gms | German Medical Science

Background and Purpose: Most people with dementia live at home and are cared for by family members. During the trajectory of dementia, creating and maintaining a stable care situation is a guiding principle of informal carers and a desirable outcome of contemporary health care policies. This study aims to theorize the complex phenomenon of stability of home-based care arrangements for people with dementia and aims to identify relevant influencing factors.

Methods: We conduct a meta-study according to Paterson and colleagues.

Research Focus: Eligible studies are identified by systematic database searches, backward and forward citation tracking, snowballing and theoretical sampling. Thematic synthesis is the leading approach for the analysis of research findings, research methods, and theoretical frameworks.

Results: N=144 studies are included. Preliminary results show that dementia itself, the interpretation and acting of all persons involved as well as the respective health care system and societal and cultural norms influence the stability of home-based care arrangements. The dynamic nature of stability is overlooked in research and there is a lack of studies with a trajectory perspective. Most quantitative studies focus on risk factors for institutionalization, but fail to comprehend the dynamics behind. Qualitative research aims at understanding informal care as a social construction, but pays little attention to its direct impact on whether or not a care arrangement can be maintained over time.

Conclusions: This meta-study illustrates how stability has been understood and approached in dementia research and it provides a sound theoretical basis to develop stability promoting interventions for the community setting.