This review updated a previous review [Gaugler JE (2005) Family involvement in residential long-term care: a synthesis and critical review. Aging and Mental Health 9, 105–118] and focused on dementia. Fourteen years of development in family involvement with care homes following placement of a relative was explored. The review aimed to investigate two questions: (1) What types of involvement do families have with care homes following placement of people living with dementia? (2) Which factors influence family involvement with care homes? PsycINFO, MEDLINE and CINAHL Plus were searched for publications between January 2005 and December 2018. Thirty-three papers representing 30 studies were included. Papers were appraised using a quality rating tool designed for use with mixed study designs. Studies were of a reasonable quality though some weaknesses included single-site samples, high attrition rates and poor reporting. Twenty-eight papers highlighted types of involvement including collaboration, family–staff relationship development, decision making and visiting. Twenty-five papers pertained to factors influencing involvement, which included outcome of care quality evaluation, wish for recognition and sense of integration into the care team. Type of family involvement has changed over time with increased emphasis on families’ desire for partnership, to be active rather than passive advocates, and to focus on care monitoring and evaluation. Seven themes of family involvement activities are featured and a non-linear process is proposed. When compared to patient and family-centred care principles, an analysis of family involvement types found good fit overall and potential for framework improvements. Over 30 diverse factors influence inter-family variation in the level and nature of family involvement. Consideration of these factors and resolution of the gaps in evidence, including intergenerational and cultural concerns, can improve care home facilitation of family participation. This dementia-specific review is a comprehensive timely complement to Gaugler's seminal work about older adults in care.

MRCPsych courses play a key role in helping trainees prepare for Membership examinations and specialist training. Historically, their social aspect, although arguably as important, has perhaps not been sufficiently prioritised. During a pandemic, when teaching is largely delivered virtually, the social benefit of meeting peers is highlighted by its absence. Given the future likelihood of increased virtual teaching, it is of paramount importance to explore ways of enhancing the sociability of teaching courses. In addition to the social needs of trainees, there is a recognised need to increase and integrate the neuroscience component of the curriculum to better meet the needs of modern day mental health research, treatment and practice. This article describes how the Birmingham MRCPsych course successfully addressed both these issues with a 2-day ‘residential’ in October 2019, and considers whether future residentials could be delivered virtually.

The Sanctuary Model (Sanctuary) is a trauma-informed model of care for human services. The model is made up of tools, norms and theoretical underpinnings that form the basis of building safety and promoting recovery from adversity within the context of communities. Sanctuary focuses on healing those who have experienced trauma, by being purposeful and deliberate about the well-being of the system as a whole, including the client, staff, the organisation and more broadly the community. Churches of Christ Care Pathways have been implementing this model within the Australian out-of-home care context including Foster and Kinship Care, Intensive Foster Care, Residential, Supported Independent Living and Intervention Services for the past three years. This article provides a brief description of components of the model, including the SELF model, Community Meetings, Safety Plans, Psycho-Educational Group Work, Self Care Plans, Red Flag Meetings and Team Meetings; detailing practice examples from its use within an Australian context. This article aims to make the link between the model and practice.

Background: Family carers of people with dementia are at risk of psychological morbidity, and it is suggested that this may also be the case in paid carers as caring for people with dementia can be emotionally and physically demanding. Care homes have historically had difficulty recruiting and retaining staff, and job stress has previously been linked to high turnover amongst long-term care staff. We performed a systematic review of studies of the prevalence of psychological stress in staff caring for people with dementia in residential long-term care settings.

Methods: We conducted a comprehensive literature search of MEDLINE, PsychINFO and Web of Science databases up to May 2009, supplemented by a search of the references of all relevant articles. Search terms encompassed nursing staff, residential care and psychological distress. Validity of studies was graded by two authors independently using a standardized checklist.

Results: We identified 601 studies of which five met our inclusion criteria. Two studies reported on prevalence rates of staff distress and found 37% and 5% levels of being “at risk” from burnout, four studies reported mean stress scores and all were low.

Conclusions: All studies were either small or used instruments with unsatisfactory psychometric properties and so our conclusions are limited by the lack of good quality evidence. The preliminary evidence suggests that most staff who remain working in homes do not have a high prevalence of psychological stress or level of symptoms.

There has been debate for some years as to whether the best model of care for people with dementia emphasises specialist facilities or integrated service provision. Although the United Kingdom National Service Framework for Older People recommended that local authority social services departments encourage the development of specialist residential care for people with dementia, uncertainty continues as to the benefits of particular care regimes, partly because research evidence is limited. This paper examines a large number of ‘performance measures’ from long-term care facilities in North West England that have residents with dementia. Of the 287 in the survey, 56 per cent described themselves as specialist services for elderly people with mental ill-health problems (known familiarly as ‘EMI homes’). It was envisaged that EMI homes would score higher than non-EMI homes on several measures of service quality for people with dementia that were developed from research evidence and policy documents. The analysis, however, found that EMI homes performed better than non-EMI homes on only a few measures. While both home types achieved good results on some standards, on others both performed poorly. Overall, EMI and non-EMI homes offered a similar service.