{Critical review of studies on social support and its relation to the well-being of people suffering from dementia}.

Many people suffering from dementia live at home, in spite of the demands that such a situation puts on those who care for them. The role of helper is usually assumed by a particular family member who is therefore more likely to feel the impact of the caregiving responsibility. Researchers are concerned with the relationship between the well-being of these helpers and their informal social support. This article presents a critical review of 21 studies of that relationship. The various dimensions of social support considered in the studies are analyzed, as are the methodological limits. A discussion of findings about the relationships between social support and well-being completes the analysis. It appears that researchers have a limited conception of social support and assess only a few of its many dimensions in a variety of ways. Very few authors explicitly specify underlying assumptions or a theory relevant to their conceptualization of social support. The weakness and the diversity of this conceptualization are reflected in the measurement tools which consist of a few ad hoc questions on social support in nearly 50% of the studies. Few studies consider the support availability, duration, conflict, and reciprocity. The buffering effect model of support is examined in one study. Inadequate sample size, unrepresentative samples, and lack of control in regard to confounding variables are among the methodological problems identified. When researchers use an evaluative approach to measure social support, the relationships between support and well-being are more often significant than when a descriptive approach is used. In future studies, researchers should be careful to better articulate the theoretical notions proposed in studies on caring for a family member with dementia at home with those coming from studies on social support in general. It is important for researchers to strengthen their study design and to carry out longitudinal studies; they must also try to understand how the influence of society works. From this perspective, one avenue for the future might involve studying the sequence of relationships between stress, support, coping strategies, and well-being. This is all the more important because at the present time certain studies on the caring of persons with dementia are based on a conceptual framework of stress. Such a framework considers support as a mediating factor.