Care Planning for Community-Dwelling People with Dementia: A Systematic Scoping Review

Table 3

Considerations during care planning for people with dementia and their care partners.

Topics and description	Person with dementia	Care partner	Author (year)
Care planning processes
Advance care plan and crisis plan	X		Brodaty (2013) [48]
			Cheffey (2013) [49]
			Chodosh (2012, 2015) [37, 38]
			Molony (2018) [27]
			Moorhouse (2014) [50]
			Unwin (2019) [52]
			Victorian Department of Health (2013) [31]
Daily maintenance plan	X		Cheffey (2013) [49]
Review care plan	X		NCCMH (2007) [2]
			Unwin (2019) [52]
			Victorian Department of Health (2013) [31]
When things decline	X		Cheffey (2013) [49]
Financial and legal	X	X	Bass (2013, 2014) [35, 36]
			Brodaty (2013) [48]
			Judge (2011) [39]
			Morhardt (2015) [47]
			NCCMH (2007) [2]
			Pierce (2010) [29]
			Victorian Department of Health (2013) [31]
Keep up to date	X		Brown (2021) [44]
Person with dementia/care partner involvement
Endorsement of plan by person with dementia and care partner	X		NCCMH (2007) [2]
Named health and social care staff-specific responsibilities and who to go to for help	X		NCCMH (2007) [2]
Recommended support services	X	X	Bass (2013, 2014) [35, 36]
			Brodaty (2013) [48]
			Cheffey (2013) [49]
			Chodosh (2012, 2015) [37, 38]
			Judge (2011) [39]
			Molony (2018) [27]
			NCCMH (2007) [2]
			Orsulic-Jeras (2019) [34]
			Pierce (2010) [29]
			Unwin (2019) [52]
			Victorian Department of Health (2012) [30]
			Victorian Department of Health (2013) [31]
Lifestyle/activities
Driving, safety to drive and medico-legal aspects	X		Brodaty (2013) [48]
			Chodosh (2012) [38]
			NCCMH (2007) [2]
			Unwin (2019) [52]
			Victorian Department of Health (2013) [31]
Exercise: physical and cognitive (CST, brain training)	X		Brodaty (2013) [48]
			Unwin (2019) [52]
			Victorian Department of Health (2013) [31]
Food, nutrition, weight gain or loss, and meals	X		Molony (2018) [27]
			Unwin (2019) [52]
Functional challenges	X		Bass (2014) [36]
			Cheffey (2013) [49]
			Chodosh (2015) [37]
			Judge (2011) [39]
			Molony (2018) [27]
			NCCMH (2007) [2]
			Orsulic-Jeras (2019) [34]
			Pierce (2010) [29]
			Unwin (2019) [52]
			Victorian Department of Health (2012) [30]
Living environment/situation	X		Bass (2014) [36]
			Brodaty (2013) [48]
			Molony (2018) [27]
			Morhardt (2015) [47]
			NCCMH (2007) [2]
			Victorian Department of Health (2012) [30]
			Toteh Osakwe (2022) [45]
Recreational activities	X		Molony (2018) [27]
			Morhardt (2015)
			Orsulic-Jeras (2019) [34]
			NCCMH (2007) [2]
Goals	X	X	Bass (2013, 2014) [35, 36]
			Judge (2011) [39]
			Molony (2018) [27]
			Unwin (2019) [52]
			Victorian Department of Health (2012) [30]
Personal history	X		Pierce (2010) [29]
			Molony (2018) [27]
			Morhardt (2015) [47]
			Victorian Department of Health (2012) [30]
			Brown (2021) [44]
			Toteh Osakwe (2022) [45]
Record of personal experience	X		Cheffey (2013) [49]
Family members and primary carer		X	Bass (2013, 2014) [35, 36]
			NCCMH (2007) [2]
Safety	X		Bass (2014) [36]
			Brodaty (2013) [35]
			Chodosh (2012, 2015) [37, 38]
			Judge (2011) [39]
			Molony (2018) [27]
			Orsulic-Jeras (2019) [34]
			Pierce (2010) [29]
			Unwin (2019) [52]
			Victorian Department of Health (2013) [31]
Sharing diagnosis: how to tell others	X		Cheffey (2013) [49]
Social support and engagement	X	X	Bass (2013, 2014) [35, 36]
			Brodaty (2013) [48]
			Chodosh (2015) [37]
			Judge (2011) [39]
			Morhardt (2015) [47]
			Pierce (2010) [29]
			Unwin (2019) [52]
			Victorian Department of Health (2012) [30]
Spiritual	X		Molony (2018) [27]
Values	X		Molony (2018) [27]
			Orsulic-Jeras (2019) [34]
Carer needs		X	Bass (2013) [35]
			Molony (2018) [27]
			Unwin (2019) [52]
			Victorian Department of Health (2013) [31]
Information and training
Information about dementia	X	X	Bass (2013, 2014) [35, 36]
			Brodaty (2013) [48]
			Cheffey (2013) [49]
			Chodosh (2015) [37]
			Judge (2011) [39]
			NCCMH (2007) [2]
Local information sources: including libraries and advocacy organisations	X	X	Bass (2013, 2014) [35, 36]
			Judge (2011) [39]
			NCCMH (2007) [2]
			Victorian Department of Health (2012) [30]
			Victorian Department of Health (2013) [31]
Capacity to care: training about communication, problem solving, and behaviour management		X	Bass (2013) [35]
			Judge (2011) [39]
			NCCMH (2007) [2]
			Unwin (2019) [52]
Healthcare
Behaviour: nonpharmacological interventions, including prevention	X		Bass (2014) [36]
			Brodaty (2013) [48]
			Chodosh (2012, 2015) [37, 38]
			Judge (2011) [39]
			Molony (2018) [27]
			NCCMH (2007) [2]
			Unwin (2019) [52]
			Toteh Osakwe (2022) [45]
			Victorian Department of Health (2013) [31]
Mental health needs mental health support for caretakers	X	X	Bass (2013) [35]
			Brodaty (2013) [48]
			Cheffey (2013) [49]
			Chodosh (2015) [37]
			Judge (2011) [39]
			Pierce (2010) [29]
			NCCMH (2007) [2]
Medication: cholinesterase inhibitors, memantine, and medications to avoid	X		Bass (2013, 2014) [35, 36]
			Brodaty (2013) [48]
			Chodosh (2015) [37]
			Judge (2011) [39]
			Pierce (2010) [29]
			NCCMH (2007) [2]
			Unwin (2019) [52]
			Toteh Osakwe (2022) [45]
			Victorian Department of Health (2013) [31]
Physical health needs	X	X	Bass (2013) [35]
			Brodaty (2013) [48]
			Cheffey (2013) [49]
			Judge (2011) [39]
			Molony (2018) [27]
			NCCMH (2007) [2]
			Unwin (2019) [52]
Strategies to manage cognitive challenges/memory difficulties	X		Brodaty (2013) [48]
			Cheffey (2013) [49]
			NCCMH (2007) [2]
			Unwin (2019) [52]
			Toteh Osakwe (2022) [45]