Dietmar Ausserhofer1, Mieke Deschodt2, Sabina De Geest3, Theo van Achterberg2, Gabriele Meyer4, Hilde Verbeek5, Ingeborg Strømseng Sjetne6, Iwona Malinowska-Lipień7, Peter Griffiths8, Wilfried Schlüter9, Moriah Ellen10, Sandra Engberg11. 1. College of Health-Care Professions Claudiana, Bozen, Italy; Institute of Nursing Science, University of Basel, Basel, Switzerland. Electronic address: dietmar.ausserhofer@unibas.ch. 2. KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium. 3. Institute of Nursing Science, University of Basel, Basel, Switzerland; KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium. 4. Martin Luther University Halle-Wittenberg, Halle (Saale), Germany. 5. Maastricht University, CAPHRI School for Public Health and Primary Care, Department of Health Services Research, Maastricht, Netherlands. 6. The Knowledge Centre in Norwegian Institute of Public Health, Oslo, Norway. 7. Jagiellonian University, Krakow, Poland. 8. National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), University of Southampton, Southampton, United Kingdom. 9. European Association for Directors and Providers of Long-Term Care Services for the Elderly, Berlin, Germany. 10. Jerusalem College of Technology, Jerusalem, Israel; The Gertner Institute for Epidemiology and Health Policy Research, Tel Aviv, Israel; McMaster University, Ontario, Hamilton, Canada. 11. Institute of Nursing Science, University of Basel, Basel, Switzerland; School of Nursing, University of Pittsburgh, Pittsburgh, PA.
Abstract
BACKGROUND: There is increasing emphasis on promoting "homelike" residential care models enabling care-dependent people to continue living in a self-determined manner. Yet, little is known about the outcomes of homelike residential care models. PURPOSE: We aimed to (1) identify homelike residential care models for older care-dependent people with and without dementia, and (2) explore the impact of these models on resident-, family-, and staff-related outcomes. DESIGN AND METHODS: We applied a scoping review method and conducted a comprehensive literature search in PubMed, Embase, and CINAHL in May 2015. RESULTS: We included 14 studies, reported in 21 articles. Studies were conducted between 1994 and 2014, most using a quasi-experimental design and comparing the Eden Alternative (n = 5), nondementia-specific small houses (eg Green House homes) (n = 2), and dementia-specific small houses (n = 7) with usual care in traditional nursing homes. The studies revealed evidence of benefit related to physical functioning of residents living in dementia-specific small houses and satisfaction with care of residents living in nondementia-specific small houses compared with those living in traditional nursing homes. We did not find other significant benefits related to physical and psychosocial outcomes of residents, or in family- and staff-related outcomes. IMPLICATIONS: The current evidence on homelike residential care models is limited. Comparative-effectiveness research building on a clear theoretical framework and/or logic model and including a standardized set of resident-, family-, and staff-related outcomes, as well as cost evaluation, is needed to provide a stronger evidence base to justify the uptake of more homelike residential care models.
BACKGROUND: There is increasing emphasis on promoting "homelike" residential care models enabling care-dependent people to continue living in a self-determined manner. Yet, little is known about the outcomes of homelike residential care models. PURPOSE: We aimed to (1) identify homelike residential care models for older care-dependent people with and without dementia, and (2) explore the impact of these models on resident-, family-, and staff-related outcomes. DESIGN AND METHODS: We applied a scoping review method and conducted a comprehensive literature search in PubMed, Embase, and CINAHL in May 2015. RESULTS: We included 14 studies, reported in 21 articles. Studies were conducted between 1994 and 2014, most using a quasi-experimental design and comparing the Eden Alternative (n = 5), nondementia-specific small houses (eg Green House homes) (n = 2), and dementia-specific small houses (n = 7) with usual care in traditional nursing homes. The studies revealed evidence of benefit related to physical functioning of residents living in dementia-specific small houses and satisfaction with care of residents living in nondementia-specific small houses compared with those living in traditional nursing homes. We did not find other significant benefits related to physical and psychosocial outcomes of residents, or in family- and staff-related outcomes. IMPLICATIONS: The current evidence on homelike residential care models is limited. Comparative-effectiveness research building on a clear theoretical framework and/or logic model and including a standardized set of resident-, family-, and staff-related outcomes, as well as cost evaluation, is needed to provide a stronger evidence base to justify the uptake of more homelike residential care models.
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