Given that approximately 41.8 million Americans provide unpaid care to older adults and caregiving roles are often associated with decreased well-being, it is critical to identify strategies to maximize their well-being. The purpose of this review was to explore which activities significantly improve well-being among caregivers of older adults. A systematic literature review was conducted using PsycINFO and 24 research articles met inclusion criteria and were included in the final analysis. Eight cohesive activity categories were identified: Social (n = 5), Psychoeducation (n = 3), Arts/entertainment in the home (n = 2), Psychotherapy (n = 5), Religious/Spiritual (n = 4), Multimodal (n = 4), Physical (n = 5), and Arts/entertainment outside the home (n = 2). Findings suggest that caregivers of older adults should seek opportunities for engagement in meaningful activities, particularly social, psychoeducational activities, arts/entertainment activities in the home, which showed positive impacts, as well as psychotherapy, religious/spiritual, multimodal, and physical activities, which showed mixed impacts on caregivers’ psychological well-being.
Aboulafia-BrakhaT.SucheckiD.Gouveia-PaulinoF.NitriniR.PtakR. (2014). Cognitive-behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer’s disease. Aging & Mental Health, 18(6), 801–808. https://doi.org/10.1080/13607863.2014.880406
3.
Alonso-CortésB.Seco-CalvoJ. (2021). Involvement in self-care and psychological well-being of Spanish family caregivers of relatives with dementia. Health and Social Care in the Community, 29(5), 1308–1316. https://doi.org/10.1111/hsc.13171
4.
AlvesS.TeixeiraL.AzevedoM. J.DuarteM.PaúlC. (2016). Effectiveness of a psychoeducational programme for informal caregivers of older adults. Scandinavian Journal of Caring Sciences, 30(1), 65–73. https://doi.org/10.1111/scs.12222
5.
BeachS. R.SchulzR.WilliamsonG. M.MillerL. S.WeinerM. F.LanceC. E. (2005). Risk factors for potentially harmful informal caregiver behavior. Journal of the American Geriatrics Society, 53(2), 255–261. https://doi.org/10.1111/j.1532-5415.2005.53111.x
6.
BolinK.LindgrenB.LundborgP. (2008). Your next of kin or your own career? Caring and working among the 50+ of Europe. Journal of Health Economics, 27(3), 718–738. https://doi.org/10.1016/j.jhealeco.2007.10.004
7.
BomJ.BakxP.SchutF.van DoorslaerE. (2019). The impact of informal caregiving for older adults on the health of various types of caregivers: A systematic review. The Gerontologist, 59(5), e629–e642. https://doi.org/10.1093/geront/gny137
8.
BryantC. (2017). Psychological interventions for older adults: Evidence-based treatments for depression, anxiety, and carer stress. In ChiuH.ShulmanK. (Eds.), Mental health and illness worldwide: Mental health and illness of the elderly (pp. 481–514). Springer Science + Business Media. https://doi.org/10.1007/978-981-10-2414-6_21
9.
ByrneK.OrangeJ. B.Ward-GriffinC. (2011). Care transition experiences of spousal caregivers: From a geriatric rehabilitation unit to home. Qualitative Health Research, 21(10), 1371–1387. https://doi.org/10.1177/1049732311407078
10.
CaldeiraR. d. B.NeriA. L.BatistoniS. S. T.CachioniM. (2017). Variables associated with the life satisfaction of elderly caregivers of chronically ill and dependent elderly relatives. Revista Brasileira De Geriatria E Gerontologia, 20(4), 502–515. https://doi.org/10.1590/1981-22562017020.160177
11.
CamicP. M.WilliamsC. M.MeetenF. (2013). Does a ‘singing together group’ improve the quality of life of people with a dementia and their carers? A pilot evaluation study. Dementia, 12(2), 157–176. https://doi.org/10.1177/1471301211422761
12.
ChanW. C.LamL. C. W.LautenschlagerN.DowB.MaS. L. (2020). Home-based exercise intervention for caregivers of persons with dementia: A randomised controlled trial: Abridged secondary publication. Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi, 26 Suppl 7(6), 13–16. https://www.ncbi.nlm.nih.gov/pubmed/33229611
13.
ChengS.LauR. W. L.MakE. P. M.NgN. S. S.LamL. C. W. (2014). Benefit-finding intervention for Alzheimer caregivers: Conceptual framework, implementation issues, and preliminary efficacy. The Gerontologist, 54(6), 1049–1058. https://doi.org/10.1093/geront/gnu018
14.
ChengS.LiK.OrP. P. L.LosadaA. (2022). Do caregiver interventions improve outcomes in relatives with dementia and mild cognitive impairment? A comprehensive systematic review and meta-analysis. Psychology and Aging, 37(8), 929–953. https://doi.org/10.1037/pag0000696
15.
Di LoritoC.DuffC.RogersC.TuxworthJ.BellJ.FothergillR.WilkinsonL.BoscoA.HoweL.O'BrienR.GodfreyM.DunlopM.van der WardtV.BoothV.LoganP.CowleyA.HarwoodR. H. (2021). Tele-rehabilitation for people with dementia during the COVID-19 pandemic: A case-study from England. International Journal of Environmental Research and Public Health, 18(4), 1717. https://doi.org/10.3390/ijerph18041717
16.
FeggM. J.BrandstätterM.KöglerM.HaukeG.Rechenberg-WinterP.FenstererV.KüchenhoffH.HentrichM.BelkaC.BorasioG. D. (2013). Existential behavioural therapy for informal caregivers of palliative patients: A randomised controlled trial. Psycho-Oncology, 22(9), 2079–2086. https://doi.org/10.1002/pon.3260
17.
FifeB.Brooks-CleatorL.LewisJ. P. (2020). “The world was shifting under our feet, so I turned to my devotionals as his dementia worsened”: The role of spirituality as a coping mechanism for family caregivers of Alaska Native elders with dementia. Journal of Religion, Spirituality and Aging, 33(3), 252–270. https://doi.org/10.1080/15528030.2020.1754995
18.
FoleyJ. A.DoreC.ZarkaliA.LivingstonG.CipolottiL.MummeryC. J.WeilR. S. (2020). Evaluation of START (STrAtegies for RelaTives) adapted for carers of people with Lewy body dementia. Future Healthcare Journal, 7(3), e27–e29. https://doi.org/10.7861/fhj.2020-0003
19.
FreedmanV. A.KasperJ. D.CornmanJ. C.AgreeE. M.Bandeen-RocheK.MorV.SpillmanB. C.WallaceR.WolfD. A. (2011). Validation of new measures of disability and functioning in the national health and aging trends study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 66(9), 1013–1021. https://doi.org/10.1093/gerona/glr087
20.
FunkL.StajduharK.ToyeC.AounS.GrandeG.ToddC. (2010). Part 2: Home-Based family caregiving at the end of life: A comprehensive review of published qualitative research (1998-2008). Palliative Medicine, 24(6), 594–607. https://doi.org/10.1177/0269216310371411
21.
GauglerJ. E.PestkaD. L.DavilaH.SalesR.OwenG.BaumgartnerS. A.ShookR.CunninghamJ.KenneyM. (2018). The complexities of family caregiving at work: A mixed-methods study. International Journal of Aging and Human Development, 87(4), 347–376. https://doi.org/10.1177/0091415017752936
22.
HiranoA.UmegakiH.SuzukiY.HayashiT.KuzuyaM. (2016). Effects of leisure activities at home on perceived care burden and the endocrine system of caregivers of dementia patients: A randomized controlled study. International Psychogeriatrics, 28(2), 261–268. https://doi.org/10.1017/S1041610215001295
23.
HuangS. (2022). Depression among caregivers of patients with dementia: Associative factors and management approaches. World Journal of Psychiatry, 12(1), 59–76. https://doi.org/10.5498/wjp.v12.i1.59
24.
IraniE.WangF.MeyerK.MooreS. E.DingK. (2023). Social activity restriction and psychological health among caregivers of older adults with and without dementia. Journal of Aging and Health, 0(0), 8982643231209089. https://doi.org/10.1177/08982643231209089
25.
IsaacV.StewartR.ArteroS.AncelinM.RitchieK. (2009). Social activity and improvement in depressive symptoms in older people: A prospective community cohort study. American Journal of Geriatric Psychiatry, 17(8), 688–696. https://doi.org/10.1097/JGP.0b013e3181a88441
26.
KajiyamaB.ThompsonL. W.Eto-IwaseT.YamashitaM.Di MarioJ.Marian TzuangY.Gallagher-ThompsonD. (2013). Exploring the effectiveness of an Internet-based program for reducing caregiver distress using the iCare Stress Management e-Training Program. Aging & Mental Health, 17(5), 544–554. https://doi.org/10.1080/13607863.2013.775641
27.
KandolaA.Ashdown-FranksG.HendrikseJ.SabistonC. M.StubbsB. (2019). Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neuroscience & Biobehavioral Reviews, 107, 525–539. https://doi.org/10.1016/j.neubiorev.2019.09.040
28.
KazemiA.AzimianJ.MafiM.AllenK.MotalebiS. A. (2021). Caregiver burden and coping strategies in caregivers of older patients with stroke. BMC Psychology, 9(1), 51. https://doi.org/10.1186/s40359-021-00556-z
29.
KellyJ. F.EddieD. (2020). The role of spirituality and religiousness in aiding recovery from alcohol and other drug problems: An investigation in a National U.S. sample. Psychology of Religion and Spirituality, 12(1), 116–123. https://doi.org/10.1037/rel0000295
30.
KillenA.FlynnD.O’BrienN.TaylorJ. (2022). The feasibility and acceptability of a psychosocial intervention to support people with dementia with Lewy bodies and family care partners. Dementia, 21(1), 77–93. https://doi.org/10.1177/14713012211028501
31.
K WardS.TurnerA.A HambridgeJ.A HalpinS.E ValentineM.L SweetappleA.H WhiteJ.HackettM. L. (2016). Group cognitive behavioural therapy for stroke survivors with depression and their carers. Topics in Stroke Rehabilitation, 23(5), 358–365. https://doi.org/10.1080/10749357.2016.1143706
32.
LaiH.LiY.LeeL. (2012). Effects of music intervention with nursing presence and recorded music on psycho-physiological indices of cancer patient caregivers. Journal of Clinical Nursing, 21(5-6), 745–756. https://doi.org/10.1111/j.1365-2702.2011.03916.x
33.
LavretskyH.EpelE. S.SiddarthP.NazarianN.CyrN. S.KhalsaD. S.LinJ.BlackburnE.IrwinM. R. (2013). A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: Effects on mental health, cognition, and telomerase activity. International Journal of Geriatric Psychiatry, 28(1), 57–65. https://doi.org/10.1002/gps.3790
34.
LeD. D.IbukaY. (2023). Understanding the effects of informal caregiving on health and well-being: Heterogeneity and mechanisms. Social Science & Medicine, 317, 115630. https://doi.org/10.1016/j.socscimed.2022.115630
35.
LinsS.Hayder-BeichelD.RückerG.MotschallE.AntesG.MeyerG.LangerG. (2014). Efficacy and experiences of telephone counselling for informal carers of people with dementia. Cochrane Database of Systematic Reviews, 2014(9), CD009126. https://doi.org/10.1002/14651858.CD009126.pub2
36.
LoiS. M.DowB.MooreK.HillK.RussellM.CyartoE.MaltaS.AmesD.LautenschlagerN. (2016). Factors associated with depression in older carers. International Journal of Geriatric Psychiatry, 31(3), 294–301. https://doi.org/10.1002/gps.4323
37.
LuY. Y.BakasT.YangZ.WeaverM. T.AustromM. G.HaaseJ. E. (2016). Feasibility and effect sizes of the revised daily engagement of meaningful activities intervention for individuals with mild cognitive impairment and their caregivers. Journal of Gerontological Nursing, 42(3), 45–58. https://doi.org/10.3928/00989134-20160212-08
38.
MackenzieC. S.AbdulrazaqS. (2021). Social engagement mediates the relationship between participation in social activities and psychological distress among older adults. Aging & Mental Health, 25(2), 299–305. https://doi.org/10.1080/13607863.2019.1697200
39.
MahdaviB.Fallahi-KhoshknabM.MohammadiF.HosseiniM. A.HaghiM. (2017). Effects of spiritual group therapy on caregiver strain in home caregivers of the elderly with Alzheimer's disease. Archives of Psychiatric Nursing, 31(3), 269–273. https://doi.org/10.1016/j.apnu.2016.12.003
40.
MahindruA.PatilP.AgrawalV. (2023). Role of physical activity on mental health and well-being: A review. Cureus, 15(1), e33475. https://doi.org/10.7759/cureus.33475
41.
MarshallE.LaCailleR. A.LaCailleL. J.LeeJ. E.PetersonE. (2022). Effects of physical activity interventions for caregivers of adults: A meta-analysis. Health Psychology, 41(9), 585–598. https://doi.org/10.1037/hea0001212
42.
MeyersJ. L.BrownQ.GrantB. F.HasinD. (2017). Religiosity, race/ethnicity, and alcohol use behaviors in the United States. Psychological Medicine, 47(1), 103–114. https://doi.org/10.1017/S0033291716001975
43.
MinJ.AilshireJ.CrimminsE. M. (2016). Social engagement and depressive symptoms: Do baseline depression status and type of social activities make a difference?Age and Ageing, 45(6), 838–843. https://doi.org/10.1093/ageing/afw125
44.
MiyawakiC. E.TahijaN.McClellanA.ChenN. (2022). Feasibility study of caregiver-provided life review: Implementation, adaptation, and effects on care recipients' depressive symptoms. Clinical Gerontologist, 1–12, 2144578. https://doi.org/10.1080/07317115.2022.2144578(Advance online publication).
45.
MontgomeryW.GorenA.Kahle-WrobleskiK.NakamuraT.UedaK. (2018). Alzheimer's disease severity and its association with patient and caregiver quality of life in Japan: Results of a community-based survey. BMC Geriatrics, 18(1), 141. https://doi.org/10.1186/s12877-018-0831-2
46.
MusichS.WangS. S.KraemerS.HawkinsK.WickerE. (2017). Caregivers for older adults: Prevalence, characteristics, and health care utilization and expenditures. Geriatric Nursing, 38(1), 9–16. https://doi.org/10.1016/j.gerinurse.2016.06.017
OhA.GanS.BoscardinW. J.AllisonT. A.BarnesD. E.CovinskyK. E.SmithA. K. (2021). Engagement in meaningful activities among older adults with disability, dementia, and depression. Archives of Internal Medicine (1960), 181(4), 560-562. https://doi.org/10.1001/jamainternmed.2020.7492
51.
OshioT.KanM. (2016). How do social activities mitigate informal caregivers’ psychological distress? Evidence from a nine-year panel survey in Japan. Health and Quality of Life Outcomes, 14(1), 117. https://doi.org/10.1186/s12955-016-0521-8
52.
O’TooleM. S.ZachariaeR.RennaM. E.MenninD. S.ApplebaumA. (2017). Cognitive behavioral therapies for informal caregivers of patients with cancer and cancer survivors: A systematic review and meta-analysis. Psycho-Oncology, 26(4), 428–437. https://doi.org/10.1002/pon.4144
53.
ParkC. L.SaccoS. J.KrausS. W.MazureC. M.HoffR. A. (2021). Influences of religiousness/spirituality on mental and physical health in OEF/OIF/OND military veterans varies by sex and race/ethnicity. Journal of Psychiatric Research, 138, 15–23. https://doi.org/10.1016/j.jpsychires.2021.03.034
54.
PatelV.ChisholmD.Rabe-HeskethS.Dias-SaxenaF.AndrewG.MannA. (2003). Efficacy and cost-effectiveness of drug and psychological treatments for common mental disorders in general health care in Goa, India: A randomised, controlled trial. Lancet (London, England), 361(9351), 33–39. https://doi.org/10.1016/S0140-6736(03)12119-8
55.
PearceM.GarciaL.AbbasA.StrainT.SchuchF. B.GolubicR.KellyP.KhanS.UtukuriM.LairdY.MokA.SmithA.TainioM.BrageS.WoodcockJ. (2022). Association between physical activity and risk of depression: A systematic review and meta-analysis. Archives of General Psychiatry, 79(6), 550–559. https://doi.org/10.1001/jamapsychiatry.2022.0609
56.
PfeifferK.BeischeD.HautzingerM.BerryJ. W.WengertJ.HoffrichterR.BeckerC.van SchayckR.ElliottT. R. (2014). Telephone-based problem-solving intervention for family caregivers of stroke survivors: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 82(4), 628–643. https://doi.org/10.1037/a0036987
57.
RathierL. A.DavisJ. D.PapandonatosG. D.GroverC.TremontG. (2015). Religious coping in caregivers of family members with dementia. Journal of Applied Gerontology, 34(8), 977–1000. https://doi.org/10.1177/0733464813510602
58.
RegierN. G.GitlinL. N. (2017). Psychosocial and environmental treatment approaches for behavioral and psychological symptoms in neurocognitive disorders: An update and future directions. Current Treatment Options in Psychiatry, 4(1), 80–101. https://doi.org/10.1007/s40501-017-0105-1
59.
RegierN. G.ParisiJ. (under review). Demographic predictors of activity patterns in older adults.
60.
RyuE.JenkinsG. D.WangY.OlfsonM.TalatiA.LepowL.CoombesB. J.CharneyA. W.GlicksbergB. S.MannJ. J.WeissmanM. M.WickramaratneP.PathakJ.BiernackaJ. M. (2023). The importance of social activity to risk of major depression in older adults. Psychological Medicine, 53(6), 2634–2642. https://doi.org/10.1017/S0033291721004566
SadavoyJ.SajedinejadS.ChiuM. (2021). A quasi-experimental study of the effectiveness of the Reitman Centre CARERS group intervention on family caregivers of persons with dementia. International Journal of Geriatric Psychiatry, 36(6), 811–821. https://doi.org/10.1002/gps.5481
63.
SchulzR.EdenJ. (2016). Families caring for an aging America (1st ed.). National Academies Press. https://doi.org/10.17226/23606
64.
SinghB.OldsT.CurtisR.DumuidD.VirgaraR.WatsonA.SzetoK.O'ConnorE.FergusonT.EglitisE.MiatkeA.SimpsonC. E.MaherC. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: An overview of systematic reviews. British Journal of Sports Medicine, 57(18), 1203–1209. https://doi.org/10.1136/bjsports-2022-106195
65.
SmagulaS. F.IsenbergA. S.StahlS. T.AlexopoulosG. S.ReynoldsC. F.RodakowskiJ. (2022). Adaptation and pilot study of a behavioral intervention targeting morning activation deficits in dementia caregivers: Scheduling Activity and Monitoring Mornings (SAMM). American Journal of Geriatric Psychiatry, 30(4), 494–503. https://doi.org/10.1016/j.jagp.2021.09.017
66.
StahlS. T.RodakowskiJ.SmagulaS. F. (2021). Timing of daily activities over a 24-hour period and affective status among a national cohort of older dementia caregivers. Journal of Aging and Health, 33(1-2), 125–132. https://doi.org/10.1177/0898264320962363
67.
SunF.HodgeD. R. (2014). Latino Alzheimer’s disease caregivers and depression: Using the stress-coping model to examine the effects of spirituality and religion. Journal of Applied Gerontology, 33(3), 291–315. https://doi.org/10.1177/0733464812444462
68.
TeriL.LogsdonR. G.McCurryS. M.PikeK. C.McGoughE. L. (2020). Translating an evidence-based multicomponent intervention for older adults with dementia and caregivers. The Gerontologist, 60(3), 548–557. https://doi.org/10.1093/geront/gny122
69.
ThaiJ. N.BarnhartC. E.CagleJ.SmithA. K. (2016). “It just consumes your life”: Quality of life for informal caregivers of diverse older adults with late-life disability. The American journal of hospice & palliative care, 33(7), 644–650. https://doi.org/10.1177/1049909115583044
70.
ToughH.BrinkhofM. W. G.FeketeC. (2020). Is informal caregiving at odds with optimal health behaviour? A cross-sectional analysis in the caregiving partners of persons with spinal cord injury. Health Psychology and Behavioral Medicine, 8(1), 526–542. https://doi.org/10.1080/21642850.2020.1838282
71.
WakuiT.SaitoT.AgreeE. M.KaiI. (2012). Effects of home, outside leisure, social, and peer activity on psychological health among Japanese family caregivers. Aging & Mental Health, 16(4), 500–506. https://doi.org/10.1080/13607863.2011.644263
72.
WangL.ChienW.LeeI. Y. M. (2012). An experimental study on the effectiveness of a mutual support group for family caregivers of a relative with dementia in mainland China. Contemporary Nurse, 40(2), 210–224. https://doi.org/10.5172/conu.2012.40.2.210
73.
WangX.RobinsonK. M.HardinH. K. (2015). The impact of caregiving on caregivers’ medication adherence and appointment keeping. Western Journal of Nursing Research, 37(12), 1548–1562. https://doi.org/10.1177/0193945914533158
74.
WattsA. S.MortbyM. E.BurnsJ. M. (2018). Depressive symptoms as a barrier to engagement in physical activity in older adults with and without Alzheimer’s disease. PLoS One, 13(12), e0208581. https://doi.org/10.1371/journal.pone.0208581
75.
WengP.ChiangY. (2014). Psychological restoration through indoor and outdoor leisure activities. Journal of Leisure Research, 46(2), 203–217. https://doi.org/10.1080/00222216.2014.11950320
76.
WernerP.ClayO. J.GoldsteinD.Kermel-SchifmannI.HerzM. K.EpsteinC.MittelmanM. S. (2021). Assessing an evidence-based intervention for spouse caregivers of persons with Alzheimer's disease: Results of a community implementation of the NYUCI in Israel. Aging & Mental Health, 25(9), 1676–1683. https://doi.org/10.1080/13607863.2020.1774740
77.
Winters-StoneK. M.LyonsK. S.DobekJ.DieckmannN. F.BennettJ. A.NailL.BeerT. M. (2016). Benefits of partnered strength training for prostate cancer survivors and spouses: Results from a randomized controlled trial of the Exercising Together project. Journal of Cancer Survivorship, 10(4), 633–644. https://doi.org/10.1007/s11764-015-0509-0
78.
WolffJ. L.MulcahyJ.HuangJ.RothD. L.CovinskyK.KasperJ. D. (2018). Family caregivers of older adults, 1999–2015: Trends in characteristics, circumstances, and role-related appraisal. The Gerontologist, 58(6), 1021–1032. https://doi.org/10.1093/geront/gnx093
WymanD. L.ButlerL.BrightP.Morgan-TrimmerS.BudgettJ.CooperC. (2022). A systematic review of process evaluations for psychosocial interventions designed to improve the wellbeing and quality of life of community-dwelling people with dementia and their carers. International Journal of Geriatric Psychiatry, 37(12), 5828. https://doi.org/10.1002/gps.5828
81.
ZhaoX.LiuH.FangB.ZhangQ.DingH.LiT. (2021). Continuous participation in social activities as a protective factor against depressive symptoms among older adults who started high-intensity spousal caregiving: Findings from the China health and retirement longitudinal survey. Aging & Mental Health, 25(10), 1821–1829. https://doi.org/10.1080/13607863.2020.1822283
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