Shared-housing arrangements for care-dependent older persons - Characteristics, development and drivers

Shared-Housing Arrangements (SHA) for care-dependent older persons gain increasing importance as a setting for nursing care in Germany, both in terms of numbers and user preference. This article aims to answer the questions in which phases SHA have developed over time, what the initiator's objectives are, and what factors contributed to SHA proliferation. A systematic review of the literature was conducted that finally included 73 articles. As a result it can be demonstrated that SHA started from "individual user initiatives", became "developing novel services" and finally established themselves as "regular services" in the nursing setting. A typology of different models of SHA can be organised along two dimensions: Firstly the temporal dimension of care organisation and secondly the way care services are purchased. Objectives formulated by the initiators of SHA are: Establishment of a family - like environment, inclusion of relatives, community orientation, security of care provision and maintenance of self-determination. Tailor-made financial and legal regulations supported the spread of SHAs. In reflection of the available literature it becomes evident that no satisfactory consensus on those elements exist that are constitutive for SHAs. Furthermore, there is a dearth of research on whether postulated objectives and other health related goals are actually being met in SHAs. Open questions pertain also the level of self-determination achieved in practice and other outcomes attained.