'There's no place like home' - A scoping review on the impact of home-like residential care models on resident-, family- and staff-related outcomes

Background: There is increasing emphasis on promoting ‘home-like’ residential care models enabling care-dependent people to continue living in a self-determined manner. Yet, little is known about the outcomes of home-like residential care models. Purpose: We aimed to (1) identify home-like residential care models for older care-dependent people with and without dementia and (2) explore the impact of these models on resident-, family- and staff-related outcomes. Design and Methods: We applied a scoping review method and conducted a comprehensive literature search in PubMed, Embase and CINAHL in May, 2015.Results: We included 14 studies, reported in 21 articles. Studies were conducted between 1994 and 2014, most using a quasi-experimental design and comparing the Eden Alternative (n=5), non-dementia specific small houses, e.g. Green House® homes (n=2), and dementia specific small houses (n=7) with usual care in traditional nursing homes. The studies revealed evidence of benefit related to physical functioning of residents living in dementia-specific small houses and satisfaction with care of residents living in non-dementia-specific small houses compared with those living in traditional nursing homes. We did not find other significant benefits related to physical and psychosocial outcomes of residents, or in family- and staff-related outcomes. Implications: The current evidence on home-like residential care models is limited. Comparative-effectiveness research building on a clear theoretical framework and/or logic model and including a standardized set of resident-, family- and staff-related outcomes, as well as cost evaluation, is needed to provide a stronger evidence base to justify the uptake of more home-like residential care models.