Exploring themes in the narratives of couples in which one partner has dementia to identify what short couple interventions should focus on

Objective: Despite strong evidence showing the association between relationship quality and outcomes for both partners in couples with dementia, studies show little or no statistical evidence of the effectiveness of short-term couple interventions in dementia. The aim of this study was to address the question of what topics a short couple intervention should focus on, and what content and components such an intervention should include. Method: In this cross-sectional, qualitative investigation we used thematic analysis of transcribed interviews from couples (N=4), after they participated in the short-term couple intervention for dementia. Using thematic analysis, we extracted codes and identified the themes appearing in the narratives of couples obtained in in-depth interviews. Results: The main four themes which emerged were Loss, Change, Relationships, and Coping with difficulties, which included several sub-themes. Conclusion: This study indicates that high relationship quality and effective dyadic coping should be seen as a “relationship reserve” (a concept alike to cognitive reserve), that may act as a resilience factor in dementia. Well-designed, structured, multi-component couple interventions can enhance couples’ relationship reserve and, what follows, help to prevent carer burden, depression and burn-out, slower cognitive decline in the partner with dementia and improve the psychological well-being of both partners. To be more effective, such interventions should include both an educational and a therapeutic modules (with the latter consisting of a relational component, a component focused on self-care of caregiving partner, and a component addressing depression in both partners), and should be tailored for the needs of individual couples and adjusted depending on stages of dementia.