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Effectiveness of family meetings for family caregivers on delaying time to nursing home placement of dementia patients: a randomized trial


Joling, Karlijn J, van Marwijk, Harm W.J., van der Horst, Henriëtte E, Scheltens, Philip, van de Ven, Peter M., Appels, Bregje A., van Hout, Hein P.J.


Plos One, Volume: 7, No.: 8, Pages.: e42145-e42145

Year of Publication



Background: Interventions relieving the burden of caregiving may postpone or prevent patient institutionalization. The objective of this study was to determine whether a family meetings intervention was superior to usual care in postponing nursing home placement of patients with dementia.; Methods: A randomized multicenter trial was conducted among 192 patients with a clinical diagnosis of dementia living at home at enrolment and their primary family caregiver. Dyads of caregivers and patients were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions with the primary caregiver and four family counseling sessions that included family members and friends. The primary outcome measure was the time until institutionalization of the patient. Intention-to-treat as well as per protocol analyses were performed. Survival analyses were carried out to evaluate the effectiveness of the intervention.; Results: During 18 months follow-up 23 of 96 relatives with dementia of caregivers in the intervention group and 18 of 96 relatives with dementia of caregivers in the usual care group were institutionalized. No significant difference between the intervention and the usual care group was found in time until institutionalization (adjusted hazard ratio (HR) 1.46, 95% confidence interval (CI) 0.78 to 2.74). The per-protocol analysis revealed no significant effect either (adjusted HR 0.57, 95% CI 0.21 to 1.57), although the number of placements among the adherers was relatively low (9.4%). A subgroup effect was found for patients’ age, with a significantly higher risk of institutionalization for ‘younger’ patients in the intervention group compared with the usual care group (adjusted HR = 4.94, 95% CI 1.10 to 22.13).; Conclusion: This family meetings intervention for primary caregivers of patients with dementia did not postpone patient institutionalization more than usual care.; Trial Registration: CONTROLLED-TRIALS.COM ISRCTN90163486.;

Bibtex Citation

@article{Joling_2012, doi = {10.1371/journal.pone.0042145}, url = {}, year = 2012, month = {aug}, publisher = {Public Library of Science ({PLoS})}, volume = {7}, number = {8}, pages = {e42145}, author = {Karlijn J. Joling and Harm W. J. van Marwijk and Henriëtte E. van der Horst and Philip Scheltens and Peter M. van de Ven and Bregje A. Appels and Hein P. J. van Hout}, editor = {Jerson Laks}, title = {Effectiveness of Family Meetings for Family Caregivers on Delaying Time to Nursing Home Placement of Dementia Patients: A Randomized Trial}, journal = {{PLoS} {ONE}} }


aged, aged, 80 and over, caregivers, communication, dementia, family, female, followup studies, humans, institutionalization, intervention, male, meeting, middle aged, mortality, nursing, nursing homes, social support

Countries of Study


Types of Study

Cost and service use study, Randomised Controlled Trial

Type of Outcomes

Service use or cost reductions (incl. hospital use reduction, care home admission delay)

Type of Interventions

Intervention for Carers

Carer Focussed Interventions