Dementia care navigation: A systematic review on different service types and their prevalence

Abstract

BackgroundDementia Care Navigators (DCNs) are professionals without clinical training, who provide individualised emotional and practical support to people living with dementia, working alongside clinical services. Navigator services have been implemented but the service offered vary without a consistent overview provided. The aim of this narrative systematic review was to describe and compare existing service formats, and to synthesise evidence regarding their implementation and impacts.MethodsThe review was registered on PROSPERO [CRD42021292518]. Three electronic databases were searched and included studies reported on a DCN service, defined as a service in which non‐clinically trained workers provide personalised advice and support to people with dementia and/or carers in the community. Two independent reviewers screened abstracts and titles and read through full papers for inclusion. Risk of bias was assessed using the Standard Quality Assessment QualSyst.ResultsWe included 14 papers reporting on six studies. All services were US‐based and only varied by integration and training provided. Studies reported different degrees of impact on service utilisation and on symptoms and mental well‐being of people with dementia and their carers, with too little evidence to draw substantial/meaningful conclusions and studies employing different outcome measures. One study evidenced greater impacts on people with more advanced dementia compared to earlier stages.ConclusionsDCN services have the potential to effectively provide non‐clinical support to people with dementia and carers from the point of diagnosis. Further research from countries other than the USA, focusing on the impact on social care and social support service access and utilisation, and utilising similar established outcome measures are required.

Perceptions and outcomes of an embedded Alzheimer Society First Link Coordinator in rural primary health care memory clinics

“…Results of the current study indicate that these strategies to counter barriers to service accessibility and use are addressed by having FLC as integral members of rural memory clinics. Our findings are consistent with the recommendation that improving access to services requires dementia care navigators to be well integrated into health and social care systems [ 28 ].…”

“…Recent reviews of dementia navigation [ 28 , 29 ] have identified some positive outcomes related to service use but agree that there is not enough evidence to make substantial conclusions. Giebel et al [ 28 ] conclude that there is mixed evidence on effectiveness of care navigation, despite studies showing sizable benefits for some outcomes, and stress the need for more evaluation of impact on care utilization and in countries outside the USA which does not have universal health coverage. Kokorelias et al [ 29 ] concluded there is strong evidence for care navigation in delaying institutionalization and outcomes such as caregiver mastery, but weak evidence for health service use and functional independence.…”