The psychosocial needs of people with dementia living alone: a narrative synthesis systematic review

The number of people with dementia living alone is predicted to double by 2039. People with dementia may live alone through choice and others due to life events like bereavement. There are unique challenges to living alone for people with dementia, their care partners and services supporting those individuals. The current review sought to summarise the psychosocial needs reported by people with dementia who live alone. Searches were completed accessing Academic Search Ultimate, MEDLINE, CINAHL Ultimate, APA PsycArticles and APA PsycInfo. Eligible articles explored the needs or experiences of people with dementia living alone through qualitative or mixed methods. The data was synthesized narratively, and the National Institute of Care and Health Excellence’s quality appraisal checklist was used to assess all included studies. Needs were identified across all domains of Kitwood’s model; love, identity, attachment, inclusion, occupation and comfort. The data revealed overlapping needs between those with dementia who live alone and those who live with others but importantly, needs that were distinct or exacerbated by living alone with dementia. Specifically, threat to personhood without others to maintain stories about identity and the management of living at home with the recognition that this would eventually end. The heterogeneity of people with dementia who live alone was highlighted and the gaps in the representation of the needs of specific groups in the research were considered such as individuals from the LGBTQ + community. Thus, the need for an intersectional and person-centred approach to future research and clinical practice was discussed.