Conclusions 'Access to a befriender facilitator' is neither an effective nor a cost-effective intervention in the support of carers of people with dementia, although there is a suggestion of cost-effectiveness for the care dyad (carer and care recipient). In common with many services for carers of people with dementia, uptake of befriending services was not high. However, the small number of carers who engaged with befrienders for 6 months or more reported a reduction in scores on HADS depression that approached statistical significance compared with controls (95% CI ;0.09 to 2.84). While providing only weak evidence of any beneficial effect, further research into befriending interventions for carers is warranted.
Implications for healthcare Volunteers can be safely involved in the provision of emotional support for carers. When considering commissioning support services for carers of people with dementia, befriending schemes alone should not be commissioned, and short-term contracts should not be considered.
Recommendations for further research Additional research is required to establish: the characteristics of carers most likely to take up befriending; befriender;carer characteristics of successful matches; interplay between statutory and voluntary support services and support from families; carer well-being in the context of receipt of befriending; and placement of the care recipient in long-term residential or nursing care. Future cost-effectiveness evaluations of carer support should include outcomes for both the carer and care recipient. Further work is required on economic methods for carer intervention research.