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A systematic review on inequalities in accessing and using community-based social care in dementia

Published online by Cambridge University Press:  12 May 2023

Clarissa Giebel Open the ORCID record for Clarissa Giebel [Opens in a new window] ,
Kerry Hanna Open the ORCID record for Kerry Hanna [Opens in a new window] ,
James Watson Open the ORCID record for James Watson [Opens in a new window] ,
Thomas Faulkner ,
Lena O’Connell ,
Sandra Smith  and
Warren James Donnellan
Clarissa Giebel*
Affiliation:
Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK NIHR Applied Research Collaboration North West Coast, Liverpool, UK
Kerry Hanna
Affiliation:
School of Health Sciences, University of Liverpool, UK
James Watson
Affiliation:
Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
Thomas Faulkner
Affiliation:
Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK NIHR Applied Research Collaboration North West Coast, Liverpool, UK Mersey Care NHS Trust, UK
Lena O’Connell
Affiliation:
Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK
Sandra Smith
Affiliation:
NIHR Applied Research Collaboration North West Coast, Liverpool, UK
Warren James Donnellan
Affiliation:
Department of Psychology, University of Liverpool, Liverpool, UK
*
Correspondence should be addressed to: Clarissa Giebel, Department of Primary Care & Mental Health, University of Liverpool, Waterhouse Building Block A, Brownlow Street, Liverpool, UK. Email: Clarissa.Giebel@liverpool.ac.uk.
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Abstract

Objectives:

To evaluate and synthesize the evidence base on barriers and facilitators to accessing and using community-based social care in dementia.

Design:

Mixed-methods systematic review.

Setting:

Community-based social care (such as day care, respite care, paid home care, and peer support groups).

Participants:

People living with dementia and unpaid carers.

Measurements:

Seven databases were searched in March 2022, including English and German evidence published from 2000 focusing on inequalities in community-based social care for dementia across the globe. Titles and abstracts were screened by two reviewers, with all full texts screened by two reviewers also. Study quality was assessed using QualSyst.

Results:

From 3,904 screened records, 39 papers were included. The majority of studies were qualitative, with 23 countries represented. Barriers and facilitators could be categorized into the following five categories/themes: situational, psychological, interpersonal, structural, and cultural. Barriers were notably more prominent than facilitators and were multifaceted, with many factors hindering or facilitating access to social care linked together.

Conclusions:

People with dementia and carers experience significant barriers in accessing care in the community, and a varied approach on multiple levels is required to address systemic and individual-level barriers to enable more equitable access to care for all.

Keywords

inequalitiessocial caredementia

Information

Type
Review Article
Information
International Psychogeriatrics , Volume 36 , Special Issue 7: Issue Theme: Health inequities in health and social care in geriatric psychiatry , July 2024 , pp. 540 - 563
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of International Psychogeriatric Association

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