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dc.contributor.authorDawson, Alisonen_UK
dc.contributor.authorBowes, Alisonen_UK
dc.contributor.authorKelly, Fionaen_UK
dc.contributor.authorVelzke, Karien_UK
dc.contributor.authorWard, Richarden_UK
dc.description.abstractBackground: This paper synthesises research evidence about the effectiveness of services intended to support and sustain people with dementia to live at home, including supporting carers. The review was commissioned to support an inspection regime and identifies the current state of scientific knowledge regarding appropriate and effective services in relation to a set of key outcomes derived from Scottish policy, inspection practice and standards. However, emphases on care at home and reduction in the use of institutional long term care are common to many international policy contexts and welfare regimes. Methods: Systematic searches of relevant electronic bibliographic databases crossing medical, psychological and social scientific literatures (CINAHL, IngentaConnect, Medline, ProQuest, PsychINFO and Web of Science) in November 2012 were followed by structured review and full-text evaluation processes, the latter using methodology-appropriate quality assessment criteria drawing on established protocols. Results: Of 131 publications evaluated, 56 were assessed to be of ‘high' quality, 62 of ‘medium' quality and 13 of ‘low' quality. Evaluations identified weaknesses in many published accounts of research, including lack of methodological detail and failure to evidence conclusions. Thematic analysis revealed multiple gaps in the evidence base, including in relation to take-up and use of self-directed support by people with dementia, use of rapid response teams and other multidisciplinary approaches, use of technology to support community-dwelling people with dementia, and support for people without access to unpaid or informal support. Conclusions: In many areas, policy and practice developments are proceeding on a limited evidence base. Key issues affecting substantial numbers of existing studies include: poorly designed and overly narrowly focused studies; variability and uncertainty in outcome measurement; lack of focus on the perspectives of people with dementia and supporters; and failure to understanding the complexities of living with dementia, and of the kinds of multifactorial interventions needed to provide holistic and effective support. Weaknesses in the evidence base present challenges both to practitioners looking for guidance on how best to design and deliver evidence-based services to support people living with dementia in the community and their carers and to those charged with the inspection of services.en_UK
dc.publisherBioMed Centralen_UK
dc.relationDawson A, Bowes A, Kelly F, Velzke K & Ward R (2015) Evidence of what works to support and sustain care at home for people with dementia: A literature review with a systematic approach. BMC Geriatrics, 15 (1), Art. No.: 59.
dc.rights© 2015 Dawson et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.en_UK
dc.subjectCare at homeen_UK
dc.titleEvidence of what works to support and sustain care at home for people with dementia: A literature review with a systematic approachen_UK
dc.typeJournal Articleen_UK
dc.citation.jtitleBMC Geriatricsen_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderCare Inspectorateen_UK
dc.contributor.affiliationApplied Social Scienceen_UK
dc.contributor.affiliationDementia and Ageingen_UK
dc.contributor.affiliationBournemouth Universityen_UK
dc.contributor.affiliationDementia Services Development Centreen_UK
dc.contributor.affiliationDementia and Ageingen_UK
dc.relation.funderprojectPromotion of dementia standards: literature reviewen_UK
dc.subject.tagDementia and Service Provisionen_UK
dc.subject.tagDementia Care: Improvingen_UK
dc.subject.tagDementia Researchen_UK
dc.subject.tagDementia Servicesen_UK
dc.subject.tagService Quality in the Public Sectoren_UK
dc.subject.tagSystematic reviewen_UK
rioxxterms.typeJournal Article/Reviewen_UK
local.rioxx.authorDawson, Alison|0000-0002-2834-4871en_UK
local.rioxx.authorBowes, Alison|0000-0001-8594-7348en_UK
local.rioxx.authorKelly, Fiona|en_UK
local.rioxx.authorVelzke, Kari|en_UK
local.rioxx.authorWard, Richard|0000-0001-6215-7503en_UK
local.rioxx.project1112/jul/003/scswis|Care Inspectorate|en_UK
local.rioxx.filenameDawson et al_BMC Geriatrics_2015.pdfen_UK
Appears in Collections:Faculty of Social Sciences Journal Articles

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