Risk assessment for people living with dementia: a systematic review.

Hoe, Juanita ORCID: https://orcid.org/0000-0003-4647-8950, Profyri, Elena, Kemp, Charlotte, Manela, Monica, Webster, Lucy, Anthony, Justine, Costafreda, Sergi, Arrojo, Frank, Souris, Helen and Livingston, Gill (2023) Risk assessment for people living with dementia: a systematic review. International Psychogeriatrics. pp. 1-26. ISSN 1041-6102

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This systematic review identified key components of risk assessment for people with dementia, examined attitudes towards risk identification and risk assessment, and appraised existing risk assessment tools.

Systematic searches of five databases on two platforms (EBSCO, OVID) and grey literature
databases (Open Grey, Base) were conducted. Studies were screened for inclusion based on predetermined eligibility criteria and quality assessed using the Mixed Methods Appraisal Tool. Findings were tabulated and synthesised using thematic synthesis.

Our review found people with dementia, their family carers, and healthcare professionals differed in how risk is conceptualised, with views being shaped by media perceptions, personal experiences, sociocultural influences, dementia knowledge and dementia severity. We found that mobilisation (causing falls inside and getting lost outside) is the most frequently identified risk factor. Our findings show people with dementia are generally risk-tolerant, while healthcare professionals may adopt risk-averse approaches because of organisational requirements. We found factors that disrupt daily routines, living and caring arrangements, medication management, and unclear care pathways contribute towards adverse risk events. We discovered that most studies about risk and risk assessment scales did not consider insight of the person with dementia into risks although this is important for the impact of a risk. No risk instrument identified had sufficient evidence that it was useful.

Accurate risk assessment and effective communication strategies that include the perspectives of people with dementia are needed to enable risk-tolerant practice. No risk instrument to date was shown to be widely acceptable and useful in practice.

Item Type: Article
Identifier: 10.1017/S1041610223004398
Keywords: Dementia; Risk identification; Risk assessment; Home - safety; Risk enablement; Decision-making; Care-planning
Subjects: Medicine and health
Depositing User: Juanita Hoe
Date Deposited: 19 Feb 2024 09:57
Last Modified: 06 May 2024 02:45
URI: https://repository.uwl.ac.uk/id/eprint/10675


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