Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach

摘要: This paper synthesises research evidence about the effectiveness of services intended to support and sustain people with dementia live at home, including supporting carers. The review was commissioned an inspection regime identifies current state scientific knowledge regarding appropriate effective in relation a set key outcomes derived from Scottish policy, practice standards. However, emphases on care home reduction use institutional long term are common many international policy contexts welfare regimes. Systematic searches relevant electronic bibliographic databases crossing medical, psychological social literatures (CINAHL, IngentaConnect, Medline, ProQuest, PsychINFO Web Science) November 2012 were followed by structured full-text evaluation processes, latter using methodology-appropriate quality assessment criteria drawing established protocols. Of 131 publications evaluated, 56 assessed be ‘high’ quality, 62 ‘medium’ 13 ‘low’ quality. Evaluations identified weaknesses published accounts research, lack methodological detail failure conclusions. Thematic analysis revealed multiple gaps base, take-up self-directed dementia, rapid response teams other multidisciplinary approaches, technology community-dwelling for without access unpaid or informal support. In areas, developments proceeding limited base. Key issues affecting substantial numbers existing studies include: poorly designed overly narrowly focused studies; variability uncertainty outcome measurement; focus perspectives supporters; understanding complexities living kinds multifactorial interventions needed provide holistic Weaknesses base present challenges both practitioners looking guidance how best design deliver evidence-based community their carers those charged services.