Alzheimer’s Association, 2017). Currently, there is a lack of research on effective strategies in OT to support individuals with Alzheimer’s and their caregivers.
DESIGN: The researchers conducted a qualitative thematic synthesis of the literature available on occupational therapy aimed to support individuals with Alzheimer’s disease and their caregivers.
METHOD: Key words aligned with the purpose of this study were used to search the following databases: EBSCOhost, MEDLINE Plus, Academic Search Complete, and OTseeker. Fifty-one articles that met inclusion criteria were peer reviewed by the research group. After the original data extraction, investigators initially determined 68 codes for the articles. A constant comparative approach, peer review, and discussion ensued until data saturation and informational redundancy were reached.
RESULTS: The end result was 20 codes grouped into four broad themes. The four overarching themes which emerged from the literature included (1) OT interventions improved quality of life (QOL) for a person with Alzheimer’s disease, (2) caregiver training decreased caregiver burden, (3) environmental modifications enhanced functional performance for the person with Alzheimer’s disease, and (4) OT interventions increased engagement in occupations, which reinforced health and well-being for this population and caregivers. Evidence-based strategies to support outcomes within each theme were identified. Person-centered OT interventions used environmental modifications, caregiver training, and engagement in occupations to improve QOL for the person with Alzheimer’s disease and reduced caregiver burden.
CONCLUSION: OT interventions should embrace caregiver education and training in order to decrease caregiver burden. The evidence also implies that when occupational therapists encourage both individuals with Alzheimer’s disease and their caregivers to engage in occupations, especially activities of daily living, caregiver burden is reduced, and the health and well-being of both individuals are enriched.
IMPACT STATEMENT: In order for OT practitioners to embrace the tenets of evidence-based practice, continuous efforts must be made to conduct critical appraisals of literature that clearly outline how to use the evidence to modify practice to support outcomes. This thematic synthesis of the literature effectively revealed how occupational therapy services can improve QOL for individuals with Alzheimer’s disease, reduce caregiver burden by implementing caregiver training, and enhance functional performance through environmental modifications and highlighted the importance of continuous engagement in occupations.
References
Alzheimer’s Association. (2017). 2017 Alzheimer’s disease facts and figures. Retrieved from http://alz.org/facts/overview.asp
Centers for Disease Control and Prevention. (2015). Alzheimer’s disease. Retrieved from http://www.cdc.gov/aging/aginginfo/alzheimers.htm
Dooley, N. R., & Hinojosa, J. (2004). Improving quality of life for persons with Alzheimer’s disease and their family caregivers: Brief occupational therapy intervention. American Journal of Occupational Therapy, 58, 561–569. https://doi.org/10.5014/ajot.58.5.561
