How Do Older People Experience Person-Centred Integrated Care? An Integrative Review of the Evidence

Background: ‘Person-centred integrated care’ (PCIC) emerged in literature, policy and practice to meet the increasing care needs of an older population living longer with increased levels of chronic illness, multimorbidity and at enhanced risk of care fragmentation. Most evaluations of PCIC have been service-centred, rather than person-centred, and there is a lack of research on the effects of integrated care on patients, especially older people.

Methods: This integrative review explored evidence regarding older people’s PCIC experiences, synthesising empirical literature from five databases: Medline, PsycInfo, CINAHL, Embase and Web of Science.

Results: Findings included: i) definitions and components of integrated care and conceptualisations of person-centredness in the context of integrated care; ii) older people’s positive PCIC experiences featured: coordination; continuity and relational care; involvement in care, including effective communication and information about care; and holistic care; iii) integrated care optimises care when successfully delivered, however, older people’s experiences were mixed; and iv) barriers included a lack of integrated care frameworks developed from patients’ perspectives, poor communication and information and staff shortages and turnover leading to discontinuity, limited time for meaningful interactions and follow-up care.

Conclusion: While PCIC optimises care experiences, its evaluation is challenged by multiple conceptualisations and lack of engagement with service users.