Abstract
Background
Dementia is a syndrome associated with stigma and social isolation. Forty-two percent
of people with dementia in the United States and almost 40% in the United Kingdom
live in assisted living and residential care facilities. Up to 90% of residents with
dementia experience behavioral and psychological symptoms of dementia (BPSD). Currently
psychotropic drugs are often used to manage BPSD, despite the drugs' limited efficacy
and adverse effects. Even though psychosocial approaches are as effective as medical
ones without side effects, their uptake has been slow. Social networks that investigate
the structure of relationships among residents and staff may represent an important
resource to increase the uptake of psychosocial approaches and facilitate improvements
in care.
Objectives
To conduct a systematic review of social network studies set in long-term care (LTC),
including residents with dementia, and identify network factors influencing the care
available to residents.
Method
Peer-reviewed articles across CINAHL, EMBASE, IBSS, Medline, PsychInfo, Scopus, and
Web of Science were searched from January 1994 to December 2014 inclusive, using PRISMA
guidelines. Studies included those examining social networks of residents or staff
in LTC.
Results
Nine articles from studies in the United States, Europe, Asia, and Australia met search
criteria. Resident networks had few social connections. One study proposed that residents
with high centrality be encouraged to welcome new residents and disseminate information.
The high density in 2 staff network studies was associated with the cooperation needed
to provide care to residents with dementia. Staff's boundary-spanning led to higher-status
nurses becoming more involved in decision-making and problem-solving in one study.
In another, the outcome was staff treating residents with more respect and actively
caring for them.
Conclusion
These studies suggest interventions using a network approach may improve care services
in LTC.
Keywords
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Article info
Publication history
Published online: January 05, 2016
Footnotes
The authors declare no conflicts of interest.
J.I.M. was supported in the review by a scholarship from the Dementia Collaborative Research Centre, University of New South Wales, Australia.
Identification
Copyright
© 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
