Year: 2024
Type: article
Study design: Systematic Review
Abstract: Care refusal behaviors by institutionalized older adults with dementia pose significant challenges for professional caregivers in residential care settings. This scoping review mapped the determinants and effects of care refusal in this population. A systematic search of five databases identified 19 studies published between 2013 and 2023. The findings indicated that personal, relational, environmental, and organizational factors influence care refusal behaviors in institutional settings. Cognitive impairment, communication difficulties, elderspeak, unfamiliar institutional environments, and task-oriented care were key determinants. Care refusal compromised health outcomes, disrupted care provision, and exacerbated neuropsychiatric symptoms in residential care facilities. Terminological inconsistencies and methodological limitations were identified as research gaps. Developing standardized terminology and person-centered strategies represents priority areas for coordinated action across policy, practice, and research to address the impact of refusal behaviors while upholding the rights of institutionalized older adults with dementia.
Source: Journal of Applied Gerontology
Authors: Joao Partel Araujo, Rosa Melo, Helena Amaro Luz, Catherine Van Son, Thuy-Anh Giang, Liliana Henriques, Syaakirah Noor
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,200
OpenAlex ID: W4404283970