Homelike Models of Long-Term Care: A 2021 Update


( Last Updated : November 26, 2021)
Project Status:
Completed
Project Line:
Health Technology Review
Project Sub Line:
Rapid Review
Project Number:
RC1393-000

Details


Question

  1. What is the clinical effectiveness of homelike models of care (e.g., Eden Alternative and Greenhouse Concepts of Care) for residents of long-term care facilities?
  2. What is the cost-effectiveness of homelike models of care for residents of long-term care facilities?
  3. What are the evidence-based guidelines for homelike models of care for residents of long-term care facilities?

Key Message

Among residents with dementia, positive effects of small-scale homelike models of care on social interaction were observed in 1 non-randomized study, whereas the evidence from relevant primary studies captured in 1 systematic review was mixed. Residents with dementia living in small-scale homelike care facility compared with a traditional nursing home may spend more time in a positive mood or engagement, based on findings from 1 non-randomized study. Evidence captured in 1 systematic review suggested lower use of restraints and psychotropic drugs in small-scale homelike settings compared with traditional nursing homes; however, a non-randomized study published in 2020 found no differences in psychotropic drug use. Associations between homelike models of care and safety outcomes (e.g., COVID-19 infection, fall injuries) suggested a benefit of small-scale homelike long-term care settings over traditional large-scale settings.