Models of care across settings supporting ageing in place: a narrative review

Older people's preference is to age in place. With an ageing population, the demand for services that are effective in supporting older people to live at home independently has increased dramatically. This narrative review provides an overview of recent evidence of models of care in the aged and community care and health care sectors that contribute to supporting older people (≥ 65 years) to age in place (ie, delay or avoid entry into residential long term care). Overall, there is limited evidence for the identified models of care about the outcome of ageing in place, but there is evidence of positive contributions to other aspects of wellbeing. Complex multifactorial care models, particularly those that are person-centred, address the health and social needs of older people in the community, include comprehensive assessment and care planning, and are delivered by a multidisciplinary clinical team, had the most consistent evidence for supporting older people to age in place. Specialist geriatric care and home-based palliative team care models have robust evidence of assisting individuals to achieve their aims to stay and to die at home. However, how these complex multifactorial care models work (ie, what elements contribute to success) and how to scale up specialist team care models are substantial challenges. No panacea exists for supporting all people to age in place, but care integration, collaboration among care settings, and multidisciplinary person-centred clinical care that addresses health-related decline and challenges are consistently reported to contribute to its success.