Person-centered care improves psychiatric symptoms and quality of life in dementia patients

Kim SK, Park M Effectiveness of person-centered care on people with dementia: A systematic review and meta-analysis  Clinical Interventions in Aging. 2017 Feb; 12: 381-397

Review question

• Is person-centered care more effective with regards to quality of life and psychiatric symptoms when compared to usual care in individuals diagnosed with dementia.

Background

• Dementia patients suffer from reduced cognitive and physical function which makes providing care difficult. This often leads to institutionalization and use of drugs with harmful side effects to control their symptoms.

• Currently, there is a greater focus on treatments that are person-centered, in an attempt to improve care practices by recognizing individuality of patients. Many long-term care facilities have implemented person-centered care, and many health systems around the world have implemented this approach.

• Although studies have looked at how person-centered care is, there is a need for studies examining the effectiveness of this approach with regards to patient outcomes. 

How the review was done

• A detailed search of a number of electronic databases for studies published from 1963 to 2015 was conducted. Studies that focused on comparing dementia patient outcomes (e.g., psychiatric symptoms and quality of life) between person-centered care and usual care, were included in the review.

• A total of 11,149 studies were identified in searches, and 77 were included in the review after assessments for eligibility.

• This review was funded by the National Research Foundation of Korea.

What the researchers found

• The review found that person-centered care significantly reduced psychiatric symptoms such as agitation and depression.

• Researchers noted that the effects of person-centered care interventions were generally short term, lasting six weeks on average.

• Analysis of studies showed that person-centered care was less effective at improving quality of life in the long-term than in the short-term. Quality-of-life improvement was greater in patients with less severe dementia.

Conclusion

• The review found that person-centered care significantly improved psychiatric symptoms and quality of life when compared with usual care. As included studies took place in long-term care settings, results may not be generalizable to acute-care or hospital settings. More research is needed to investigate effectiveness of specific interventions as well as to explore the effects of person-centered care on caregivers.