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Homelike Models in Long Term Care: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Last updated: June 5, 2019
Project Number: RC1125-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

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

Evidence of limited quality from nine non-randomized studies suggested there was no difference between homelike and traditional models of care with respect to depression or affective state, and findings were inconsistent for cognitive functioning, quality of life, neuropsychiatric outcomes, social engagement, and functional status. Specifically, results presented in some studies suggested no difference between homelike models of care and traditional models, whereas others showed greater effectiveness and one study showed worse effectiveness for one outcome. No evidence regarding the cost-effectiveness of homelike models of care for long-term care residents or relevant evidence-based guidelines were identified.