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Barriers and facilitators to home-based end-of-life care for people with dementia: A meta-ethnographic study
Guo Yin, Divya Sivaramakrishnan, Yajing Wang, Huimin Chong, Leah Macaden. International Journal of Nursing Studies, 2026-04-01
Topic: Risk, prevention and care in population studies
Six core themes were identified through the synthesis of data from 17 studies. System-level factors included ambiguous and obstructed entry points for end-of-life care, strained supply, financial thresholds for care services, and unstable care support. Family-level factors involved powerlessness in perceiving and seeking care and the limits of family capacity. Based on these findings, a conceptual framework was developed, which comprehensively presents the complexity of home-based end-of-life care for people with dementia. Home-based end-of-life care for people with dementia remains a "long and challenging journey." Future research should pay greater attention to factors that enable and strengthen service provision and to feasible ways of implementing such care. Additionally, the existing evidence mainly comes from developed countries in the Global North and is largely based on the perspectives of family caregivers and healthcare professionals. Future research needs to incorporate the perspectives of people with dementia and pay attention to the context of low- and middle-income countries. REGISTRATION: The review protocol was registered with PROSPERO (CRD42024578005).
Key findings
- Six core themes were identified through the synthesis of data from 17 studies.
- System-level factors included ambiguous and obstructed entry points for end-of-life care, strained supply, financial thresholds for care services, and unstable care support.
- Family-level factors involved powerlessness in perceiving and seeking care and the limits of family capacity.
- Based on these findings, a conceptual framework was developed, which comprehensively presents the complexity of home-based end-of-life care for people with dementia.
- Home-based end-of-life care for people with dementia remains a "long and challenging journey." Future research should pay greater attention to factors that enable and strengthen service provision and to feasible ways of implementing such care.
Why it matters
This synthesis of 17 studies found home-based end-of-life care for people with dementia remains a long and challenging journey, with system-level and family-level barriers. It does not test any treatment, cure or prevention.
Study details
- Evidence strengthLow
How this study scored 36/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International Journal of Nursing Studies) |
| Journal's citation record | 2 / 4 | International Journal of Nursing Studies: journal h-index 210 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.5 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 3 / 6 | Cited 6.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Leah Macaden: h-index 17 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Edinburgh: institution h-index 1,378 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41930886) |
| Free to read | 2 / 2 | Free to read |
| Total | 36 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1016/j.ijnurstu.2026.105517
- PubMed: 41930886
- Original source →
- Free full text: International Journal of Nursing Studies →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Yin, G., Sivaramakrishnan, D., Wang, Y., Chong, H., & Macaden, L. (2026). Barriers and facilitators to home-based end-of-life care for people with dementia: A meta-ethnographic study. International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2026.105517
Vancouver
Yin G, Sivaramakrishnan D, Wang Y, Chong H, Macaden L. Barriers and facilitators to home-based end-of-life care for people with dementia: A meta-ethnographic study. International Journal of Nursing Studies. 2026. doi:10.1016/j.ijnurstu.2026.105517. PMID: 41930886.
BibTeX
@article{yin2026-41930886,
author = {Yin, Guo and Sivaramakrishnan, Divya and Wang, Yajing and Chong, Huimin and Macaden, Leah},
title = {{Barriers and facilitators to home-based end-of-life care for people with dementia: A meta-ethnographic study}},
journal = {International Journal of Nursing Studies},
year = {2026},
doi = {10.1016/j.ijnurstu.2026.105517},
pmid = {41930886},
url = {https://doi.org/10.1016/j.ijnurstu.2026.105517}
}
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