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

      research-article
      , MscN, , MD, PhD, , MD, PhD, , MD, PhD
      International Journal of Integrated Care
      Igitur publishing
      frail elderly, caregivers, health services needs, demand

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          Abstract

          Introduction

          Informal caregivers are important resources for community-dwelling frail elderly. But caring can be challenging. To be able to provide long-term care to the elderly, informal caregivers need to be supported as well. The aim of this study is to review the current best evidence on the effectiveness of different types of support services targeting informal caregivers of community-dwelling frail elderly.

          Methods

          A systematic literature search was performed in Medline, PsychINFO, Ovid Nursing Database, Cinahl, Embase, Cochrane Central Register of Controlled Trials and British Nursing Index in september 2010.

          Results

          Overall, the effect of caregiver support interventions is small and also inconsistent between studies. Respite care can be helpful in reducing depression, burden and anger. Interventions at the individual caregivers’ level can be beneficial in reducing or stabilizing depression, burden, stress and role strain. Group support has a positive effect on caregivers’ coping ability, knowledge, social support and reducing depression. Technology-based interventions can reduce caregiver burden, depression, anxiety and stress and improve the caregiver’s coping ability.

          Conclusion

          Integrated support packages where the content of the package is tailored to the individual caregivers’ physical, psychological and social needs should be preferred when supporting informal caregivers of frail elderly. It requires an intense collaboration and coordination between all parties involved.

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          Most cited references33

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            Cochrane Handbook for Systematic Reviews of Interventions

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              Developing integrated health and social care services for older persons in Europe

              Abstract Purpose This paper is to distribute first results of the EU Fifth Framework Project ‘Providing integrated health and social care for older persons—issues, problems and solutions’ (PROCARE—http://www.euro.centre.org/procare/). The project's first phase was to identify different approaches to integration as well as structural, organisational, economic and social-cultural factors and actors that constitute integrated and sustainable care systems. It also served to retrieve a number of experiences, model ways of working and demonstration projects in the participating countries which are currently being analysed in order to learn from success—or failure—and to develop policy recommendations for the local, national and European level. Theory The paper draws on existing definitions of integrated care in various countries and by various scholars. Given the context of an international comparative study it tries to avoid providing a single, ready-made definition but underlines the role of social care as part and parcel of this type of integrated care in the participating countries. Methods The paper is based on national reports from researchers representing ten organisations (university institutes, consultancy firms, research institutes, the public and the NGO sector) from 9 European countries: Austria, Denmark, Finland, France, Germany, Greece, Italy, the Netherlands, and the UK. Literature reviews made intensive use of grey literature and evaluation studies in the context of at least five model ways of working in each country. Results As a result of the cross-national overview an attempt to classify different approaches and definitions is made and indicators of relative importance of the different instruments used in integrating health and social care services are provided. Conclusions The cross-national overview shows that issues concerning co-ordination and integration of services are high on the agenda in most countries. Depending on the state of service development, various approaches and instruments can be observed. Different national frameworks, in particular with respect to financing and organisation, systemic development, professionalisation and professional cultures, basic societal values (family ethics), and political approaches have to be taken into account during the second phase of PROCARE during which transversal and transnational analysis will be undertaken based on an in-depth analysis of two model ways of working in each country. Discussion Far from a European vision concerning integrated care, national health and social care systems remain—at best—loosely coupled systems that are facing increasing difficulties, given the current challenges, in particular in long-term care for older persons: increasing marketisation, lack of managerial knowledge (co-operation, co-ordination), shortage of care workers and a general trend towards down-sizing of social care services continue to hamper the first tentative pathways towards integrated care systems.
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                Author and article information

                Contributors
                Role: PhD student
                Journal
                Int J Integr Care
                Int J Integr Care
                IJIC
                International Journal of Integrated Care
                Igitur publishing (Utrecht, The Netherlands )
                1568-4156
                Jul-Sep 2012
                10 August 2012
                : 12
                : e133
                Affiliations
                Department of Primary and Interdisciplinary Care, University of Antwerp, Universiteitsplein 1, BE-2610 Wilrijk (Antwerp), Belgium
                Department of Primary and Interdisciplinary Care, University of Antwerp Universiteitsplein 1, BE-2610 Wilrijk (Antwerp), Belgium, E-mail: johan.wens@ 123456ua.ac.be
                Department of Primary and Interdisciplinary Care, University of Antwerp, Universiteitsplein 1, BE-2610 Wilrijk (Antwerp), Belgium, E-mail: veronique.verhoeven@ 123456ua.ac.be
                Department of Primary and Interdisciplinary Care, University of Antwerp, Universiteitsplein 1, BE-2610 Wilrijk (Antwerp), Belgium, E-mail: roy.remmen@ 123456ua.ac.be
                Author notes
                Correspondence to: Maja Lopez Hartmann, Department of Primary and Interdisciplinary Care, University of Antwerp Universiteitsplein 1, BE-2610 Wilrijk (Antwerp), Belgium, E-mail: maja.lopezhartmann@ 123456ua.ac.be
                Article
                ijic2012133
                10.5334/ijic.845
                3601532
                23593047
                01012275-0cc7-4dfe-91b0-862f08a99855
                Copyright 2012, International Journal of Integrated Care (IJIC)

                This work is licensed under a ( http://creativecommons.org/licenses/by/3.0) Creative Commons Attribution 3.0 Unported License

                History
                : 08 March 2011
                : 11 June 2012
                : 21 June 2012
                Categories
                Research and Theory

                Health & Social care
                frail elderly,caregivers,health services needs,demand
                Health & Social care
                frail elderly, caregivers, health services needs, demand

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