Occupational therapy for people with dementia transitioning to residential care: A scoping review

This scoping review aims to describe the literature about the experiences of family caregivers and persons living with dementia transitioning into residential care facilities; and to identify missed opportunities for occupational therapy to support this transition.

The methodological framework proposed by Arksey and O'Malley guided the review. Six electronic databases were systematically searched for peer-reviewed studies published between Jan 2017 and June 2024 including people with dementia aged 65+ years prior to, during and post-admission to a residential care facility and/or family caregiver.

Twenty-three studies met the inclusion criteria, reporting research from Australia, Europe and North America. Family caregivers and people with dementia face multiple challenges prior to, during, and after admission to a residential care facility. Four overarching themes were identified; (1) Factors during the transition process with two subthemes: caregiver perceptions and heightened emotions; (2) Trying to get help; (3) Effectiveness of transition interventions; and (4) Unmet needs. Families feel overwhelmed, uncertainty about accessing residential care, guilt about relinquishing care and role loss post-admission. Persons living with dementia report experiencing a loss of autonomy and connection with their family, staff and co-residents. The understanding of dynamics and relationships during transitions can impact health and well-being, highlighting the importance of tailored support from various healthcare professionals, including occupational therapists.

Findings suggest that the transition into a residential care facility is complex and filled with emotional, psychological, familial and functional changes. Navigating these changes represents a unique opportunity for occupational therapists to utilise their distinctive skill set to navigate this transition and support the health and well-being of caregivers and persons living with dementia.