“There's No Place Like Home”: A Scoping Review on the Impact of Homelike Residential Care Models on Resident-, Family-, and Staff-Related Outcomes

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• 作者：Dietmar Ausserhofer ; PhD ; RN^a ; ^b ; ^{dietmar.ausserhofer@unibas.ch" class="auth_mail" title="E-mail the corresponding author} ; Mieke Deschodt ; PhD ; RN^c ; Sabina De Geest ; PhD ; RN^b ; ^c ; Theo van Achterberg ; PhD ; RN^c ; Gabriele Meyer ; PhD ; RN^d ; Hilde Verbeek ; PhD^e ; Ingeborg Strø ; mseng Sjetne ; PhD ; RN^f ; Iwona Malinowska-Lipień ; PhD ; RN^g ; Peter Griffiths ; PhD ; RN^h ; Wilfried Schlü ; ter ; PhDⁱ ; Moriah Ellen ; MBA ; PhD^j ; ^k ; ^l ; Sandra Engberg ; PhD ; RN^b ; ^m
• 关键词：Long-term care ; homelike ; small-scale ; residential facilities ; scoping review
• 刊名：Journal of the American Medical Directors Association
• 出版年：2016
• 出版时间：1 August 2016
• 年：2016
• 卷：17
• 期：8
• 页码：685-693
• 全文大小：314 K

文摘

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.