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The art of successful implementation of psychosocial interventions in residential dementia care: a systematic review of the literature based on the RE-AIM framework

  • Petra Boersma (a1), Julia C.M. van Weert (a2), Jeroen Lakerveld (a3) and Rose-Marie Dröes (a4)



In the past decades many psychosocial interventions for elderly people with dementia have been developed and implemented. Relatively little research has been done on the extent to which these interventions were implemented in the daily care. The aim of this study was to obtain insight into strategies for successful implementation of psychosocial interventions in the daily residential dementia care. Using a modified RE-AIM framework, the indicators that are considered important for effective and sustainable implementation were defined.


A systematic literature search was undertaken in PubMed, PsycINFO, and Cinahl, followed by a hand search for key papers. The included publications were mapped based on the dimensions of the RE-AIM framework: Reach, Effectiveness, Adoption, Implementation, and Maintenance.


Fifty-four papers met the inclusion criteria and described various psychosocial interventions. A distinction was made between studies that used one and studies that used multiple implementation strategies. This review shows that to improve their knowledge, caregivers needed at least multiple implementation strategies, only education is not enough. For increasing a more person-centered attitude, different types of knowledge transfer can be effective. Little consideration is given to the adoption of the method by caregivers and to the long-term sustainability (maintenance).


This review shows that in order to successfully implement a psychosocial method the use of multiple implementation strategies is recommended. To ensure sustainability of a psychosocial care method in daily nursing home care, innovators as well as researchers should specifically pay attention to the dimensions Adoption, Implementation, and Maintenance of the RE-AIM implementation framework.


Corresponding author

Correspondence should be addressed to: P. Boersma, VU University Medical Center, Department of Psychiatry and Elderly Care Medicine, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. Phone: +31-06-31006715; Fax +31-20-4448234. Email:


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Aylward, S., Stolee, P., Keat, N. and Johncox, V. (2003). Effectiveness of continuing education in long-term care: a literature review. The Gerontologist, 43, 259271.
Bliss, M. J. and Emshoff, J. G. (2002). Workbook for Designing a Process Evaluation. Georgia: Georgia State University.
Brooker, D. (2004). What is person-centred care in dementia? Reviews in Clinical Gerontology, 13, 215222.
Burgio, L. et al. (2001). Judging outcomes in psychosocial interventions for dementia caregivers: the problem of treatment implementation. The Gerontologist, 41, 481489.
Burgio, L. D. et al. (2001). Come talk with me: improving communication between nursing assistants and nursing home residents during care routines. The Gerontologist, 41, 449460.
Chalmers, I. and Altman, D. G. (1995). Systematic Review. London: BMJ Publishing Group.
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I. and Petticrew, M. (2008). Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ, 337, a1655.
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A. and Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science, 4. doi:10.1186/1748-5908-4-50.
De Lange, J. (2004). Dealing with dementia. Effects of integrated emotion-oriented care on adaptation and coping of people with dementia in nursing homes: a qualitative study as part of a randomised clinical trial. Thesis. Utrecht, the Netherlands: Trimbos-instituut.
Dröes, R. M. (1997a). Psychomotor group therapy for demented patients in the nursing home. In Miesen, B. and Jones, G. (eds.), Care-giving in Dementia II (pp. 95118). London: Routledge.
Dröes, R. M. (1997b). Psychosocial treatment for demented patients: methods and effects. In Miesen, B. and Jones, G. (eds.), Care-giving in Dementia II (pp. 127148). London: Routledge.
Dröes, R. M. (2007). Insight in coping with dementia: listening to the voice of those who suffer from it. Aging and Mental Health, 11, 115118.
Dröes, R. M., Van Mierlo, L. D., Van der Roest, H. G. and Meiland, F. J. M. (2011). Focus and Effectiveness of psychosocial interventions for people with dementia in institutional care settings from the perspective of coping with the disease. Non-pharmacological Therapies in Dementia, 1, 139159.
Dzewaltowski, D. A., Glasgow, R. E., Klesges, L. M., Estabrooks, P. A. and Brock, E. (2004). RE-AIM: evidence-based standards and a web resource to improve translation of research into practice. Annals of Behavioral Medicine, 28, 7580.
Edvardsson, D., Fetherstonhaugh, D. and Nay, R. (2010). Promoting a continuation of self and normality: person-centred care as described by people with dementia, their family members and aged care staff. Journal of Clinical Nursing, 19, 26112618.
Eggenberger, E., Heimerl, K. and Bennett, M. I. (2013). Communication skills training in dementia care: a systematic review of effectiveness, training content, and didactic methods in different care settings. International Psychogeriatrics, 25, 345358.
Finnema, E., Dröes, R. M., Ribbe, M. and Van Tilburg, W. (2000). A review of psychosocial models in psychogeriatrics: implications for care and research. Alzheimer Disease and Associated Disorders Alzheimer, 14, 6880.
Finnema, E., Dröes, R. M., Ribbe, M. and Van Tilburg, W. (2000). The effects of emotion-oriented approaches in the care for persons suffering from dementia: a review of the literature. International Journal of Geriatric Psychiatry, 15, 141161.
Glasgow, R. E., Vogt, T. M. and Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions: the RE-AIM framework. American Journal of Public Health, 89, 13221327.
Gould, E. and Reed, P. (2009). Alzheimer's Association Quality Care Campaign and professional training initiatives: improving hands-on care for people with dementia in the U.S.A. International Psychogeriatrics, 21 (Suppl. 1), S25S33.
Grol, R. and Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients’ care. Lancet, 362, 1225–30.
Grol, R. P., Bosch, M. C., Hulscher, M. E., Eccles, M. P. and Wensing, M. (2007). Planning and studying improvement in patient care: the use of theoretical perspectives. Milbank Q, 85, 93138.
Kitson, A. L. (2009). The need for systems change: reflections on knowledge translation and organizational change. Journal of Advanced Nursing, 65, 217228.
Kitson, A. L., Rycroft-Malone, J., Harvey, G., McCormack, B., Seers, K. and Titchen, A. (2008). Evaluating the successful implementation of evidence into practice using the PARiSH framework: theoretical and practical challenges. Implementation Science, 3. doi:10.1186/1748-5908-3-1.
Kitwood, T. (1997). Dementia Considered: The Person Comes First. Buckingham: Open University Press.
Kuske, B., Hanns, S., Luck, T., Angermeyer, M. C., Behrens, J. and Riedel-Heller, S. G. (2007). Nursing home staff training in dementia care: a systematic review of evaluated programs. International Psychogeriatrics, 19, 818841.
Lakerveld, J., Bot, S., Chinapaw, M., Van, T. M., Kingo, L. and Nijpels, G. (2012). Process evaluation of a lifestyle intervention to prevent diabetes and cardiovascular diseases in primary care. Health Promotion Practice, 13, 696706.
Lawrence, V., Fossey, J., Ballard, C., Moniz-Cook, E. and Murray, J. (2012). Improving quality of life for people with dementia in care homes: making psychosocial interventions work. British Journal of Psychiatry, 201, 344351.
Moyle, W., Chi Hsu, M., Lieff, S. and Vernooij-Dassen, M. (2010). Recommendations for staff education and training for older people with mental illness in long-term aged care. International Psychogeriatrics, 22, 10971106.
Olazaran, J. et al. (2010). Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dementia and Other Geriatric Cognitive Disorders, 30, 161178.
Prince, M., Prina, M. and Guerchet, M. (2013). Journey of Caring, An Analysis of Long-term Care for Dementia. World Alzheimer Report 2013. London: Alzheimer's Disease International.
Rycroft-Malone, J. (2004). The PARIHS Framework – A framework for guiding the implementation of evidence-based practice. Journal of Nursing Care Quality, 19, 297304.
Schrijnemaekers, V. J., Van, R. E., Van Heusden, M. J. and Widdershoven, G. A. (2002). Compliance in a randomized controlled trial: the implementation of emotion-orientated care in psycho-geriatric facilities. Journal of Advanced Nursing, 39, 182189.
Shadish, W. R., Cook, T. D. and Campbell, D. T. (2002). Experimental and Quasi-Experimental Designs for Generalized Causal Interference. Boston, NY: Houghton Mifflin Harcourt.
Stevens, A. B. et al. (1998). Teaching and maintaining behaviour management skills with nursing assistants in a nursing home. The Gerontologist, 38, 379384.
Terada, S. et al. (2013). Person-centered care and quality of life of patients with dementia in long-term care facilities. Psychiatry Research, 205, 103108.
Van de Mortel, T. F. (2008). Faking it: social desirability response bias in self-report research. Australian Journal of Advanced Nursing, 25, 4048.
Van der Kooij, C. H. (2003). Just Being Nice? The Maieutic Concept of Care and Applying Integrated Perception Based Care in Psycho Geriatric Nursing Environments. Utrecht: Lemma.
Van der Roest, H. G. et al. (2009). What do community-dwelling people with dementia need? A survey of those who are known to care and welfare services. International Psychogeriatrics, 21, 949965.
Van Mierlo, L. D., Meiland, F. J., Van der Roest, H.G. and Dröes, R. M. (2012). Personalised caregiver support: effectiveness of psychosocial interventions in subgroups of caregivers of people with dementia. International Journal of Geriatric Psychiatry, 27, 114.
Van Mierlo, L. D., Van der Roest, H.G., Meiland, F.J. and Dröes, R. M. (2010). Personalized dementia care: proven effectiveness of psychosocial interventions in subgroups. Ageing Research Reviews, 9, 163183.
Van Weert, J. C., Kerkstra, A., Van Dulmen, A. M., Bensing, J. M., Peter, J. G. and Ribbe, M. W. (2004). The implementation of snoezelen in psychogeriatric care: an evaluation through the eyes of caregivers. International Journal of Nursing Studies, 41, 397409.
Van Weert, J.C., Van Dulmen, A. M., Spreeuwenberg, P. M., Bensing, J. M. and Ribbe, M. W. (2005a). The effects of the implementation of snoezelen on the quality of working life in psychogeriatric care. International Psychogeriatrics, 17, 407427.
Van Weert, J.C., Van Dulmen, A. M., Spreeuwenberg, P. M., Ribbe, M. W. and Bensing, J. M. (2005a). Effects of snoezelen, integrated in 24 h dementia care, on nurse-patient communication during morning care. Patient Education and Counseling, 58, 312326.
Vernooij-Dassen, M. and Moniz-Cook, E. (2014). Raising the standard of applied dementia care research: addressing the implementation error. Aging and Mental Health, doi:10:1080/13607863.2014.899977.
Vernooij-Dassen, M., Vasse, E., Zuidema, S., Cohen-Mansfield, J. and Moyle, W. (2010). Psychosocial interventions for dementia patients in long-term care. (Review). International Pscyhogeriatrics, 22, 11211128.
Visser, S. M., McCabe, M. P., Hudgson, C., Buchanan, G., Davison, T. E. and George, K. (2008). Managing behavioural symptoms of dementia: effectiveness of staff education and peer support. Aging and Mental Health, 12, 4755.


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Supplementary materials

Boersma Supplementary Material
Appendix A

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Supplementary materials

Boersma Supplementary Material
Appendix B

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