Background and Objectives: Person-centered care is the gold standard of care for people living with dementia, yet few systematic reviews have detailed how it is delivered in practice. This mixed-methods review aimed to examine the delivery of person-centered care, and its effectiveness, for people living with dementia in residential aged care. Research Design and Methods: A systematic review and meta-analysis. Eligible studies were identified across 4 databases. Quantitative and qualitative studies containing data on person-centered care delivered to people with dementia living in residential aged care were included. Meta-analysis using a random-effects model was conducted where more than 3 studies measured the same outcome. A narrative meta-synthesis approach was undertaken to categorize verbatim participant quotes into representative themes. Risk of bias was undertaken using quality appraisal tools from the Joanna Briggs Institute. Results: 41 studies were identified for inclusion. There were 34 person-centered care initiatives delivered, targeting 14 person-centered care outcomes. 3 outcomes could be pooled. Meta-analyses demonstrated no reduction in agitation (standardized mean difference −0.27, 95% confidence interval [CI], −0.58, 0.03), improvement in quality of life (standardized mean difference −0.63, 95% CI: −1.95, 0.70), or reduced neuropsychiatric symptoms (mean difference −1.06, 95% CI: −2.16, 0.05). Narrative meta-synthesis revealed barriers (e.g., time constraints) and enablers (e.g., staff collaboration) to providing person-centered care from a staff perspective. Discussion and Implications: The effectiveness of person-centered care initiatives delivered to people with dementia in residential aged care is conflicting. Further high-quality research over an extended time is required to identify how person-centered care can be best implemented to improve resident outcomes.

Objectives: The importance of trauma‐informed care (TIC) within residential aged care (RAC) settings has been increasingly recognised. TIC would ensure that older people who have experienced trauma over their lifetime have their needs better understood and accommodated. This scoping review examined the extent to which TIC has been applied within RAC settings.Methods: A scoping review was conducted according to Cochrane recommendations and the PRISMA‐ScR checklist. A systematic search of six databases (Embase, Emcare, CENTRAL, CINAHL, PsychInfo and Medline) was performed in July 2022 and March 2023 and peer‐reviewed primary research, in English and involved RAC staff or residents (aged 65 years and over) providing or receiving TIC were eligible for inclusion. Studies focused on trauma intervention, assessment, screening, or treatment were excluded. Thematic synthesis was performed to extract themes relating to trauma‐informed practice, barriers and enablers to TIC, and outcomes from the application of TIC approaches.Results: Five articles were included. There was little evidence of the implementation of TIC interventions in RAC settings. Only one study examined the application of a TIC framework in a RAC setting. However, there was some evidence that approaches that consider resident's experience of trauma have emerged from practice experience and been used in RAC as an extension of person‐centred care.Conclusions: Whilst trauma‐informed approaches to resident care are emerging through practice experience, and despite policy recommendations to do so, there is little evidence that formal TIC interventions or frameworks have been applied to RAC internationally. This study highlights a gap in research and practice and makes several recommendations for further research and implementation of TIC in RAC.

Young people who leave Out-of-Home Care (OoHC) are a significantly vulnerable cohort. No after-care support program to date has been completely informed by young people and their care team. This scoping study explored the perspectives of young people and their wider care team on: (1) challenges surrounding the transition process; and (2) how these challenges can be addressed. Semi-structured interviews and focus group sessions were conducted with 33 stakeholders from OoHC (i.e., young people in care; young people who had transitioned from care; carers; caseworkers and senior OoHC executives). Four themes captured the challenges of transitioning out of care, including: (1) inadequate processes underpinning the transition; (2) instability within the family unit; (3) financial challenges and (4) lack of independence during care. Stakeholders agreed that greater support during the transition process is necessary, including life-skills training while in care and a post-care worker and/or mentor to provide after-care support. These findings provide compelling insights into the challenges that young people transitioning from OoHC experience and possible solutions for how such challenges can be addressed. These findings will inform the development and delivery of a co-designed and specialised after-care support service for this population.

The evolution of trauma-informed care (TIC) since its inception has resulted in myriad models and frameworks across a variety of settings. However, there is a lack of a consistent definition and understanding of what constitutes TIC. We conducted an integrative review, using a rapid review methodology, concept and content analysis, and thematic synthesis to identify the existing models and frameworks of TIC and their common values, components and principles, and synthesise these to inform a contemporary understanding of TIC. Two-hundred and eighty-eight included sources from the academic and grey literature internationally were analysed, resulting in 10 values, 10 principles, and 28 components of TIC. Foundational components of TIC were identified as understanding trauma, ensuring safety and trust, empowerment and collaboration, supporting trauma recovery and emotional management, and taking a whole-of-organisation approach. We present a proposed integrated definition of TIC, core values, conceptual model, and framework for application across settings. The integrated model and framework have potential utility in the implementation of TIC and development of setting-specific practice strategies, particularly in new settings. It provides a contemporaneous description of TIC that has the potential to inform future research, policy development, and practice that can support its application.