Chapter 9: Efficacy and Limitations of Training in Assertive Social Skills for Older People Caring for a Relative With Dementia

The rise in Alzheimer's due to global ageing poses significant challenges for caregivers, predominantly older women. The caregiving role often results in emotional, physical, and social tolls, leading to chronic stress, deteriorating health, and caregiver burnout. This paper focusses on the importance of assertive social competence as a coping strategy and protective factor against caregiver stress and burnout. It helps caregivers effectively interact in social contexts, managing communication difficulties, problematic behaviours and conflicts while creating supportive social networks. These skills, therefore, decrease caregiver stress and improve their mental health, leading to a better quality of life and improved patient care. Various programmes have been implemented to enhance caregivers' assertive communication, such as psycho-educational intervention programmes, online training, telehealth, and face-to-face programmes. While these have shown varying degrees of success, all indicate that self-efficacy is an essential mechanism for change. Notably, assertive social competence has been linked with improved emotional health and reduced conflicts. Despite the positive implications of assertive training for caregivers, current studies have limitations that hinder conclusive and generalisable results, including small sample sizes, inadequate follow-up periods, and participant bias. Cultural constraints and the heterogeneity of interventions also challenge comparing the results. Thus, further research is required to improve the effectiveness and generalisability of assertiveness training for caregivers.