Effect of integrated family support versus day care only on behavior and mood of patients with dementia

Objective: This study tests the hypothesis that integrated family support, in which patients and caregivers are both supported by one professional sta ff, is more effective in influencing behavior problems and mood of the deme ntia patient than nonintegrated support, such as psychogeriatric day care o nly. Design: A quasi-experimental pretest-posttest control group design wit h matched groups was applied. Setting: Psychogeriatric day-care centers of four community centers and three nursing homes. Participants: Fifty-six dem entia patients living at home and their caregivers. Intervention: The patie nts in the experimental group (n = 33) participated together with their car egivers in an integrated family support program, whereas the patients in th e control group (n = 23) received psychogeriatric day care only. Measuremen ts: Behavior problems and mood were observed using standardized behavior ob servation scales. Results:After 7 months the experimental support program, compared to the regular psychogeriatric day care, showed a large positive e ffect on the total number of behavior problems (effect size.75), and also s pecifically on the degree of inactivity (effect size.66) and nonsocial beha vior (effect size.61). No effect on mood was found. Conclusions: In influen cing the total amount of behavior problems, as well as the degree of inacti vity and nonsocial behavior, the integrated family support program proved t o be more effective than psychogeriatric day care. Because behavior problem s are an important determinant for admission of persons with dementia into a nursing home, integrated family support may contribute to the delay of in stitutionalization.