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Models of home care services for persons with dementia: a narrative review

Published online by Cambridge University Press:  12 February 2015

Lee-Fay Low  and
Jennifer Fletcher
Lee-Fay Low*
Affiliation:
Faculty of Health Sciences, University of Sydney, Room M309B, M Block, 75 East St, Lidcombe, NSW 2141, Australia
Jennifer Fletcher
Affiliation:
Faculty of Health Sciences, University of Sydney, RM303, M Block, 75 East St, Lidcombe, NSW 2141, Australia
*
Correspondence should be addressed to: Lee-Fay Low, Associate Professor in Ageing and Health, Faculty of Health Sciences, University of Sydney, Room M309B, M Block, 75 East St, Lidcombe, NSW 2141, Australia. Phone: +61 2 9036 7368. Email: lee-fay.low@sydney.edu.au.
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Abstract

Background:

Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care.

Methods:

We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs.

Results:

Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study.

Conclusions:

There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.

Keywords

dementiaAlzheimer’s diseasecommunity careaged careservice delivery
Type
Review Article
Information
International Psychogeriatrics , Volume 27 , Special Issue 10: Psychosocial and Ethical Aspects of Dementia , October 2015 , pp. 1593 - 1600
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Alzheimer's Society (2011). Support. Stay. Save. Care and Support of People with Dementia in their Own Homes. UK: Alzheimers's Society.Google Scholar
Australian Institute of Health and Welfare (2012). Residential Aged care in Australia 2010–11: A Statistical Overview. Aged care statistics series. Canberra: Australian Institute of Health and Welfare.Google Scholar
Beerens, H. C.et al. (2014). Quality of life and quality of care for people with dementia receiving long term institutional care or professional home care: the European RightTimePlaceCare study. Journal of the American Medical Directors Association, 15, 54–61. doi: 10.1016/j.jamda.2013.09.010.CrossRefGoogle ScholarPubMed
Beland, F. and Hollander, M. J. (2011). Integrated models of care delivery for the frail elderly: international perspectives. Gaceta Sanitaria, 25 (Suppl. 2), 138–146. doi: 10.1016/j.gaceta.2011.09.003.CrossRefGoogle ScholarPubMed
Beland, F.et al. (2006). Integrated services for frail elders (SIPA): a trial of a model for Canada. Canadian Journal on Aging, 25, 5–42. doi: 10.1353/cja.2006.0019.CrossRefGoogle Scholar
Bernabei, R.et al. (1998). Randomised trial of impact of model of integrated care and case management for older people living in the community. BMJ, 316, 1348–1351. doi: 10.1136/bmj.316.7141.1348.CrossRefGoogle ScholarPubMed
Brijnath, B. (2012). Why does institutionalised care not appeal to Indian families? Legislative and social answers from urban India. Ageing and Society, 32, 697–717. doi: 10.1017/S0144686X11000584.CrossRefGoogle Scholar
Carlson, B. L., Foster, L., Dale, S. B. and Brown, R. (2007). Effects of cash and counseling on personal care and well-being. Health Services Research, 42, 467–487. doi: 10.1111/j.1475-6773.2006.00673.x.CrossRefGoogle ScholarPubMed
Case Management Society of America (2008). Glossary/FAQ's.Google Scholar
Chatterji, P., Burstein, N. R., Kidder, D. and White, A. (1998). Evaluation of the Program of All-Inclusive Care for the Elderly (PACE) Demonstration: The impact of PACE on participant outcomes. Cambridge, MA: Abt Associates.Google Scholar
Department of Health and Ageing (2012). Evaluation of the consumer-directed care initiative – Final Report. In Ageing, D. o. H. a. (Ed.): KPGM.Google Scholar
Department of Health, UK (2012). Caring for our Future: Reforming Care and Support. In Health, D. o. (Ed.) London: The Stationary Office Ltd.Google Scholar
Dubuc, N., Dubois, M. F., Rache, M., Gueye, N. and Hébert, R. (2011). Meeting the home-care needs of disabled older persons living in the community: does integrated services delivery make a difference? BMC Geriatrics, 11, 67. doi: 10.1186/1471-2318-11-67.CrossRefGoogle Scholar
Eloniemi-Sulkava, U., Notkola, I. L., Hentinen, M., Kivela, S. L., Sivenius, J. and Sulkava, R. (2001). Effects of supporting community-living demented patients and their caregivers: a randomized trial. Journal of the American Geriatrics Society, 49, 1282–1287. doi: 10.1046/j.1532-5415.2001.49255.x.CrossRefGoogle ScholarPubMed
Galik, E. M., Resnick, B., Gruber-Baldini, A., Nahm, E.-S., Pearson, K. and Pretzer-Aboff, I. (2008). Pilot testing of the restorative care intervention for the cognitively impaired. Journal of the American Medical Directors Association, 9, 516–522. doi: 10.1016/j.jamda.2008.04.013.CrossRefGoogle ScholarPubMed
Giannini, R.et al. (2007). Outcomes from a program of home care attendance in very frail elderly subjects. Archives of Gerontology and Geriatrics, 44, 95–103. doi: 10.1016/j.archger.2006.03.002.CrossRefGoogle ScholarPubMed
Glendinning, C.et al. (2008). Evaluation of the Individual Budgets Pilot Programme. London: Individual Budgets Evaluation Network.Google Scholar
Grabowski, D. C. (2006). The cost-effectiveness of noninstitutional long-term care services: review and synthesis of the most recent evidence. Medical Care Research and Review, 63, 3–28. doi: 10.1177/1077558705283120.CrossRefGoogle ScholarPubMed
Hebert, R., Durand, P. J., Dubuc, N. and Tourigny, A. (2003). PRISMA: a new model of integrated service delivery for the frail older people in Canada. International Journal of Integrated Care, 3, e08.CrossRefGoogle ScholarPubMed
Hébert, R., Raîche, M., Dubois, M. F., Gueye, N. R., Dubuc, N. and Tousignant, M. (2010). Impact of PRISMA, a coordination-type integrated service delivery system for frail older people in Quebec (Canada): a quasi-experimental study. Journals of Gerontology – Series B Psychological Sciences and Social Sciences B, 65, 107–118. doi: 10.1093/geronb/gbp027.CrossRefGoogle Scholar
Jansen, A. P. D.et al. (2011). Effectiveness of case management among older adults with early symptoms of dementia and their primary informal caregivers: a randomized clinical trial. International Journal of Nursing Studies, 48, 933–943. doi: 10.1016/j.ijnurstu.2011.02.004.CrossRefGoogle ScholarPubMed
Jansen, L.et al. (2009). Formal care providers’ perceptions of home- and community-based services: informing dementia care quality. Home Health Care Services Quarterly, 28, 1–23. doi: 10.1080/01621420802700952.CrossRefGoogle ScholarPubMed
Khanassov, V., Vedel, I. and Pluye, P. (2014). Case management for dementia in primary health care: a systematic mixed studies review based on the diffusion of innovation model. Journal of Clinical Interventions in Aging, 9, 915–928. doi: 10.2147/CIA.S64723.CrossRefGoogle ScholarPubMed
King, A., Parsons, M., Robinson, E. and Jörgensen, D. (2012). Assessing the impact of a restorative home care service in New Zealand: a cluster randomised controlled trial. Health and Social Care in the Community, 20, 365–374. doi: 10.1111/j.1365-2524.2011.01039.x.CrossRefGoogle ScholarPubMed
Knapp, M.et al. (2007). Dementia UK: The Full Report. In Society, A. s. (Ed.) London.Google Scholar
Koch, T.et al. (2012). The potential of case management for people with dementia: a commentary. International Journal of Geriatric Psychiatry, 27, 1305–1314. doi: 10.1002/gps.3783.CrossRefGoogle ScholarPubMed
Kodner, D. L. (2003). Consumer-directed services: lessons and implications for integrated systems of care. International Journal of Integrated Care, 3, e12.CrossRefGoogle ScholarPubMed
Kodner, D. L. (2006). Whole-system approaches to health and social care partnerships for the frail elderly: an exploration of North American models and lessons. Health and Social Care in the Community, 14, 384–390. doi: 10.1111/j.1365-2524.2006.00655.x.CrossRefGoogle ScholarPubMed
König, H. H.et al. (2014). The costs of dementia from the societal perspective: is care provided in the community really cheaper than nursing home care? Journal of the American Medical Directors Association, 15, 117–126. doi: 10.1016/j.jamda.2013.10.003.CrossRefGoogle ScholarPubMed
Lakey, L. and Saunders, T. (2011). Getting Personal? Making Personal Budgets Work for People with Dementia. UK: Alzheimer's Society.Google Scholar
Leutz, W. N. (1999). Five laws for integrating medical and social services: lessons from the United States and the United Kingdom. The Milbank Quarterly, 77, 77–110. doi: 10.1111/1468-0009.00125.CrossRefGoogle ScholarPubMed
Lewin, G. and Vandermeulen, S. (2010). A non-randomised controlled trial of the Home Independence Program (HIP): an Australian restorative programme for older home-care clients. Health and Social Care in the Community, 18, 91–99. doi: 10.1111/j.1365-2524.2009.00878.x.Google ScholarPubMed
Lewin, G.et al. (2013). Executive Summary: the modification and trial of a successful Home lndependence Program for people living with dementia (HIPD): maintaining independence and improving quality of life. http://dev.blacklight.com.au/dcrc/images/dcrc/output-files/668-668-dcrc_hipd_report_exec_summary_04092013_.pdf; last accessed September 30, 2014.Google Scholar
Low, L. F. and Brodaty, H. (2008). Access and limitations of community services for older persons: a guide for the GP. Australian Family Physician, 37, 431–436.Google Scholar
Low, L. F., White, F., Jeon, Y. H., Gresham, M. and Brodaty, H. (2012). Desired characteristics and outcomes of community care services for persons with dementia: what is important according to clients, service providers and policy? Australasian Journal on Ageing, 32, 91–96. doi: 10.1111/j.1741-6612.2012.00625.x.CrossRefGoogle Scholar
Low, L. F., Yap, M. and Brodaty, H. (2011). A systematic review of different models of home and community care services for older persons. BMC Health Services Research, 11, 93. doi: 10.1186/1472-6963-11-93.CrossRefGoogle ScholarPubMed
Lynch, M. P., Hernandez, M. and Estes, C. (2008). PACE: has it changed the chronic care paradigm? Social Work in Public Health, 23, 3–24. doi: 10.1080/19371910802162033.CrossRefGoogle ScholarPubMed
Meng, H., Friedman, B., Wamsley, B. R., Mukamel, D. and Eggert, G. M. (2005). Effect of a consumer-directed voucher and a disease-management-health-promotion nurse intervention on home care use. Gerontologist, 45, 167–176. doi: 10.1093/geront/45.2.167.CrossRefGoogle Scholar
Meret-Hanke, L. A. (2011). Effects of the program of all-inclusive care for the elderly on hospital use. Gerontologist, 51, 774–785. doi: 10.1093/geront/gnr040.CrossRefGoogle ScholarPubMed
Miller, R., Newcomer, R. and Fox, P. (1999). Effects of the Medicare Alzheimer's Disease Demonstration on nursing home entry. Health Services Research, 34, 691–714.Google ScholarPubMed
Minkman, M. M. N., Ligthart, S. A. and Huijsman, R. (2009). Integrated dementia care in the Netherlands: a multiple case study of case management programmes. Health and Social Care in the Community, 17, 485–494. doi: 10.1111/j.1365-2524.2009.00850.x.CrossRefGoogle ScholarPubMed
Moray Council (2012). Pilot Dementia Reablement Service. Moray, Scotland: Moray Council.Google Scholar
Mukamel, D. B., Bajorska, A. M. and Temkin-Greener, H. (2002). Health care services utilization at the end of life in a managed care program integrating acute and long-term care. Medical Care, 40, 1136–1148. doi: 10.1097/01.MLR.0000036427.38825.17.CrossRefGoogle Scholar
National Pace Association (2012). Who, What and Where is PACE? Virginia: National PACE Association.Google Scholar
Newcomer, R., Spitalny, M., Fox, P. and Yordi, C. (1999). Effects of the medicare Alzheimer's disease demonstration on the use of community-based services. Health Services Research, 34, 645–667.Google ScholarPubMed
Pacala, J. T., Kane, R. L., Atherly, A. J. and Smith, M. A. (2000). Using structured implicit review to assess the quality of care in the Program of All-Inclusive Care for Elderly (PACE). Journal of the American Geriatric Society, 48, 903–910.CrossRefGoogle ScholarPubMed
Parsons, J. G. M., Sheridan, N., Rouse, P., Robinson, E. and Connolly, M. (2013). A randomized controlled trial to determine the effect of a model of restorative home care on physical function and social support among older people Archives of Physical Medicine and Rehabilitation, 94, 1015–1022. doi: 10.1016/j.apmr.2013.02.003.CrossRefGoogle Scholar
Pimouguet, C., Lavaud, T., Dartigues, J. and Helmer, C. (2010). Dementia case management effectiveness on health care costs and resource utilization: a systematic review of randomized controlled trials. The Journal of Nutrition, Health and Aging, 14, 669–676. doi: 10.1007/s12603-010-0314-4.CrossRefGoogle ScholarPubMed
Reed, J., Cook, G., Childs, S. and McCormack, B. (2005). A literature review to explore integrated care for older people. International Journal of Integrated Care, 5, e17.CrossRefGoogle ScholarPubMed
Samus, Q. M.et al. (2014). A multi-dimensional home-based care coordination intevention for elders with memory disorders: the Maximising Independence at Home (MIND) pilot randomized trial. American Journal of Geriatric Psychiatry, 22, 398–414. doi: 10.1016/j.jagp.2013.12.175.CrossRefGoogle Scholar
Somme, D., Trouve, H., Dramé, M., Gagnon, D., Couturier, Y. and Saint-Jean, O. (2012). Analysis of case management programs for patients with dementia: a systematic review. Alzheimer's and Dementia, 8, 426–436. doi: 10.1016/j.jalz.2011.06.004.CrossRefGoogle ScholarPubMed
SPRU University of York and PSSRU University of Kent (2009). Care Services Efficiency Delivery Homecare Re-ablement Prospective Longitudinal Study Final Report. Department of Health.Google Scholar
Tam-Tham, H., Cepoiu-Martin, M., Ronksley, P. E., Maxwell, C. J. and Hemmelgarn, B. R. (2013). Dementia case management and risk of long-term care placement: a systematic review and meta-analysis. International Journal of Geriatric Psychiatry, 28, 889–902. doi: 10.1002/gps.3906.CrossRefGoogle ScholarPubMed
Temkin-Greener, H. and Mukamel, D. (2002). Predicting place of death in the Program of All-Inclusive Care for the Elderly (PACE): participant versus program characteristics. Journal of the American Geriatrics Society, 50, 125–135. doi: 10.1046/j.1532-5415.2002.50018.x.CrossRefGoogle ScholarPubMed
van der Roest, H. G.et al. (2009). What do community-dwelling people with dementia need? A survey of those who are known to care and welfare services. International Psychogeriatrics, 21, 949–965. doi: 10.1017/S1041610209990147.CrossRefGoogle Scholar
Verkade, P. J., Van Meijel, B., Brink, C., Van Os-Medendorp, H., Koekkoek, B. and Francke, A. L. (2010). Delphi-research exploring essential components and preconditions for case management in people with dementia. BMC Geriatrics, 10, 54. doi: 10.1186/1471-2318-10-54.CrossRefGoogle Scholar
Vickrey, B. G.et al. (2006). The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial. Annals of Internal Medicine, 145, 713–726.CrossRefGoogle ScholarPubMed
von Kutzleben, M., Schmid, W., Halek, M., Holle, B. and Bartholomeyczik, S. (2012). Community-dwelling persons with dementia: what do they need? What do they demand? What do they do? A systematic review on the subjective experiences of persons with dementia. Aging and Mental Health, 16, 378–390. doi: 10.1080/13607863.2011.614594.CrossRefGoogle ScholarPubMed
Weber, S. R., Pirraglia, P. A. and Kunik, M. E. (2011). Use of services by community-dwelling patients with dementia: a systematic review. American Journal of Alzheimer's Disease and Other Dementias, 26, 195–204. doi: 10.1177/1533317510392564.CrossRefGoogle ScholarPubMed
Wiener, J. M. (2007). Commentary: cash and counseling in an international context. Health Services Research, 42, 567–576. doi: 10.1111/j.1475-6773.2006.00695.x.CrossRefGoogle Scholar
Woolrych, R. and Sixsmith, J. (2013). Toward integrated services for dementia: a formal carer perspective. Journal of Integrated Care, 21, 208–220. doi: 10.1108/JICA-02-2013-0006.CrossRefGoogle Scholar
World Health Organisation (2008). Integrated health services – what and why.Google Scholar
World Health Organization and Alzheimer's Disease International (2012). Dementia: A public health priority. UK: World Health Organization.Google Scholar
Wübker, A.et al. (2014). Costs of care for people with dementia just before and after nursing home placement: primary data from eight European countries. European Journal of Health Economics, doi: 10.1007/s10198-014-0620-6.CrossRefGoogle Scholar
You, E., Dunt, D. R., White, V., Vander Hoorn, S. and Doyle, C. (2014). Risk of death or hospital admission among community-dwelling older adults living with dementia in Australia. BMC Geriatrics, 14, 71. doi: 10.1186/1471-2318-14-71.CrossRefGoogle ScholarPubMed