Caring through the Fog: A Scoping Review of Coping Strategies Among Family Caregivers of Dementia Patients

Background and Purpose: As the population ages, the risk for cognitive decline and diseases like Alzheimer’s and dementia increases. Around 6.9 million people in the US aged 65 or older are living with Alzheimer’s dementia—a population which is projected to be 13.8 million by 2060 (2024 Alzheimer’s Disease Facts and Figures, 2024). Caregiving for dementia patients is a challenging responsibility for many family caregivers. Previous studies reported higher burden and stress and experiences of more depressive symptoms among dementia caregivers than nondementia caregivers (Sheehan et al., 2021). Factors associated with family caregivers’ burden are related to patients’ condition, such as cognitive impairment, behavioral problems and self-rated health, as well as social connection which includes social support, family relationship and family functions (Han et al., 2014). This scoping review aims to identify coping strategies practiced among family caregivers of dementia patients by systematically mapping the existing literature.

Methods: The review employed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) (Tricco et al., 2018). Five relevant databases were used: APA PsycInfo, Academic Search Premiere, Abstracts in Gerontology, Medline, and PubMed. A set of key terms was used for the search such as coping, dementia patients, and informal caregivers. Peer-reviewed journal articles published in English between 2015 and 2025 were initially identified. From an initial search result of 1391 articles, a total of 714 articles were identified (after removing all duplicate) for title and abstract review. Final search was completed (date). A set of inclusion and exclusion criteria was applied, and two reviewers independently conducted a blind review. A total of 99 articles were included for full text screening. Throughout the review, a third author was involved in resolving any article selection conflict between two primary reviewers.

Results: A total of 17 articles that met all inclusion criteria were analyzed. Three reviewers independently extracted data from the articles. The extracted data were then integrated, synthesized and categorized into thematically representative themes. The analysis revealed three main coping styles employed by family caregivers of individuals with dementia: (i) problem-solving coping, (ii) emotional coping and (iii) avoidance coping each encompassing several subthemes related to coping strategies. Problem solving coping included strategies such as seeking social and other instrumental support, planning and organizing responsibilities, self-care, and role-based skill learning. Emotional coping involved religious and spiritual practice and love and empathy-based coping. Avoidance coping involved the use of distractions and keeping busy, and withdrawals and ignorance.

Conclusions and Implications: The findings reflect that family carers adopt a range of coping strategies to manage their caregiving responsibilities and deal with stress and burden. Caregivers often adopt a pragmatic approach trying with different coping strategies to see what works best for patients’ and their own care. The study also finds that existing literature lacks mixed-method and longitudinal studies to investigate commonly practiced coping strategies for dementia caregiving. Reflecting the gaps in existing literature, future research should also examine how sociocultural and individual differences as well as availability of resources affect caregivers’ coping.