P37: A systematic review on inequalities in accessing and using social care in dementia – from pre- and pandemic times to moving beyond

Abstract

Objectives:To evaluate and synthesise the evidence base on barriers and facilitators to accessing and using community-based social care in dementia.Design:Mixed-methods systematic reviewSetting:Community-based social careParticipants:People living with dementia and unpaid carersMeasurements:Seven databases were searched in March 2022, including English and German evidence published from 2005 focusing on inequalities in community-based social care for dementia across the globe. Titles and abstracts were screened by two reviewers, with all full texts screened by two reviewers also. Study quality was assessed using QualSyst.Results:From 3,904 screened records, 39 papers were included. The majority of studies were qualitative, with 23 countries represented. Barriers and facilitators could be categorised into the following five categories/themes: Situational, psychological, interpersonal, structural, and cultural. Barriers were notably more prominent than facilitators, and were multi-faceted, with many factors hindering or facilitating access to social care linked together.Conclusions:People with dementia and carers experience significant barriers in accessing care in the community, and a varied approach on multiple levels is required to address systemic and individual-level barriers to enable more equitable access to care for all.