Evidence map›Paper›PMID 36896936›Full record

ArticleThe journals of gerontology. Series B, Psychological sciences and social sciences2023

Barriers and Facilitators to Home- and Community-Based Services Access for Persons With Dementia and Their Caregivers.

Molly Waymouth, Daniel Siconolfi, Esther M Friedman, Debra Saliba, Sangeeta C Ahluwalia, Regina A Shih

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In one paragraph

Article in The journals of gerontology. Series B, Psychological sciences and social sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  8. 'We're the Eyes and Ears… out There': A Qualitative Exploration of the Perceptions and Experiences of Polypharmacy Amongst Home Care Providers.Health expectations : an international journal of public participation in health care and health policy · 2026
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  11. Culturally and linguistically diverse patients in an Italian memory clinic: lessons learned from the ImmiDem project.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Molly WaymouthRAND Corporation, Santa Monica, California, USA.ORCID 0000-0002-8626-2508
Daniel SiconolfiRAND Corporation, Santa Monica, California, USA.
Esther M FriedmanInstitute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0001-6813-6471
Debra SalibaRAND Corporation, Santa Monica, California, USA.ORCID 0000-0001-5177-6616
Sangeeta C AhluwaliaRAND Corporation, Santa Monica, California, USA.
Regina A ShihRAND Corporation, Santa Monica, California, USA.

Funding

Evaluating disparities in older adult health, institutionalization, and mortality after implementation of Medicaid's Balancing Incentives ProgramR01MD010360 · NIMHD · RAND CORPORATION · PI SHIH, REGINA A · 2016 to 2020
$4.7M
NIMHD NIH HHS R01 MD010360
6 · The paper itself

Abstract

objectivesThe United States has seen increasing shifts toward home- and community-based services (HCBS) in place of institutional care for long-term services and supports. However, research has neglected to assess whether these shifts have improved access to HCBS for persons with dementia. This paper identifies HCBS access barriers and facilitators, and discusses how barriers contribute to disparities for persons with dementia living in rural areas and exacerbate disparities for minoritized populations.

methodsWe analyzed qualitative data from 35 in-depth interviews. Interviews were held with stakeholders in the HCBS ecosystem, including Medicaid administrators, advocates for persons with dementia and caregivers, and HCBS providers.

resultsBarriers to HCBS access for persons with dementia range from community and infrastructure barriers (e.g., clinicians and cultural differences), to interpersonal and individual-level barriers (e.g., caregivers, awareness, and attitudes). These barriers affect the health and quality of life for persons with dementia and may affect whether individuals can remain in their home or community. Facilitators included a range of more comprehensive and dementia-attuned practices and services in health care, technology, recognition and support for family caregivers, and culturally competent and linguistically accessible education and services. DISCUSSION: System refinements, such as incentivizing cognitive screening, can improve detection and increase access to HCBS. Disparities in HCBS access experienced by minoritized persons with dementia may be addressed through culturally competent awareness campaigns and policies that recognize the necessity of familial caregivers in supporting persons with dementia. These findings can inform efforts to ensure more equitable access to HCBS, improve dementia competence, and reduce disparities.

Indexed as

DementiaHome Care ServicesCaregiversCommunity Health ServicesEcosystemHumansMedicaidQuality of LifeUnited StatesCommunity integrationDementiaHome- and community-based care and servicesLong-term careMedicaid/Medicare

Identifiers

PMID36896936
PMCPMC10214645

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.