Janet I Mitchell1, Janet C Long2, Jeffrey Braithwaite3, Henry Brodaty4. 1. Dementia Collaborative Research Centre, School of Psychiatry, UNSW Australia, Sydney, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia. Electronic address: j.mitchell@student.unsw.edu.au. 2. Faculty of Medicine, John Walsh Centre for Rehabilitation Research, the University of Sydney, Australia. 3. Faculty of Medicine and Health Sciences, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia; Centre for Healthcare Resilience and Implementation Science, Macquarie University, Sydney, Australia. 4. Dementia Collaborative Research Centre, School of Psychiatry, UNSW Australia, Sydney, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Australia, Sydney, Australia; Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia.
Abstract
BACKGROUND: Dementia is a syndrome associated with stigma and social isolation. Forty-two percent of people with dementia in the United States and almost 40% in the United Kingdom live in assisted living and residential care facilities. Up to 90% of residents with dementia experience behavioral and psychological symptoms of dementia (BPSD). Currently psychotropic drugs are often used to manage BPSD, despite the drugs' limited efficacy and adverse effects. Even though psychosocial approaches are as effective as medical ones without side effects, their uptake has been slow. Social networks that investigate the structure of relationships among residents and staff may represent an important resource to increase the uptake of psychosocial approaches and facilitate improvements in care. OBJECTIVES: To conduct a systematic review of social network studies set in long-term care (LTC), including residents with dementia, and identify network factors influencing the care available to residents. METHOD: Peer-reviewed articles across CINAHL, EMBASE, IBSS, Medline, PsychInfo, Scopus, and Web of Science were searched from January 1994 to December 2014 inclusive, using PRISMA guidelines. Studies included those examining social networks of residents or staff in LTC. RESULTS: Nine articles from studies in the United States, Europe, Asia, and Australia met search criteria. Resident networks had few social connections. One study proposed that residents with high centrality be encouraged to welcome new residents and disseminate information. The high density in 2 staff network studies was associated with the cooperation needed to provide care to residents with dementia. Staff's boundary-spanning led to higher-status nurses becoming more involved in decision-making and problem-solving in one study. In another, the outcome was staff treating residents with more respect and actively caring for them. CONCLUSION: These studies suggest interventions using a network approach may improve care services in LTC.
BACKGROUND:Dementia is a syndrome associated with stigma and social isolation. Forty-two percent of people with dementia in the United States and almost 40% in the United Kingdom live in assisted living and residential care facilities. Up to 90% of residents with dementia experience behavioral and psychological symptoms of dementia (BPSD). Currently psychotropic drugs are often used to manage BPSD, despite the drugs' limited efficacy and adverse effects. Even though psychosocial approaches are as effective as medical ones without side effects, their uptake has been slow. Social networks that investigate the structure of relationships among residents and staff may represent an important resource to increase the uptake of psychosocial approaches and facilitate improvements in care. OBJECTIVES: To conduct a systematic review of social network studies set in long-term care (LTC), including residents with dementia, and identify network factors influencing the care available to residents. METHOD: Peer-reviewed articles across CINAHL, EMBASE, IBSS, Medline, PsychInfo, Scopus, and Web of Science were searched from January 1994 to December 2014 inclusive, using PRISMA guidelines. Studies included those examining social networks of residents or staff in LTC. RESULTS: Nine articles from studies in the United States, Europe, Asia, and Australia met search criteria. Resident networks had few social connections. One study proposed that residents with high centrality be encouraged to welcome new residents and disseminate information. The high density in 2 staff network studies was associated with the cooperation needed to provide care to residents with dementia. Staff's boundary-spanning led to higher-status nurses becoming more involved in decision-making and problem-solving in one study. In another, the outcome was staff treating residents with more respect and actively caring for them. CONCLUSION: These studies suggest interventions using a network approach may improve care services in LTC.
Authors: Barbara Resnick; Elizabeth Galik; Ann Kolanowski; Kimberly Van Haitsma; Jeanette Ellis; Liza Behrens; Nina M Flanagan; Caroline McDermott Journal: J Am Med Dir Assoc Date: 2017-11-28 Impact factor: 4.669