Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-06-02T02:27:56.461Z Has data issue: false hasContentIssue false
  • English
  • Français

Specialized Continuing Care Models For Persons with Dementia: A Systematic Review of the Research Literature

Published online by Cambridge University Press:  29 November 2010

Jacqueline Roberts ,
Gina Browne ,
Amiram Gafni ,
Michael Varieur ,
Patricia Loney  and
Maureen de Ruijter
Jacqueline Roberts
Affiliation:
McMaster University
Gina Browne
Affiliation:
McMaster University
Amiram Gafni
Affiliation:
McMaster University
Michael Varieur
Affiliation:
McMaster University
Patricia Loney
Affiliation:
McMaster University
Maureen de Ruijter
Affiliation:
McMaster University
Get access Rights & Permissions [Opens in a new window]

Abstract

This systematic overview summarizes the published literature reflecting the effectiveness of services or models of care for persons with dementia living in their homes, in specialized institutional care or assisted living centres/congregate homes. A detailed search for literature found studies evaluating respite care, day programs, counselling, congregate living, and special care units in institutions and there is some evidence of the effectiveness of these programs. No scientifically rigorous effectiveness studies, specific for persons with dementia, were found for hospice care, case management or psychogeriatric outreach mental health programs. First and foremost, more research is needed that examines the effectiveness of different programs for specific persons and their caregivers with different characteristics and the measurement of family expenditures as well as costs of programs.

Résumé

Cette vue d'ensemble méthodique résume la littérature publicée reflétant l'efficacité des services ou modèles de soins pour les personnes souffrant de démence vivant à la maison ou dans des centres, de soins hospitaliers spécialisés ou dans des maisons de groupe de soutien. Une recherche détaillée de la littérature nous a permis de découvrir des études évaluant les soins de répit, les programmes de jour, la thérapie, la vie en groupe et les unités de soins spéciaux dans les institutions et il y a évidence de l'efficacité de ces programmes. Aucune étude rigoureuse scientifiquement, spécifique aux personnes souffrant de démence, n'a été repérée sur l'efficacité des soins en hospice, de la gestion de cas ou des programmes en milieu externe de psychogériatrique en santé mentale. Tout d'abord, il faut davantage de recherche examinant l'efficacité des différents programmes pour personnes spécifiques et les personnes s'occupant d'elles, avec de différentes caractéristiques et les mesures des dépenses familiales ainsi que les coûts des programmes.

Keywords

DementiaLiterature ReviewContinuing CareDémencerevue de la littératuresoins prolongé
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , Issue 1 , Spring/Printemps 2000 , pp. 106 - 126
Copyright
Copyright © Canadian Association on Gerontology 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alfredson, B., & Annerstedt, L. (1994). Staff attitudes and job satisfaction in the care of demented elderly people: Group living compared to long-term care institutions. Journal of Advanced Nursing, 20, 964–974.Google Scholar
Annerstedt, L. (1993). Development and consequences of group living in Sweden. Social Science Medicine, 37(12), 1529–1538.Google Scholar
Annerstedt, L. (1994). An attempt to determine the impact of group living care in comparison to traditional long-term care on demented elderly patients. Aging Clinical Experimental Research, 6(5), 372–380.CrossRefGoogle Scholar
Annerstedt, L., Gustafson, L., & Nilsson, K. (1993). Medical outcomes of psychosocial intervention in demented patients: one-year clinical follow-up after relocation into group living units. International Journal of Geriatric Psychiatry,8, 833–841.Google Scholar
Austin, B., & Melbourne, P. (1990). Hospice services for the terminal Alzheimer's patient. Caring Magazine, 5(11), 60–62.Google Scholar
Berg, L., Buckwalter, K, Chaftetz, P, Gwyther, L., Holmes, D., Koepke, K, Lawton, M., Lindeman, D., Magaziner, J., Maslow, K., Morley, J., Ory, M., Rabins, P, Sloan, P., & Teresi, J. (1991). Special care units for person with dementia. Journal of the American Geriatric Society, 39(12), 1229–1236.CrossRefGoogle Scholar
Branch, L., Coulam, R., & Zimmerman, Y.. (1995). The PACE evaluation: initial findings. The Gerontologist, 35(3), 349–359.CrossRefGoogle Scholar
Brody, E., Saperstein, A., & Lawton, M.P. (1989). A multi-service respite program for caregivers of Alzheimer's patients. Journal of Gerontological Social Work, 14(1/2), 41–74.CrossRefGoogle Scholar
Brooks, C. (1989). Cost differences between hospice and non-hospice care. A comparison of insurer payments and provider charges. Evaluations & The Health Professions, 12(2), 159–178.CrossRefGoogle Scholar
Burdz, M., Eaton, W., & Bond, J. (1988). Effects of respite care on dementia and nondementia patients and their caregivers. Psychology and Aging, 3(1), 38–42.CrossRefGoogle Scholar
Canadian Study for Health and Aging Working Group. (1994). Canadian study of health and aging: study methods and prevalence of dementia. Canadian Medical Association Journal, 150(6), 899–912.Google Scholar
Carr, J., & Marshall, M. (1993). Innovations in long stay care for people with dementia. Reviews in Clinical Gerontology, 3, 157–167.CrossRefGoogle Scholar
Cole, M. (1988). Evaluation of psychogeriatric services. Canadian Journal of Psychiatry, 33(1), 57–58.Google Scholar
Conlin, M., Caranasos, G., & Davidson, R. (1992). Reduction of caregiver stress by respite care: a pilot study. Southern Medical Journal, 85(11), 1096–1100.Google Scholar
Coon, D. (1991). A concept in search of standards. In D., Coons (ed) Specialized Dementia Care Units. Baltimore: John Hopkins University Press.Google Scholar
naldson, C, & Gregson, B. (1989). Prolonging life at home: what is the cost? Community Medicine, 2(3), 200–209.Google Scholar
Drummond, M., Mohide, A., Tew, M., Streiner, D., Pringle, D., & Gilbert, J.R.(1991). Economic evaluation of a support program for caregivers of demented elderly. International Journal of Technology Assessment in Health Care, 7(2), 209–219.CrossRefGoogle Scholar
Engedal, K. (1989). Day care for demented patients in general nursing homes. Scandinavian Journal of Primary Health Care, 7, 161–166.CrossRefGoogle Scholar
Ernst, R., & Hay, J. (1994). The US economic and social costs of Alzheimer's Disease revisited. American Journal of Public Health, 84(8), 1261–1264Google Scholar
Guyatt, G., Sackett, D., & Cook, D. (1993) (1994). Users Guides to the Medical Literature. II How to use an article about therapy or prevention: A. Journal of the American Medical Association, 270(21), 2598–2601; B. Journal of the American Medical Association, 271(1), 59–63.CrossRefGoogle Scholar
Haynes, B., Sackett, D., Gray, J., Cook, D., & Guyatt, G. (1996). Transferring evidence from research into practice. 1. The role of clinical care research evidence into clinical decisions. Evidenced Based Medicine, Nov./Dec, 196–197.Google Scholar
Hedrick, S., Rothman, M., Chapko, M., Ehreth, J., Diehr, P., Inui, T., Connis, R.,Grover, P., & Kelly, J. (1993). Summary and discussion of methods and results of the adult day care evaluation study. Medical Care, 31(9), SS94-SS103.Google Scholar
Heyland, D., Kernerman, P., Gafni, A., & Cook, D. (1996). Economic evaluations in the critical care literature: do they help us improve the efficiency of our unit? Critical Care Medicine, 2(9), 1591–1598.Google Scholar
Holmes, D., Teresi, J., Weiner, A., Monaco, C, Ronch, J., & Vickers, R. (1990). Impacts associated with special care units in long term care facilities. The Gerontologist, 30(2), 178–183.CrossRefGoogle Scholar
Hu, T., Huang, L., & Cartwright, W. (1986). Evaluation of the costs of caring for the senile demented elderly: a pilot study. The Gerontologist, 26(2), 158–163.CrossRefGoogle Scholar
Kemper, P., Applebaum, R., & Harriagan, M. (1987). Community care demonstrations: What have we learned? Health Care Financing Review, 5(4), 87–100.Google Scholar
Lavoie, J.P. (1995). Support groups for informal caregivers don't work! Refocus the groups or the evaluations. Canadian Journal on Aging, 14(3), 580–603.Google Scholar
Lawton, M.P., Brody, E., & Saperstein, A. (1989). A controlled study of respite service for caregivers of Alzheimer's patients. The Gerontologist, 29(1),8–16.Google Scholar
Loney, P., Chambers, L., Bennett, K, Roberts, J., & Stratford, P. (1998). Critical appraisal of the health research literature: Prevalence or incidence of a health problem. Chronic Diseases of Canada, 19(4), 170–176.Google Scholar
Maas, M., Swanson, E., Specht, J., & Buckwalter, K. (1994). Alzheimer's special care units. Nursing Clinics of North America, 29(1), 173–194.CrossRefGoogle Scholar
Max, W., Webber, P., & Fox, P. (1995). Alzheimer Disease: the unpaid burden of caring. Journal of Aging and Health, 7(2), 179–199.Google Scholar
Milne, C, Sacco, C, Cetinski, G., & Roberts, J. (1992). Correlates of caregiver wellbeing with and without the use of a day programme for cognitively impaired elderly. Working Paper 92–1, System-Linked Research Unit, McMaster University, Hamilton, ON.Google Scholar
Mitchell, N. (1997). Personal communication. Care Manager of McConnell Place North of the Capital Care Group. Edmonton, Alberta.Google Scholar
Mittelman, M., Ferris, S., Shulman, E., Steinberg, G., & Levin, B. (1996). A Family Intervention to Delay Nursing Home Placement of Patients with Alzheimer Disease. JAMA, 276(21), 1725–1731.Google Scholar
Mittelman, M.S., Ferris, S.H., Steinberg, G., Shulman, E., Mackell, J.A., Ambinder, A., & Cohen, J. (1993). An intervention that delays institutionalization of Alzheimer's Disease patients: treatment of spouse-caregivers. Gerontologist, 33, 730–740.CrossRefGoogle Scholar
Mohide, E.A., Pringle, D.M., Streiner, D.L., Gilbert, J.R., Muir, G., & Tew, M.(1990). A randomized trial of family caregiver support in the home management of dementia. Journal of the American Geriatrics Society, 38, 446–454.Google Scholar
Montgomery, R. (1988). Respite care: lessons from a controlled design study. Health Care Financing Review, Annual Supplement, 133–138.Google Scholar
O'Leary, M., & Glenner, J. (1989). Parallel programming: for Alzheimer's disease and other Dementia patients. American Journal of Alzheimer's Care and Related Disorders and Research, 4(5),19–23.Google Scholar
Ostbye, T., & Crosse, E. (1994). Net economic costs of dementia in Canada. Canadian Medical Association Journal, 151(10), 1457–1464.Google Scholar
Oxman, A., Cook, D., & Guyatt, G. (1994). Users guides to the medical literature: VII. How to use an overview. JAMA, 272(11), 1367–1371.CrossRefGoogle Scholar
Reifler, B., Kethley, A., O'Neill, P., Hanley, R., Lewis, S., & Stenchever, D. (1982). Five-year experience of a community outreach program for the elderly. American Journal of Psychiatry, 139(2), 220–223.Google Scholar
Rice, D., Fox, P, Max, W., Webber, P., Lindeman, D. Hauch, W., & Sequia, E. (1993). The economic burden of A.Z. care. Data Watch, Summer, 164–176.Google Scholar
MRoberts, J., Browne, G., & Denton, M. (1995). Assessment of respite needs: caregivers of cognitively impaired persons living in the Halton Community. Final Report. New Horizons Grant, System-Linked Research Unit, McMaster University, Hamilton, ON.Google Scholar
Roberts, J., Browne, G., Milne, C, Spooner, L., Gafni, A., Watt, S., Drummond-Young, M., Legris, J., LeClair, K, Beaumont, L., & Roberts, J. (1999).Problem solving counselling for caregivers of cognitively impaired: Effective for whom? Nursing Research, 48(3), 263–272.CrossRefGoogle Scholar
Rovner, B., Steile, C, Shmuely, Y., & Folstein, M. (1996). A randomized trial of dementia care in nursing homes. JAGS, 44(1), 7–13.CrossRefGoogle Scholar
Sackett, D., Rosenberg, W., Gray, J.A., Haynes, R.B., & Richardson, W. (1996). Evidenced based medicine: what it is and what it isn't. British Medical Journal, 312, 71–72.CrossRefGoogle Scholar
Stolee, P., Kessler, L., & Le Clair, K. (1996). A community development and outreach program in geriatric mental health: four years' experience. Journal of American Geriatrics Society, 44(3), 314–320.Google Scholar
Tooth, J. (1996). Who wants a home life? Journal of Dementia Care, July/August, 12–14.Google Scholar
Volicer, L., Collard, A., Hurley, A., Bishop, C, Kern, D., & Karon, S. (1994). Impact of special care units for patients with advanced Alzheimer's disease on patients’ discomfort and costs. Journal of the American Geriatric Society, 42(6), 597–603.CrossRefGoogle Scholar
Wankel, M., Saunder, L., Pong, R., & Church, W. (1995). Building a stronger foundation: a framework for planning and evaluating community-based health services in Canada. Internet http://www.hwc.ca/datahpsb/hssa/ pln&eval.ans.Google Scholar
Weinberger, M., Gold, D., Divine, G., Cowper, P., Hodgson, L., Schrevner, M., & George, L. (1993). Expenditures in caring for patients with dementia who live at home. American Journal of Public Health, 83(3), 338–341.Google Scholar
Weissert, W., Wan, T., Livierators, B., & Katz, S. (1980). Effects and costs of day-care services for the chronically ill — a randomized experiment. Medical Care, 25(6), 567–584.CrossRefGoogle Scholar
Welch, H., Walsh, J., & Larson, E. (1992). The cost of institutional care in Alzheimer's Disease: nursing home and hospital use in a prospective cohort.Journal of the American Geriatrics Society, 40, 221–224.Google Scholar
Wells, Y., & Jorm, A. (1987). Evaluation of a special nursing home unit for dementia sufferers: A randomized controlled comparison with community care. Australian and New Zealand Journal of Psychiatry, 21, 524–531.Google Scholar
Wilson, S., Kovach, C, & Stearns, S. (1996). Hospice concepts in the care of end-stage dementia. Geriatric Nursing, 17(1), 6–10.Google Scholar
Wimo, A., Krakau, I., Mattsson, B., & Nelvig, A. (1994). The impact of cognitive decline and workload on the costs of dementia care. International Journal of Geriatric Psychiatry, 9, 479–489.CrossRefGoogle Scholar
Wimo, A., Mattsson, B., Adolfsson, R., Eriksson, T., & Nelvig, A. (1993). Dementia day care and its effects on symptoms and institutionalization-a controlled Swedish study. Scandinavian Journal of Primary Health Care, 11,117–123.Google Scholar
Wimo, A., Mattson, B., Krakau, I., Eriksson, T., Nelvig, A., & Karlsson, G. (1995).Cost-utility analysis of group living in dementia care. International Journal of Technology Assessment in Health Care, 11(1), 49–65.Google Scholar
Worrall, G., & Chambers, L. (1989). Can we afford not to evaluate services for persons with dementia. Canadian Family Physician, 35, 573–580.Google Scholar
Yesavage, J., & Brooks III, J. (1991). On the importance of longitudinal research in Alzheimer's Disease. American Geriatrics Society, 39, 942–944.Google Scholar