Background: Family inclusion in nursing homes is central to the provision of individualized care for people with dementia. Although positive effects can be recognized, barriers have been identified that hamper family inclusion in nursing homes. Specifically for people with dementia, insight into the content of interventions to foster family inclusion is lacking.Methods: A systematic review was performed by systematically searching the databases PubMed, Cinahl, PsycInfo and Embase. Studies were eligible if they examined (1) nursing home settings, (2) interventions to foster the inclusion of family members from people with dementia, (3) were original research articles in which effects/experiences of/with these interventions were evaluated, and (4) were written in English, Dutch or German. Findings were summarized systematically.Results: Twenty-nine studies were included. Two interventions were targeted at creating family-staff partnerships from a two-way perspective. Other interventions focused on single components, such as including family members in formal decisions (n = 9), enabling them to make better informed decisions and/or participate more actively (n = 7), or providing psychoeducation for family members (n = 3). Within the interventions, family and staff members are often treated differently. Effects on actual increase in family inclusion remain unclear.Conclusions: Very few interventions exist that try to enhance equal family-staff partnerships in nursing homes. Future interventions should pay specific attention to mutual exchange and reciprocity between family and staff. As little is known about promising (components of) interventions to foster family inclusion in nursing homes for people with dementia, more effectiveness research is needed.

In view of the likelihood that the complexity of care required by those admitted to nursing homes will continue to increase, an expert consensus study was conducted to reach consensus on the competencies which distinguish baccalaureate-educated registered nurses from other nursing staff working in nursing homes. Thirty-one international experts, identified through literature and our professional network, participated in a two-round web-based survey and an expert meeting. Experts reached consensus on 16 desirable competencies, including some not traditionally associated with nursing expertise e.g. being a team leader, role model and coach within the nursing team. These findings suggest that revision of current nursing curricula, nurse training programs and nursing home job profiles might be needed to meet the medically and psychologically complex needs of nursing home residents.

Aim This study aims to explore the relationship between work environment, job characteristics and person-centered care for people with dementia in nursing homes. Background Person-centered care approaches have become a dominant indicator for good quality of care in nursing homes. Little is known about the relationship between work environment, job characteristics and person-centered care in nursing homes. Method(s) Cross-sectional data from the LAD-study were used. Direct care staff (n = 552) of nursing homes (n = 49) filled in an online questionnaire about work environment characteristics and person-centered care. To examine relationships, multilevel linear regression analyses were conducted. Results Associations were found between a higher transformational leadership style, less social support from a leader, a higher unity in philosophy of care, higher levels of work satisfaction, more development opportunities, better experienced teamwork and staff-reported person-centered care. Conclusion(s) In a complex nursing home environment, person-centered care is influenced by organizational and work characteristics, shared values and interpersonal relationships. Implications for Nursing Leaders may consider facilitating collaboration and creating unity between care staff, clients and family members in order to provide person-centered care. Therefore, a transformational leadership style, educational programs and coaching for leaders are recommended.