Research Article
Issue Date: January/February 2021
Published Online: December 03, 2020
Updated: December 14, 2020
Home-Based Occupational Therapy for Adults With Dementia and Their Informal Caregivers: A Systematic Review
Author Affiliations
  • Sujatha E. Raj, BOT, MSc(OT), is PhD Candidate, UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia; sujatha.raj@mymail.unisa.edu.au
  • Shylie Mackintosh, PhD, MSc, BAppSc(Physio), is Associate Professor and Dean of Allied Health Programs, UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.
  • Caroline Fryer, PhD, Grad Dip (Clin Epi), BAppSc(Physio), is Senior Lecturer, Physiotherapy Program, UniSA Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.
  • Mandy Stanley, PhD, MSc(OT), BAppSc(OT), is Associate Professor, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
Article Information
Research Articles
Research Article   |   December 03, 2020
Home-Based Occupational Therapy for Adults With Dementia and Their Informal Caregivers: A Systematic Review
American Journal of Occupational Therapy, December 2020, Vol. 75, 7501205060. https://doi.org/10.5014/ajot.2020.040782
American Journal of Occupational Therapy, December 2020, Vol. 75, 7501205060. https://doi.org/10.5014/ajot.2020.040782
Abstract

Importance: People with dementia require tailored interventions to support participation and performance in their desired occupations, and informal caregivers need interventions that reduce caregiving burden to enable them to continue with their roles.

Objective: This systematic review investigated whether home-based occupational therapy interventions for adults with dementia and their informal caregivers optimized care recipients’ performance of daily occupations and reduced caregiving burden and improved caregivers’ sense of competence.

Data Sources: Eight databases were searched from 1946 to November 2019 using MeSH terms, keywords, and subject headings as appropriate for each database. Inclusion criteria were quantitative studies investigating the effects of home-based therapy provided by a qualified occupational therapist for adults with dementia and their informal caregivers.

Study Selection and Data Collection: Study selection, data collection, and methodological quality assessments using the Critical Appraisal Skills Programme criteria tool were performed independently by two reviewers. Data analysis involved a two-stage process.

Findings: From 1,229 articles identified through searches, 970 titles and abstracts were screened for eligibility after removal of duplicates. Twenty studies reported in 22 articles were included. Moderate evidence supported interventions provided jointly for adults with dementia and their informal caregivers using a combination of intervention strategies. Included studies demonstrated high risk of bias, particularly in blinding of outcome assessments.

Conclusions and Relevance: Combining individualized interventions framed in client-centeredness can enhance occupational performance for adults with dementia, reduce caregiving burden, and improve informal caregivers’ sense of competence. Further research on leisure and home management occupations is warranted.

What This Article Adds: The findings provide evidence supporting the effectiveness of home-based occupational therapy for people with dementia and their informal caregivers for consideration by funders of services.