Is there an "optimal time" to move to a care home for a person with dementia? A systematic review of the literature

Abstract

ABSTRACTBackground:There is limited evidence regarding how the decision evolves about whether and when it is best for a person with dementia to move to a care home. The factors leading to the timing of the decision remain particularly unclear. This systematic review of existing literature aims to gain an understanding of the decision-making timing and process to distinguish the drivers of these decisions, and to identify if there is an "optimal" or best time (if any) for a person with dementia to move to a care home.

Methods: Six English language electronic databases were searched up to the end of 2016, along with included papers' reference lists. Papers were screened against the inclusion criteria and rated for quality. Extracted data were thematically analyzed.

Results: The review identified 16 relevant papers. Seven themes were identified: (1) what happened before the move; (2) planning for the move, (3) weighing up the decision, (4) lack of support, (5) drivers of the decision, (6) emotional significance of the move, and (7) continued reflection on the decision. "Time" of the move was largely absent from much of the literature, although inferences were made. Overall, the decision-making process appeared to be cyclic, with family carers constantly re-evaluating when might be the time to make the move with some continuing to reflect on this even subsequently.

Conclusions: Further research is required to understand the "optimal" or best time (if any) for when a person with dementia moves to a care home, and how to determine when someone is ready to move.

Keywords: care home; care-transition; carers; decision-making; dementia; review.