Risks and risk mitigation in homecare for people with dementia - a two-sided matter: A systematic review

Backhouse, Tamara ORCID: https://orcid.org/0000-0001-8194-4174, Ruston, Annmarie, Killett, Anne ORCID: https://orcid.org/0000-0003-4080-8365, Ward, Renée, Rose-Hunt, Julia and Mioshi, Eneida (2022) Risks and risk mitigation in homecare for people with dementia - a two-sided matter: A systematic review. Health & Social Care in the Community, 30 (6). pp. 2037-2056. ISSN 0966-0410

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Policy guidance promotes supporting people to live in their own homes for as long as possible with support from homecare services. People living with dementia who need such support can experience a range of physical and cognitive difficulties, which can increase the risks associated with homecare for this group. We aimed to examine risk and safety issues for people with dementia and their homecare workers and risk mitigation practices adopted by homecare workers to address identified risks. We searched MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, ASSIA and Cochrane Central Register of Controlled Trials databases 5 March 2021. Included studies focussed on homecare for people with dementia and had a risk or safety feature reported. Risk of bias was assessed with the Joanna Briggs Institute Critical Appraisal tools. Two authors assessed articles for potential eligibility and quality. A narrative synthesis combines the findings. The search identified 2259 records; 27 articles, relating to 21 studies, met the eligibility criteria. The review identified first-order risks that homecare workers in the studies sought to address. Two types of risk mitigation actions were reported: harmful interventions and beneficial interventions. Actions adopted to reduce risks produced intended benefits but also unintended consequences, creating second-order risks to both clients with dementia and homecare workers, placing them at greater risk. Risk mitigation interventions should be person-centred, the responsibility of all relevant professions, and planned to minimise the creation of unintended risks.

Item Type: Article
Additional Information: Research Funding: ARC EoE, NIHR Applied Research Collaboration East of England. Grant Number: ARC Capacity Funding; UEA H&SCP, University of East Anglia, Health and Social Care Partners; Alzheimer's Society. Grant Number: AS-JF-17-002.
Uncontrolled Keywords: dementia,domiciliary care,homecare,review,risk,safety,social care,social sciences (miscellaneous),sociology and political science,health policy,public health, environmental and occupational health ,/dk/atira/pure/subjectarea/asjc/3300/3301
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
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Depositing User: LivePure Connector
Date Deposited: 15 Jun 2022 11:31
Last Modified: 16 Dec 2023 02:53
URI: https://ueaeprints.uea.ac.uk/id/eprint/85634
DOI: 10.1111/hsc.13865


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