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The facilitators and challenges of dying at home with dementia: A narrative synthesis

BACKGROUND: It is reported that, given the right support, most people would prefer to die at home, yet a very small minority of people with dementia do so. At present, knowledge gaps remain on how best to support end-of-life care at home for people with dementia. AIM: To identify and understand the...

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Autores principales: Mogan, Caroline, Lloyd-Williams, Mari, Harrison Dening, Karen, Dowrick, Christopher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5967035/
https://www.ncbi.nlm.nih.gov/pubmed/29781791
http://dx.doi.org/10.1177/0269216318760442
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author Mogan, Caroline
Lloyd-Williams, Mari
Harrison Dening, Karen
Dowrick, Christopher
author_facet Mogan, Caroline
Lloyd-Williams, Mari
Harrison Dening, Karen
Dowrick, Christopher
author_sort Mogan, Caroline
collection PubMed
description BACKGROUND: It is reported that, given the right support, most people would prefer to die at home, yet a very small minority of people with dementia do so. At present, knowledge gaps remain on how best to support end-of-life care at home for people with dementia. AIM: To identify and understand the challenges and facilitators of providing end-of-life care at home for people with dementia. DESIGN: Narrative synthesis of qualitative and quantitative data. DATA SOURCES: The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic literature search was conducted across six electronic databases (AMED, BNI, CINAHL, EMBASE, MEDLINE and PsycINFO) and reference lists of key journals were searched up to July 2017. RESULTS: Searches returned 1949 unique titles, of which seven studies met all the eligibility criteria (four quantitative and three qualitative). Six key themes were identified – four facilitators and two challenges. Facilitators included ‘support from health care professionals’, ‘informal caregiver resilience and extended social networks’, ‘medications and symptom management’ and ‘appropriate equipment and home adaptations’. Challenges included ‘issues with professional services’ and ‘worsening of physical or mental health’. CONCLUSION: People with dementia may not always require specialist palliative care at the end of life. Further research is required to overcome the methodological shortcomings of previous studies and establish how community development approaches to palliative care, such as compassionate communities, can support families to allow a greater number of people with dementia to die at home.
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spelling pubmed-59670352018-06-05 The facilitators and challenges of dying at home with dementia: A narrative synthesis Mogan, Caroline Lloyd-Williams, Mari Harrison Dening, Karen Dowrick, Christopher Palliat Med Review Articles BACKGROUND: It is reported that, given the right support, most people would prefer to die at home, yet a very small minority of people with dementia do so. At present, knowledge gaps remain on how best to support end-of-life care at home for people with dementia. AIM: To identify and understand the challenges and facilitators of providing end-of-life care at home for people with dementia. DESIGN: Narrative synthesis of qualitative and quantitative data. DATA SOURCES: The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic literature search was conducted across six electronic databases (AMED, BNI, CINAHL, EMBASE, MEDLINE and PsycINFO) and reference lists of key journals were searched up to July 2017. RESULTS: Searches returned 1949 unique titles, of which seven studies met all the eligibility criteria (four quantitative and three qualitative). Six key themes were identified – four facilitators and two challenges. Facilitators included ‘support from health care professionals’, ‘informal caregiver resilience and extended social networks’, ‘medications and symptom management’ and ‘appropriate equipment and home adaptations’. Challenges included ‘issues with professional services’ and ‘worsening of physical or mental health’. CONCLUSION: People with dementia may not always require specialist palliative care at the end of life. Further research is required to overcome the methodological shortcomings of previous studies and establish how community development approaches to palliative care, such as compassionate communities, can support families to allow a greater number of people with dementia to die at home. SAGE Publications 2018-05-21 2018-06 /pmc/articles/PMC5967035/ /pubmed/29781791 http://dx.doi.org/10.1177/0269216318760442 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Articles
Mogan, Caroline
Lloyd-Williams, Mari
Harrison Dening, Karen
Dowrick, Christopher
The facilitators and challenges of dying at home with dementia: A narrative synthesis
title The facilitators and challenges of dying at home with dementia: A narrative synthesis
title_full The facilitators and challenges of dying at home with dementia: A narrative synthesis
title_fullStr The facilitators and challenges of dying at home with dementia: A narrative synthesis
title_full_unstemmed The facilitators and challenges of dying at home with dementia: A narrative synthesis
title_short The facilitators and challenges of dying at home with dementia: A narrative synthesis
title_sort facilitators and challenges of dying at home with dementia: a narrative synthesis
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5967035/
https://www.ncbi.nlm.nih.gov/pubmed/29781791
http://dx.doi.org/10.1177/0269216318760442
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