Good practice in the provision of care for people living with dementia in nursing homes: a systematic review

Abstract

Background The number of people living with dementia across the world is rising, and there is a high and ever increasing proportion of people with dementia living in nursing homes. It is increasingly important that care provision in these services accounts for the specific needs of this cohort. Manifestations of dementia are modifiable with high quality dementia specific care, as such, we need to understand what good practice looks like specifically in these settings. Aim To synthesise empirical research to identify the characteristics of quality in the provision of care for people living with dementia in nursing homes. Methods Four electronic academic databases were searched: Business Complete, CINAHL, MEDLINE and APA PsychInfo. Qualitative, quantitative or mixed-methods studies published between the years of 2020-2023, that aimed to identify determinants of high quality care for people with dementia living in nursing homes, were included. Themes relating to good practices were identified and narratively summarised. Vignettes illustrating good practice were constructed from the perspective of a provider, a staff member, a resident and a family member. Results After screening of 3,356 records, 30 articles were included. This included 16 qualitative descriptive studies, 11 cross-sectional studies, 2 mixed methods studies, and 1 cohort study. Sixteen themes were identified: determinants of care quality, outcomes, person-centred care, cultural impact, care planning, meaningful engagement, eating and meals, the role of family members, restrictive practices, psychotropic medications, activities, materials, health care, end of life care, staffing and staff training. Conclusions The literature identifies what constitutes high quality care for residents with dementia in nursing homes. These findings will guide those delivering care in nursing homes in their daily work and in the implementation of quality improvement processes. It will also direct regulators, policymakers and researchers when conducting future work in this important area.