Table 1.

Characteristics of included studies.

Title of study	The Coexistence center for elderly people and its importance in the support to the family and the Health Care Network	Social participation of people with cognitive problems and their caregivers: a feasibility evaluation of the Social Fitness Programme	A coordinated preventive care approach for healthy ageing in five European cities: a mixed methods study of process evaluation components	Driving forces for home-based reablement: A qualitative study of older adults’ experiences	Interprofessional working in hospice day care and the patients’ experience of the service	The over 75 Service: Continuity of Integrated Care for Older People in a United Kingdom Primary Care Setting	Encouraging older people to engage in resistance training: a multi-stakeholder perspective	Identifying ‘value’ in day care provision for older people.	Evaluation of a transition care cognitive assessment and management pilot	Experiences of Community-Living Older Adults Receiving Integrated Care based on the chronic care model: a qualitative study	Health and social care planning in collaboration in older persons’ homes: the perspectives of older persons, family members and professionals
Author/s (year)	Derhun FM, Scolari G A De Souza, Castro, VC, De Salci, MA, Baldissera, V DA & Carreira, L, 2019	Donkers, HW, Van Der Veen, DJ, Vernooij-Dassen, MJ, Nijhuis-Van Der Sanden, MWG & Graff, MJL., 2017	Franse et al. … 2019	Hjelle KM, Tuntland H, Førland O & Alvsvåg, H 2017	Lee, 2002	MacInnes J, Baldwin J & Billings J, 2020	Pettigrew et al., 2018	Powell & Roberts 2002	Renehan, E, Haralambous, B, Galvin P, Kotis M, & Dow B, 2014	Spoorenberg, SLW, Wynia K, Fokkens, AS, Slotman, K, Dremer HPH, Reijneveld, SA, 2015	Sundstrom et al. 2018
Country	Brazil	The Netherlands	United Kingdom, Greece, Croatia, the Netherlands and Spain	Norway	UK	UK	Australia	UK	Australia	Netherlands	Sweden
Aim of study	To know the perception of the elderly people’s family about the importance of a coexistence center (day centre focused on the socially vulnerable, dependent IADL but independent in basic ADL) on family support and on the Health Care Network (HCN).	Determine feasibility of a tailor-made intervention (the Social Fitness Programme), aimed at improving social participation of people with cognitive problems and their caregivers, in terms of acceptability, demand, implementation, practicability and limited efficacy	Evaluate specific process components of the Urban Health Centres Europe (UHCE) approach: a coordinated preventive care approach aimed at healthy ageing among older persons in community settings of five cities in the United Kingdom, Greece, Croatia, the Netherlands and Spain	Describe how older adults experience participation in reablement.	Enhance understanding of hospice day care through an in-depth qualitative case study to answer: 1 How does the interprofessional team work to provide care? 2 How is this experienced by patients and how do they spend their time?	Explore the concept of continuity of care in relation to integrated care, for frail, older people in the United Kingdom as part of the European SUSTAIN project	Investigate various stakeholders’ perceptions of how older people can be encouraged to commence and continue resistance training	Identify value in day care provision for older people 1. To identify the characteristics of the elderly populations receiving different types of day care and develop criteria for attendance. 2. To determine whether achievement of a negotiated goal(s) is the most appropriate outcome measure for elderly people	Evaluate the implementation and effectiveness of the TC CAMP. The evaluation sought to explore the perceptions of staff and family carers, and outcomes for the person with dementia.	Evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs	Gain a deeper understanding of the HSCPC-meeting from the perspectives of older persons, family members, and professionals.
Methodology	Qualitative	Qualitative	Convergent mixed methods evaluation design (Creswell & Plano Clark, 2018) alongside the effect evaluation of the UHCE approach.	Qualitative arm of larger study on reablement in home-dwelling adults, including a small RCT. Recruitment based on referral to home-based services. Invited to participate in new	Framework of interprofessional working within qualitative paradigm	Multiple embedded case study design. Reported in another paper.	Qualitative	Qualitative	Mixed methods	Qualitative	Hermeneutic philosophy
Method	14 Semi-Structured Interviews undertaken by masters degree students, at a date and place of choosing by relatives. Interviews were recorded and transcribed and lasted an average of 20 minutes. Transcripts were thematically coded	Qualitative research methods (focus group discussions, interviews, collection of treatment records) and applied thematic analyses.	Quantitative data from a questionnaire and quantitative/qualitative data from log- books were collected among older persons involved in the approach. Qualitative data from focus groups were collected among older persons, informal caregivers and professionals involved in the approach.	Content analysis	Case study with interviews, observation, document analysis. The ‘case’ being a specialised hospice day care unit, including all patients & professionals within a 3-month period	Qualitative interviews with users & carers; demographic questionnaire for users & carers; interviews with professionals; focus group with managers & professionals delivering the service; documentary analysis of care plans; minutes of steering group meetings and researcher’s field notes.	A combination of interviews and focus groups was used to allow extensive discussions of relevant topics and the probing of new issues as they arose.	Mixed methods Interviews were conducted at time of entry to the service, following discharge or review three months later. Standard assessment instruments were used to collect data on functional status. Additional qual data was collected via interview.	File audits, focus groups and individual interviews with family/carers and staff, including nursing, management and allied health. Discharge destination service interviews were also conducted.	Semi-structured interviews were conducted with 23 older adults receiving integrated care and support	Interviews with older people (n=7), interviews with older persons and family (n=3), interviews with family member (n=5) and focus groups with professionals (n=10)
Quality measure	8	8	8	7	9	9	7	7	6	8	10
Phenomenon of interest	The coexistence center providing daytime stay of older people and care directed, mainly, to health promotion of older people as part of the Brazilian model of integrated care	Feasability evaluation based on experiences from professionals (programme deliverers), people with cognitive problems and their caregivers (programme recipients) of the tailor - made Programme. A cyclical process was applied. Treatment goals. Within the goal setting phase, priorities for the intervention were set.	Coordinated preventive care interventions on quality of life and independent functioning among older persons	Reablement - Perspectives of the older people themselves	Professional team working and patient experience of the service of Hospice Day Care	Integrated care viewed through the lens of the continuity of care hierarchy.	Role of resistance training in later life	The views and experiences of service users and professionals alongside information relating to costs.	Experiences of TC CAMP and perceptions of benefits and possible service gaps.	1) How do older adults experience the effects of aging? 2) How do older adults experience the care and support offered by a CCM-based integrated care model?	Understanding of value of HSCPC meeting from older people and HCPs perspective.
Setting	Community	Community	Community settings of five cities in the United Kingdom, Greece, Croatia, the Netherlands and Spain	Community-dwelling/at home	Hospice Day Care	Participants’ homes	Centres that offer resistance training programmes for older people in metropolitan and regional Western Australia	Three different day care settings: Day centre, outreach serv ice and day hospital	Transition Care Cognitive Assessment and Management Pilot (TC CAMP) funded via six restorative care places in a residential care facility	Embrace population-based integrated care model for community-living older adults.	Participants’ homes
Participants	14 relatives of older people attending the coexistence centre, coexistence center (day program) in a city in the interior of the state of Paraná, Brazil.	14 dyads of community dwelling people with cognitive problems and their caregivers (programme recipients) who wished to maintain or increase social participation	The target population consisted of persons living independently, aged 75 years or older, who were, according to their physician, able to participate in a care-pathway for at least 6 months	Eight older adults	Interprofessionals working in a hospice day care facility. The patients attending the hospice day care facility.	1) Users and carers: The inclusion criteria for users was 75 years of age or older, living at home, with multiple health and social care needs, in receipt of the service for a minimum of 12 weeks, and cognitively able to participate in the study. Informal caregivers of users were also invited to participate. 2) Managers and Professionals delivering the service. 3) Steering group consisting of managers and professionals was set up at the start of the SUSTAIN project.	Instructors (n=18) and centre mangers (n=24) were interviewed. Phase ii four focus groups with other relevant stakeholders (health practitioners n= 13 & older people n = 24).	day care attendees (n=45) (15 from each of the three settings), where applicable their informal carers and focus groups with members of the three teams.	Family carers of clients in TC CAMP (interviews). Staff including nursing, management and health service staff (interviews, focus groups) (pg 137). Clients were not interviewed as not able to give informed consent	23 older adults receiving integrated care and support	Ten older persons, eight family carers, 22 health care professionals
Data analysis	Content analysis technique in the thematic modality	All qualitative data (four focus groups and 13 interviews) were recorded and transcribed verbatim. These transcripts and 23 OT and PT treatment records were thematically analysed through a content analysis.	Quantitative data were analysed by means of descriptive statistics and multilevel logistic regression models. Qualitative data were analysed through thematic analysis.	Content analysis	Development of propositions following data coding and grouping, plus percentages of time participants spent in an activity.	Qualitative data was analysed thematically using Flick’s approach which involved bringing predetermined templates to the data, in this case the interview and focus group schedules. Quotes were sorted into categories and coded according to their origin. Each category was organised into themes using the quotes to justify interpretation. Quantitative demographic data was analysed using descriptive statistics.	Inductive approach to coding	Cost data was also collected from each of the three settings.	Qualitative data including perceptions of nursing staff, family/carers, discharge facilities and other key stakeholders were subject to content and thematic analysis	Data analysis was based on the grounded theory approach.	Hermeneutic analysis
Findings	From the family carer’s perspective, the older person’s participation in the coexistence center was an alternative to support care and institutionalisation, provided time for carer self-care and to maintain or engage in the formal work; time spent at the centre positively influenced the relationship from the family’s perspective toward the person. The performance of the coexistence center offered support to the family in the care of the elderly person.	Dyads formulated multiple intervention goals, ranging from a total of four to nineteen goals per dyad, with a range of 1 to 5 goals and a median of 2,5. In total, 34% of all goals (38 from a total of 111 goals) comprised increasing social participation. After prioritising, all dyads included at least one goal for social participation on level two on our operational model for social participation. The OT coordinated the interdisciplinary collaboration including sharing of information with the dyads’ GP, the PT and WP. The intervention was feasible according to stakeholders, and showed promising results. Feasibility and barriers. First, an acceptability barrier: discussing declined social participation was difficult, hindering recruitment. Second, a demand barrier:	Having limited function was associated with non-enrolment in falls and loneliness care-pathways (both p < .01). The mean rating of the approach was 8.3/10 (SD 1.9). Feeling supported by a care professional and meeting people were main benefits for older persons. Mistrust towards unfamiliar care providers, lack of confidence to engage in care activities and health constraints were main barriers towards engagement in care.	Themes: My willpower is needed; being with my stuff and my people; the home-trainers are essential; and training is physical exercises, not everyday activities. Intrinsic and extrinsic motivation influence reablement with some people needing more extrinsic motivational support after the time- limited reablement period is completed. The reablement team encouraged and supported the older adults to regain confidence in performing everyday activities as well as participating in the society. The municipal health and care services need	How the propositions fit into integrated care. Key forms of integrated care can include Integrated care within one sector (eg, within mental health services through multi-professional teams or networks) Integrated care between providers and patients to support shared decision-making and self-management.	Themes of continuity of care: International domain with subthemes 1) willingness to share information: Overall, there was a willingness to share information across organisations and amongst different professionals although the need to share information which was not perceived to be relevant to all agencies was questioned: “It’s kind of working together and just sharing information, rather than thinking ‘Oh we’re the district nurses and that’s the GP surgery’ and not sharing information. If we’re told something and we think it would be valuable for them to know, we’ll always pass that	Results indicate that the need for personalised attention in the establishment and maintenance phases of a resistance training programme can constitute both a positive and negative aspect of older people’s experiences. The negative aspects were identified as a series of tensions between the need for personalised attention and (a) the desire to participate in physical activity within social groups, (b) a preference for activity variation, (c) a dislike for large centres where personalised guidance is often available	Patient of the outreach service ‘valued opportunities for social contact alongside ‘exercises’ to regain their mobility. They appreciated discussion about realistic goal setting in terms of mobility improvement relevant to their home situation. There was general agreement that an attempt to negotiate goals with patients was implicit in their practice, although this was more evident in relation to particular situations where a formal plan had been agreed.	This evaluation found that it was possible to provide appropriate transition care to people with cognitive impairment who exhibited behavioural and psychological symptoms of dementia. The TC CAMP achieved length of stay and readmission rates that were comparable with transition care for cognitively intact people.	Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes “Struggling with health,” “Increasing dependency,” “Decreasing social interaction,” “Loss of control,” and “Fears;” and 2) Experiences with Embrace, with the themes “Relationship with the case manager,” “Interactions,” and “Feeling in control, safe, and secure”.	Four themes emerged: 1.Unspoken agendas and unpreparedness(older people unclear about who was who in the HSCPC meeting, most older people came to the meeting unprepared as they were not sure what to expect or what to prepare. Overall, often ambiguity about the meetings.) 2.Security and enhanced understanding (older people appreciated the meetings and felt understood and meting at home meant the older person felt safe and was able to explain their home situation - which contributed to enhanced understanding of the older person. 3.Asymmetric relationships (older people did have some difficulty joining in conversation, felt they could not always speak for themselves or defend their interests.
		some people with cognitive problems lacked motivation to improve declined social participation, sometimes in contrast to their caregivers’ wishes. Third, implementation and practicability barriers: shared decision-making, focusing the intervention and interdisciplinary collaboration between healthcare providers.		to consider individualised follow-up programmes after the intensive reablement period to maintain the achieved skills to perform everyday activities and participate in society. The support must be adjusted to the older adults’ resources and health in their process of regaining confidence to perform activities themselves.		information over” (M/P6) From a user and carer perspective, information sharing was not always apparent to users and carers of the service who recognised that whilst information was shared amongst staff within the medical practice, this was not the case for outside agencies: 2) mechanisms for information sharing: Information was shared in monthly multidisciplinary team meetings.	yet the surroundings can be considered unappealing, (d) cost issues and (e) the need for flexibility in attendance.				Not always fully involved and unsure of some decisions made - may be insufficient time to establish symmetrical relations). 4.Ambiguity about the mission and need for follow-up: older people unsure about the need for HSCPC meeting.