title: Models of home care services for persons with dementia: a narrative review.
abstract: BACKGROUND
  Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care.
  
  
  METHODS
  We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs.
  
  
  RESULTS
  Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study.
  
  
  CONCLUSIONS
  There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.
authors: Faculty of Health Sciences,University of Sydney,Room M309B,M Block,75 East St,Lidcombe,NSW 2141,Australia.
authors: Lee-Fay
authors: LF
authors: Low
authors: Faculty of Health Sciences,University of Sydney,RM303,M Block,75 East St,Lidcombe,NSW 2141,Australia.
authors: Jennifer
authors: J
authors: Fletcher
mesh_terms: D019090:Case Management; D019033:Delivery of Health Care, Integrated; D003704:Dementia / Q000451:nursing*; D006699:Home Care Services / Q000145:classification*; D006801:Humans; D008962:Models, Theoretical; D057240:Patient Preference; D011788:Quality of Life
keywords: Alzheimer’s disease; aged care; community care; dementia; service delivery