TY - JOUR
T1 - The Delivery of Person-Centered Care for People Living With Dementia in Residential Aged Care
T2 - A Systematic Review and Meta-Analysis
AU - Berkovic, Danielle E.
AU - MacRae, Ann Maria
AU - Gulline, Hannah
AU - Horsman, Phillipa
AU - Soh, Sze-Ee
AU - Skouteris, Helen
AU - Ayton, Darshini R
N1 - Funding Information:
Baptcare funded this research. D. Ayton is funded by a National Health and Medical Research Council Emerging Leader Investigator Fellowship (APP1195357). All other authors have no funding to declare.
Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America.
PY - 2024/5/1
Y1 - 2024/5/1
N2 - Background and Objectives: Person-centered care is the gold standard of care for people living with dementia, yet few systematic reviews have detailed how it is delivered in practice. This mixed-methods review aimed to examine the delivery of person-centered care, and its effectiveness, for people living with dementia in residential aged care. Research Design and Methods: A systematic review and meta-analysis. Eligible studies were identified across 4 databases. Quantitative and qualitative studies containing data on person-centered care delivered to people with dementia living in residential aged care were included. Meta-analysis using a random-effects model was conducted where more than 3 studies measured the same outcome. A narrative meta-synthesis approach was undertaken to categorize verbatim participant quotes into representative themes. Risk of bias was undertaken using quality appraisal tools from the Joanna Briggs Institute. Results: 41 studies were identified for inclusion. There were 34 person-centered care initiatives delivered, targeting 14 person-centered care outcomes. 3 outcomes could be pooled. Meta-analyses demonstrated no reduction in agitation (standardized mean difference −0.27, 95% confidence interval [CI], −0.58, 0.03), improvement in quality of life (standardized mean difference −0.63, 95% CI: −1.95, 0.70), or reduced neuropsychiatric symptoms (mean difference −1.06, 95% CI: −2.16, 0.05). Narrative meta-synthesis revealed barriers (e.g., time constraints) and enablers (e.g., staff collaboration) to providing person-centered care from a staff perspective. Discussion and Implications: The effectiveness of person-centered care initiatives delivered to people with dementia in residential aged care is conflicting. Further high-quality research over an extended time is required to identify how person-centered care can be best implemented to improve resident outcomes.
AB - Background and Objectives: Person-centered care is the gold standard of care for people living with dementia, yet few systematic reviews have detailed how it is delivered in practice. This mixed-methods review aimed to examine the delivery of person-centered care, and its effectiveness, for people living with dementia in residential aged care. Research Design and Methods: A systematic review and meta-analysis. Eligible studies were identified across 4 databases. Quantitative and qualitative studies containing data on person-centered care delivered to people with dementia living in residential aged care were included. Meta-analysis using a random-effects model was conducted where more than 3 studies measured the same outcome. A narrative meta-synthesis approach was undertaken to categorize verbatim participant quotes into representative themes. Risk of bias was undertaken using quality appraisal tools from the Joanna Briggs Institute. Results: 41 studies were identified for inclusion. There were 34 person-centered care initiatives delivered, targeting 14 person-centered care outcomes. 3 outcomes could be pooled. Meta-analyses demonstrated no reduction in agitation (standardized mean difference −0.27, 95% confidence interval [CI], −0.58, 0.03), improvement in quality of life (standardized mean difference −0.63, 95% CI: −1.95, 0.70), or reduced neuropsychiatric symptoms (mean difference −1.06, 95% CI: −2.16, 0.05). Narrative meta-synthesis revealed barriers (e.g., time constraints) and enablers (e.g., staff collaboration) to providing person-centered care from a staff perspective. Discussion and Implications: The effectiveness of person-centered care initiatives delivered to people with dementia in residential aged care is conflicting. Further high-quality research over an extended time is required to identify how person-centered care can be best implemented to improve resident outcomes.
KW - Cognitive decline
KW - Intervention studies
KW - Mixed methods
KW - Older adults
UR - http://www.scopus.com/inward/record.url?scp=85190851283&partnerID=8YFLogxK
U2 - 10.1093/geront/gnad052
DO - 10.1093/geront/gnad052
M3 - Article
C2 - 37144737
AN - SCOPUS:85190851283
SN - 0016-9013
VL - 64
JO - The Gerontologist
JF - The Gerontologist
IS - 5
M1 - gnad052
ER -