Related Experiment Video
Updated: Apr 4, 2026
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Barriers and facilitators to home-based end-of-life care for people with dementia: A meta-ethnographic study
Guo Yin1, Divya Sivaramakrishnan1, Yajing Wang1
1Nursing Studies, School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom.
Background:
Achieving a "good death" at home for people with dementia remains an aspiration rather than a reality. Despite the preference for home-based end-of-life care among people with dementia and their families, institutional deaths continue to predominate.
Objectives:
This review aims to systematically synthesize qualitative evidence to identify the barriers and facilitators influencing home-based end-of-life care for people with dementia and to develop a conceptual framework integrating these complex factors.
Methods:
Qualitative evidence synthesis using a meta-ethnographic approach. A systematic search was conducted in PubMed, MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and the Cochrane Library in October 2024. Study quality was assessed using the CASP tool, and confidence in the review findings was assessed using GRADE-CERQual.
Results:
Six core themes were identified through the synthesis of data from 17 studies. System-level factors included ambiguous and obstructed entry points for end-of-life care, strained supply, financial thresholds for care services, and unstable care support. Family-level factors involved powerlessness in perceiving and seeking care and the limits of family capacity. Based on these findings, a conceptual framework was developed, which comprehensively presents the complexity of home-based end-of-life care for people with dementia.
Conclusions:
Home-based end-of-life care for people with dementia remains a "long and challenging journey." Future research should pay greater attention to factors that enable and strengthen service provision and to feasible ways of implementing such care. Additionally, the existing evidence mainly comes from developed countries in the Global North and is largely based on the perspectives of family caregivers and healthcare professionals. Future research needs to incorporate the perspectives of people with dementia and pay attention to the context of low- and middle-income countries.
Registration:
The review protocol was registered with PROSPERO (CRD42024578005).
More Related Videos
06:25Capturing Representative Hand Use at Home Using Egocentric Video in Individuals with Upper Limb Impairment
Published on: December 23, 2020
11:21Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
Published on: July 27, 2018
Related Concept Videos
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:25Continuing Care
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:30Ethical Dilemmas II
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:30Dementia
The progression of dementia is generally gradual....