Age and Ageing 2017; 46: iii1–iii12 doi: 10.1093/ageing/afx145.28
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Oral presentations 152
KEY STAKEHOLDERS’ EXPERIENCES OF RESPITE SERVICES FOR PEOPLE WITH DEMENTIA AND THEIR PERSPECTIVES ON SERVICE DEVELOPMENT: A SYSTEMATIC REVIEW AND META-ETHNOGRAPHY
Emma O’Shea1, Suzanne Timmons2, Eamon O’Shea3, Siobhan Fox2, Kate Irving1 School of Nursing & Human Sciences, Dublin City University, Dublin, Ireland 2 Centre for Gerontology & Rehabilitation, University College Cork, Cork, Ireland 3 Irish Centre for Social Gerontology, National University of Ireland, Galway, Galway, Ireland
Background: It is important to understand how we can develop health and social care services, which can support people with dementia (PwD) to age in place, in a way that is acceptable to clients, and feasible as regards implementation. Therefore, this study aims to understand key stakeholders’ experiences of respite services for PwD, and their perspectives on service development. Method: A systematic search was conducted of the Pubmed/MedLine, Embase, Cinahl, PsychInfo, Scopus, Web of Science, and Cochrane databases (1980–2016, English) with
ﬁxed search terms relating to ‘respite’ and ‘dementia’, following PRISMA guidelines. Noblit and Hare’s meta-ethnography was employed. Key concepts were identiﬁed, reciprocal and refutational translation techniques were applied to primary studies, and ﬁndings were synthesised into third order interpretations, leading to a ‘line-of-argument’. Results: In total 23 papers were reviewed, which described 20 independent samples across 12 countries. The views of 889 participants were synthesised (13 PwD,690 carers, 44 ‘service providers’, 52 frontline staff, 70 managers, 12 volunteers, 6 academic/policymakers, 2 independent consultants). Five key concepts were identiﬁed: 1) the transition to service use 2) expanding organisational capacity 3) dementia care quality 4) building a collaborative care partnership and 5) dyad restoration. While there was broad stakeholder agreement around the key areas for development, there was divergence around the level at which they should be implemented (i.e. service[clients] vs. system[providers]), and the key implementation barriers (i.e. resources/infrastructure[providers] vs. reluctance to change[management]).In this way, a level of organisational tension was evident between frontline staff and management, impeding the organisational cultural change necessary to facilitate service development in line with dyad’s needs/preferences. Conclusion: Service managers must endeavour to build organisational capacity with frontline staff to facilitate restorative experiences for dyads, ﬁrstly by minimising withinservice organisational tension, and secondly, by leading on and fostering a collaborative solution-focused culture of care, which acknowledges the centrality of the dyad.