The effectiveness of a couple-based intervention for people living with mild Alzheimer’s disease and their spousal caregivers in Korea

Ha, Jung-Hwa
Kwak, Minyoung
Han, Ji Won
Lee, Hyeon Jung
Ingersoll-Dayton, Berit
Spencer, Beth
Kim, Ki Woong

Department of Social Welfare, Seoul National University, Korea
Department of Social Work, The 26451Chinese University of Hong Kong, PR China
Department of Neuropsychiatry, 65462Seoul National University Bundang Hospital, Korea
Department of Anthropology, Seoul National University, Korea
School of Social Work, University of Michigan, USA
Department of Neuropsychiatry, 65462Seoul National University Bundang Hospital; Department of Psychiatry, College of Medicine, Seoul National University; Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, Korea

The two first authors have equally contributed to the work

Ji Won Han, Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Korea. Email: [email protected]

Dementia 20(3):p 831-847, April 2021. | DOI: 10.1177/1471301218811547

Background and objectives

We evaluated the effectiveness of a Korean version of the Couples Life Story Approach (CLSA-K), a structured life-review program originally developed in the U.S. to help older adults with dementia and their spousal caregivers engage with each other and improve their quality of life.

Research design and methods: Fifty mild people living with mild Alzheimer’s disease and their spouses were recruited and 37 couples completed the five-week CLSA-K program. Data on psychosocial outcomes—i.e., depressive symptoms, talkativeness, mutuality (for both caregivers and care recipients) and burden (for caregivers)—were collected one week prior to (Time 1) and one week after the intervention (Time 2). Using repeated measures generalized linear models, we examined the differences in the amounts and patterns of the changes in outcomes according to age, gender, and the care-recipients’ level of cognitive impairment.

Results

Some participants benefited from the CLSA-K program, while others did not. For caregivers, mental health, and marital quality remained stable, while caregiver burden increased among those with spouses who had moderate levels of cognitive impairment. For care-recipients, younger and male participants showed increased talkativeness.

Discussion and implications

CLSA-K appears to be promising for specific subgroups of participants in Korea. Multi-component or other approaches may be more beneficial for other couples. Cultural differences as well as social positions may play a role in the acceptability and efficacy of the couple-based intervention.