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Cited by 247Dementia and Cognitive Impairment ResearchFamily Caregiving in Mental IllnessNursing care and research

Behavioural and psychological symptoms in dementia and the challenges for family carers: Systematic review

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Feast, Alexandra, Orrell, Martin, Charlesworth, Georgina, Melunsky, Nina, Poland, Fiona, Moniz-Cook, Esme·2016·British Journal of Psychiatry
DOI 10.1192/bjp.bp.114.153684PMC PMC4853642
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Abstract

Background: Tailored psychosocial interventions can help families to manage behavioural and psychological symptoms in dementia (BPSD), but carer responses to their relative's behaviours contribute to the success of support programmes. Aims: To understand why some family carers have difficulty in dealing with BPSD, in order to improve the quality of personalised care that is offered. Method: A systematic review and meta-ethnographic synthesis was conducted of high-quality quantitative and qualitative studies between 1980 and 2012. Results: We identified 25 high-quality studies and two main reasons for behaviours being reported as challenging by family carers: changes in communication and relationships, resulting in ‘feeling bereft’; and perceptions of transgressions against social norms associated with ‘misunderstandings about behaviour’ in the relative with dementia. The underlying belief that their relative had lost, or would inevitably lose, their identity to dementia was a fundamental reason why family carers experienced behaviour as challenging. Conclusions: Family carers' perceptions of BPSD as challenging are associated with a sense of a declining relationship, transgressions against social norms and underlying beliefs that people with dementia inevitably lose their ‘personhood’. Interventions for the management of challenging behaviour in family settings should acknowledge unmet psychological need in family carers.

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  • DAD may be influenced by, or may facilitate, challenging behavior in the care recipient.

    “DAD may be influenced by, or may facilitate, challenging behavior in the care recipient (Cohen-Mansfield et al., Citation2015; Feast et al., Citation2016).”

    From How do care-related beliefs contribute to depression and anxiety in family caregivers of people with dementia? Testing a cognitive vulnerability-stress model. (2025) · cites this paper as Feast et al., 2016

    The Abstract says challenging behaviours are associated with carer distress and that carers’ characteristics and responses can influence the course of those behaviours. The Discussion likewise describes carers’ negative feelings as barriers to effective responses. These passages support a possible two-way relationship, but the paper does not identify or specifically assess DAD. (LLM, conf=0.75)

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Cited by

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Authors
Feast, A., Orrell, M., Charlesworth, G., Melunsky, N., Poland, F., & Moniz-Cook, E.
Affiliations
  • National Health Service (GB)
  • University of Nottingham (GB)
  • University of East Anglia (GB)
Corresponding author
Feast, Alexandra
ORCID
Venue
British Journal of Psychiatry
Publisher
Royal College of Psychiatrists
Published
2016-05
Volume
208
Issue
5
Pages
429-434
ISSN
  • 0007-1250 (ISSN-L)
  • 1472-1465
DOI
10.1192/bjp.bp.114.153684
PMC
PMC4853642
OpenAlex
W2299075669
Cited by
247
References
5
Citations by year
2026: 29 · 2025: 23 · 2024: 22 · 2023: 36 · 2022: 29 · 2021: 31 · 2020: 18 · 2019: 24 · 2018: 19 · 2017: 14 · 2016: 2
FWCI
2.82
Type
journal article
Language
en
Open access
Licence
Locations
  • The British Journal of Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Repository@Hull (Worktribe) (University of Hull) (acceptedVersion, other-oa)
  • UEA Digital Repository (University of East Anglia) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • National Institute for Health and Care Research (RP-PG-060-1083, RP-PG-0606-1067)
  • Marie Curie (MCCC-FPR-11-U, MCCC-PRO-11-U)
  • Programme Grants for Applied Research (RP-PG-0606-1067)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
Keywords
behavioral and psychological symptoms of dementia, family caregivers, caregiver perceptions, behavioral problems, personhood, identity loss, communication breakdown, social norms, individualized care
MeSH terms
Problem Behavior, Dementia, Family Relations, Humans, Health Knowledge, Attitudes, Practice, Caregivers

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