Emotional safety of people living with dementia: a systematic review

Figures & data

Table 1. Overview of the included studies.

Author (years)	Approaches (methods)	Sample size	Included participants	Participant characteristics		Setting	Recruitment	Country	Study focus	Main findings regarding emotional safety	Critical appraisal
				Age (years)	Sex
Qualitative studies
Brataas et al. (2010)	Descriptive design (narrative interviews)	n = 9 PLWD	Mild dementia	77 − 88	f (n = 7), m (n = 2)	PLWD living at home and participating in a day care program	Existing day care program	Norway	Experiences of a person-centered and collaborative day care program	Feelings of safety may be decrease by low self-efficacy. A day care program can strengthen feelings of safety, such as through organization of a safe transfer. Feeling safe can increase well-being.	+
Brittain et al. (2010)	Participatory design (focus groups, secondary data)	(a) n = 16 PLWD (b) n = 3 caregivers n = 4 focus groups	(a) Mild to moderate dementia (b) Not described	–	f, m	Aging with dementia in public environments	Local branches of the Alzheimer’s Society	England	Experience of everyday technologies in public spaces	Contact with familiar people and the possibility of using a technical device to communicate with others can strengthen the feeling of safety in public spaces.	–
Brorsson et al. (2011)	Grounded theory (repeated in-depth interviews)	n = 7 PLWD n = 13 interviews	Early AD (MMSE: 18 − 30)	63 – 80	f (n = 5), m (n = 2)	PLWD living at home and visiting public spaces	Dementia investigation unit and dementia association	Sweden	Experiences of accessibility in public spaces	PLWD feel safe in familiar places, which improves orientation. PLWD feel insecure in payment situations or in the evening after dark.	+
Brorsson et al. (2013)	Grounded theory (repeated in-depth interviews and observations)	n = 6 PLWD n = 12 interviews n = 8 observations	Early AD (MMSE: 18 − 30)	63 – 80	f (n = 4), m (n = 2)	PLWD living at home and grocery shopping	Dementia investigation unit and dementia association	Sweden	Identification of problematic situations and critical incidents while grocery shopping	The presence of many background sounds while crossing roads and difficulties in retrieving learned behaviors reduces feelings of safety.	+
Clare et al. (2008)	Phenomenological design (unstructured conversations, secondary data)	n = 81 PLWD n = 307 conversations	Moderate to severe dementia (MMSE: 0 − 20)	59 – 96	f (n = 69), m (n = 12)	PLWD living in residential care homes	–	England, Wales	Experience and psychological impact of living with dementia in residential care homes	Dementia care should consider emotional experiences, help reduce anxiety and create feelings of safety.	+
Cronfalk et al. (2017)	Descriptive design (semistructured interviews)	n = 10 family members n = 10 interviews	Spouse, children and children-in-law of PLWD	–	f (n = 7), m (n = 3)	PLWD living in nursing homes who are regularly visited by their relatives	Subsample of an intervention study	Sweden	Experiences and coping strategies of people with advanced stage dementia who move into a nursing home	Increasing the feeling of safety is described during the change from home care to a nursing home by the assurance of access to help in the near surroundings.	–
Duggan et al. (2008)	Grounded theory (semistructured interviews)	(a) n = 22 PLWD (b) n = 14 caregivers	(a) Mild to moderate dementia (MMSE: 15 − 29) (b) Spouse and children of PWLD and housekeeper	(a) 71 − 84 (b) –	(a) f (n = 11), m (n = 11) (b) Unclear	PLWD living at home and participating in public space	National Health Service consultant psychiatrists	United Kingdom	View of PLWD and their caregivers of using outdoor environments and impact of the disease	PWLD feel safe when they visit familiar areas in public spaces.	+
Ericsson et al. (2013)	Grounded theory (Relational Time videotapes and interviews)	(a) n = 9 PLWD (b) caregivers n = 24 interviews (PLWD) n = 8 interviews (caregivers) n = 24 video sequences	(a) Moderate to severe dementia (FAST range 5 − 7) (b) Professional caregivers	(a) 75 − 97 (b) –	(a) f (n = 8), m (n = 1) (b) all were female	PLWD living at residential units for PLWD	Dementia nurse and division manager	Sweden	Description of the formation of relationships with PLWD	The feeling of safety can be strengthened within the context of relationship establishment in care situations, such as by enabling self-determination.	++
Faith (2014)	Phenomenological design (online blogs, secondary data)	n = 9 individual blogs of PLWD	Frontotemporal and vascular dementia, early onset AD and AD	50 − 65 n = 2 unknown	f (n = 6), m (n = 3)	Online blogs of PLWD	–	USA	Subjective experiences of PLWD presented in online blogs	Friendships can provide feelings of safety.	+
Genoe and Dupuis (2011), Genoe (2009)	Phenomenological design (long interviews, observations and photovoices)	n = 4 PLWD n = 16 interviews n = 66 photos	Early stage AD and vascular dementia	Unclear	f (n = 2), m (n = 2)	PLWD living in the community	Early stage support groups and dementia research program	Canada	Meaning and experience of leisure in the dementia context	In familiar areas, especially in private spaces, PLWD feel safe.	++
Hadjri et al. (2015)	Descriptive design (semistructured interviews)	n = 22 manager of care homes	–	–	–	Care and nursing homes for PLWD in urban and rural settings	Telephone recruitment via phone number list	England	Identification of housing options for PLWD and their specific designs	The building design should allow PWLD to feel safe.	–
Hansen et al. (2017)	Descriptive design (semistructured focus group interviews)	n = 24 health care providers (focus groups with 5 – 8 participants)	Registered nurses and assistant nurses	–	f (n = 24)	Home care services for PLWD in a Norwegian setting	Leader of home care services	Norway	Perception and fulfillment of the psychological needs of PLWD by home care services	Feeling socially and physically safe is a primary psychosocial need. The hurried behavior of others can reduce feelings of safety. Feeling safe can increase psychological health.	+
Hung et al. (2017)	Participatory design (observations, go-along interviews and video recording)	n = 5 PLWD (all participants were interviewed twice alone or together with another participant)	AD and vascular and unspecified subtype of dementia	65 – 84	f (n = 2), m (n = 3)	PLWD were admitted to a medical unit of an urban hospital (different reasons and lengths of stay)	Nurses in a medical unit of an urban hospital	Canada	Experiences of PLWD with the physical and social environment in a hospital	Feeling psychologically safe is a primary psychological need. A key aspect of a supportive hospital environment is the availability of a place of safety that includes access to help and an adapted building design.	++
Hynninen et al. (2015)	Descriptive design (individual and joint unstructured interviews)	(a) n = 7 PLWD (b) n = 5 relatives n = 4 interviews (PLWD) n = 2 interviews (relatives) n = 3 joint interviews	(a) Mild or moderate AD (b) Spouse, and children of PLWD	(a) 74 − 85 (b) 52 – 78	(a) f (n = 5), m (n = 2) (b) f (n = 4), m (n = 1)	Surgical wards of a university hospital	Head nurses instructed the nursing staff	Finland	View of PLWD and their relatives concerning the treatment of older PLWD in surgical wards	PLWD feel safe when their relatives are nearby.	+
Lawrence et al. (2011)	Unclear (in-depth interviews)	(a) n = 27 bereaved caregivers (b) n = 23 care professionals n = 50 interviews	(a) Family members and friends of PLWD (b) Physicians, nurses, health care assistants and manager	–	(a) f (n = 21), m (n = 6) (b) –	Different organizations providing end-of-life care for PLWD in four different boroughs in south London	Community mental health teams, care homes, hospitals, palliative care, and Alzheimer’s Society, carer organizations	England	Definition and application of good end-of-life care for PLWD in different care settings	In a “warm atmosphere” in nursing homes, PLWD can feel safe.	++
Mazaheri et al. (2014)	Descriptive design (semistructured interviews)	n = 15 PLWD	AD and vascular dementia	66 – 88	f (n = 8), m (n = 7)	PLWD who were born in Iran living at home or in group dwellings for PLWD in Sweden	Staff of care centers for PLWD	Sweden	Experience of living with dementia among Iranian immigrants in Sweden	PWLD describe feeling safe in public spaces when they become lost but still find their way home. PLWD also feel safe when other people have a positive attitude towards PWLD.	+
Mjørud et al. (2017)	Phenomenological hermeneutic design (unstructured face-to-face interviews and observations)	n = 12 PLWD n = 20 interviews	Mild to severe dementia (clinical dementia rating scale (1 − 3))	71 – 95	f (n = 10), m (n = 2)	PLWD living in a nursing home for three to six months	Head nurse in the unit	Norway	Experience of living in a nursing home and identification of factors that improve or reduce well-being	The feeling of safety can be created in nursing homes through access to help with daily activities and the knowledge that PLWD are not alone.	++
Panke-Kochinke (2013)	Descriptive biographical design (group interviews and narrative biographical-oriented interviews)	n = 3 self-help groups n = 5 group interviews (5 − 9 PLWD) n = 8 interviews (4 PLWD)	Early stage dementia	Not clear	f, m	PLWD who engage in self-help groups	Bundesverband der Alzheimer Gesellschaft e. V.	Germany	Self-awareness of PLWD and the meaning of the self-help group related to the development of self-concept	Coping with dementia was described as a constant equilibrium between the experience of a “successful life” and the experience of disenfranchisement processes, which can be represented in the model of “inner security”.	+
Sørensen et al. (2008)	Grounded theory (semistructured in-depth interviews)	n = 11 PLWD	Mild AD (MMSE: 22 − 27)	65 – 82	f (n = 5) m (n = 6)	PLWD living at home with a spouse	Subsample of the Danish Alzheimer Intervention Study	Denmark	Coping strategies of PLWD in everyday life and social relationships	Behavioral and psychological symptoms of dementia, such as difficulty communicating, are associated with reduced feeling of safety.	–
Wang et al. (2012)	Exploratory research design (one-on-one in-depth interviews)	n = 12 family caregivers	Spouse, children and children-in-law of PLWD	47 – 78	f (n = 12)	Family members caring for their relatives with AD with hoarding behavior for six or more months	Outpatient dementia clinic and local dementia association	Taiwan	Characteristics and underlying meaning of hoarding behavior in PLWD	Hoarding behavior as an expression of safety needs in situations in which there is a feeling of being financially exploited by others.	+
Wang et al. (2015)	Exploratory research design (semistructured interviews)	n = 65 family caregivers	Spouse, children, children-in-law and other relatives of PLWD	34 − 81	f (n = 47), m (n = 18)	Family caregiver of people living with AD and disruptive behaviors within the last two weeks	Outpatient dementia clinic at a university hospital and a home care center	Taiwan	Investigated and compared the needs of PLWD with five different disruptive behaviors	Disruptive behavior as an expression of unmet needs for feeling mentally and economically safe, especially among women.	+
Yatczak (2014)	Ethnographic design (observations, informal semistructured interviews and videotaping)	(a) n = 67 residents (n = 24 PLWD) (b) n = 23 family members (c) n = 79 staff	(a) Moderate to advanced stage dementia (GDS: 5 − 7) (b) Family members of PLWD (c) Nursing staff, administrators, intake coordinators, dietary staff, housekeeping staff	–	f, m	PLWD living in a senior care community	Health care staff	USA	Relationship between PLWD and the “material world” (interaction with objects)	Routines in everyday life can strengthen the feeling of safety.	+
Quantitative studies
Manera et al. (2016)	Feasibility study (self-reported questionnaires)	(a) n = 29 PLWD (b) n = 28 people with mild cognitive impairment	(a) AD, mixed and vascular dementia, primary progressive aphasia, organic brain syndrome (MMSE: 20.2 ± 3.1) (b) (MMSE: 25.4 ± 2.6)	(a) 65 − 90 (b) 62 − 89	(a) f (n = 12), m (n = 17) (b) f (n = 13), m (n = 15)	Participants visit an institute for regular medical consultation or neuropsychological assessments	Memory center and research unit	France	Assessed acceptability, interest and usability problems of Virtual Reality for PLWD compared to a paper condition for attention training	Participants reported high feelings of security in the Virtual Reality training (mean = 9.4/10, standard deviation = 1.3).	–
Osborne et al. (2010)	Descriptive design (interviews and questionnaires)	(a) n = 51 PLWD (b) n = 51 close relatives	(a) AD, vascular, frontotemporal, Lewy body and Korsakoff’s dementia (b) Partner, children and siblings of PLWD	(a) 60 − 94 (b) –	(a) f (n = 32), m (n = 19) (b) f, m	PLWD living in the community or in residential/nursing homes	Health services, day centers, nursing homes and support groups	England	Analyzed the associations between demographic, cognitive and psychological factors and parent fixation in PLWD	PLWD can experience dependence on others and a loss of control. Those who previously gained a feeling of safety through independence and control may be less able to cope with dementia.	–
Mixed-methods studies
Groenewoud et al. (2017)	Unclear (observations and interviews)	n = 54 PLWD n = 177 observations n = 177 interviews	Mild to severe dementia	59 – 95	f (n = 30), m (n = 24)	PLWD participating in day care centers or living in facilities from health care organizations	Health care staff	The Netherlands	Feelings about playing one-player causal games and access for PLWD	PLWD reported negative experiences and a reduced feeling of safety while playing games.	–
Nijhof et al. (2013)	Evaluation study (semistructured interviews, project group meetings, nurse diaries, cost analysis and observations)	(a) n = 14 PLWD (b) n = 14 informal caregivers (c) n = 14 formal caregiver n = 38 semistructured interviews (informal caregivers) n = 8 project meetings	(a) Mild to severe dementia (MMSE: 13 − 29) (b) – (c) Health care providers, project manager, technician and research assistant	(a) 58 − 87 (b) – (c) 35 – 79	(a) f (n = 6), m (n = 8) (b) – (c) f (n = 8), m (n = 6)	PLWD living at home and receiving homecare services	Formal caregivers selected clients diagnosed with dementia	The Netherlands	Evaluating preventive sensor technologies that detect behavior-related problems at home	The preventive sensor technology promoted a feeling of safety.	+

PLWD: people living with dementia; AD: Alzheimer’s disease; f: female; m: male; MMSE: Mini Mental State Examination; FAST: Functional Assessment Staging Test; GDS: Global Deterioration Scale.

Critical appraisal: “++ (all or most of the checklist criteria have been fulfilled, where they have not been fulfilled the conclusions are very unlikely to alter), + (some of the checklist criteria have been fulfilled, where they have not been fulfilled, or not adequately described, the conclusions are unlikely to alter), – (few or no checklist criteria have been fulfilled and the conclusions are likely or very likely to alter)” (National Institute for Health & Care Excellence, 2012).

Table 2. Inner conditions of emotional safety in people living with dementia.

Dimensions	Inner condition	Specification	Context or setting	Self-reported strategies
				Self-performed strategies of PLWD	Strategies performed by others
Inner conditions related to psychological aspects	Perceived self-efficacy and self-determination [1^a, 3^a, 9^b, 12^a]	Perceived demands described as impossible to overcome and decreased feelings of safety [3^a]	Leaving home to visit public spaces [3^a]	Not leaving the house alone [3^a]	–
		Feeling safe in problematic situations, ended positively from the point of view of PLWD [12^a]	Finding way back home [12^a]	Using visual aids (note with name/address or recognition of the physical landscape) [4^b, 10^a, 11^a]	–
		Impairment of internal safety when self-efficacy is disturbed by processes of incapacitation [1^a]	Relationships with close relatives [1^a]	–	Support by self-help groups for the development of solution strategies [1^a]
		Perceived self-determination leads to feelings of safety [9^b]	Professional caregiver considers the wishes of PLWD and reacts accordingly and quickly [9^b]	Leaving decisions that PLWD cannot make or can only make with difficulty to other people [9^b]	Other people make decision at PLWD’s request [9^b]
	Willingness to receive support [1^a]	Feeling safe can only be achieved if PLWD are willing to be supported [1^a]	PLWD search for what they describe as good [1^a]	–	–
	Perceived dependency on others [1^a]	Coping with perceived dependency, negative perceived control and experience of safety [1^a]	Perceived dependency in relationship with others [1^a]	–	–
	Perceived mental stability [15^c]	Perceived mental stability increase feelings of safety [15^c]	Needs of PLWD and disruptive behaviors [15^c]	A desire to feel mentally safe expressed in repeated and altered eating behavior and delusions [15^c]	–
	Perceived familiarity [4^b, 6^a, 8^b, 10^a, 11^a]	Feelings of safety are present in familiar places [6^a, 8^b, 10^a, 11^a]	Finding way back home [6^a] PLWD living in the community [10^a, 11^a]	Claiming private spaces [10^a, 11^a]	Places no longer familiar are not visited by the PLWD and their relatives [6^a]
			Use of outdoor environments [8^b]
		Feeling safe when familiar faces are around PLWD [4^b]	Leaving home to visit public spaces [4^b]	–	–
	Perceived information need [1^a]	Providing information can strengthen feelings of safety [1^a]	The role of self-help groups [1^a]	–	Support from self-help groups [1^a]
	Assurance that others care for PLWD [2^a, 5^a, 7^c, 13^a, 14^b]	Feelings of safety were described as knowing that support is always available [2^a, 7^c, 13^a]	Living in a nursing home [7^c, 13^a] Hospital environment [2^a]	–	Transition between home care and nursing home [7^c]
		Perceived safety when knowing PLWD are monitored by formal caregiver [14^b]	Living at home [14^b]	–	Use of monitoring systems [14^b]
		Decreased feeling of safety when worrying that others are not cared for [5^a]	Crossing roads [5^a]	Increased attention, waiting until an unsafe situation has changed, and changing behavior [5^a]	Use physical assistive devices (e.g. traffic lights) [5^a]
Inner conditions related to economic aspects	Perceived material stability and control [15^c, 16^c]	“Ensuring a stable feeling for personal belongings” promotes feeling of safety [15^c, 16^c]	Hoarding behavior [15^c, 16^c]	A need for material safety expressed by hoarding and aggressive behavior [15^c, 16^c] PLWD feel safer when they express their concerns about maintaining self-control (though often in aggressive behavior) [15^c]	Identify patients’ security needs [16^c]
	Perceived preparedness for possible situations [16^c]	“Gaining a steady feeling of preparedness” promotes feeling of safety [16^c]	Hoarding behavior [16^c]
	Fear of being exploited by others [6^a, 15^c, 16^c]	PLWD do not feel safe when they are afraid of being exploited by others [6^a, 15^c, 16^c]	Payment situation [6^a] Hoarding behavior [15^c, 16^c]

[1] Panke-Kochinke (2013); [2] Hung et al. (2017); [3] Brataas et al. (2010); [4] Brittain et al. (2010); [5] Brorsson et al. (2013); [6] Brorsson et al. (2011); [7] Cronfalk et al. (2017); [8] Duggan et al. (2008); [9] Ericsson et al. (2013); [10] Genoe and Dupuis (2011); [11] Genoe (2009); [12] Mazaheri et al. (2014); [13] Mjørud et al. (2017); [14] Nijhof et al. (2013); [15] Wang et al. (2015); [16] Wang et al. (2012).

^a Perspective of PLWD: [1, 2, 3, 5, 6, 10, 11, 12, 13].

^b Perspectives of PLWD and others: [4, 8, 9, 14].

^c Perspectives of family members: [7, 15, 16].

Figure 1. Study selection process (PRISMA-Statement) (Moher et al., 2009).

Table 3. Outer conditions of emotional safety in people living with dementia.

Dimensions	Outer conditions	Specification	Context or setting	Self-reported strategies
				Self-performed strategies of PLWD	Strategies performed by others
Outer conditions related to social aspects	Opportunity to interact socially [1^a, 2^a, 3^a, 12^a, 13^a, 17^c, 18^a, 19^a, 20^b]	PLWD feel safe when they interact socially and are not alone [12^a]	Visiting public spaces [12^a]	People who threaten feelings of safety are avoided [1^a, 7^c]	–
	Attitude towards PLWD [1^a, 3^a, 12^a, 13^a]	A subtheme of feelings of safety are positive attitudes (goodness, respect, understanding, considering each other equals, and open-mindedness) [3^a, 13^a]	Participating in a day care program [3^a] Nursing home [13^a]	–	–
		If others do not discriminate and express dissatisfaction with PLWD, PLWD feel safe [12^a]	Visiting public spaces [12^a]	–	–
		Unpleasant and offensive attitude (deficits PLWD are named (e.g. forgetfulness)) decrease feelings of safety [1^a]	Living in a relationship [1^a]	–	–
		A place of sympathy and recognition increases feelings of safety [1^a]	Meaning of self-help groups [1^a]	–	–
	Behavior of others [2^a, 17^c, 18^a]	Unconcentrated or hurried behavior can decrease feelings of safety in PLWD [17^c]	Living at home and using home care services [17^c]	–	Highlighted safety in care [17^c]
		PLWD feel threatened when others move too fast [2^a]	Hospital environment [2^a]	–	–
		PLWD feel threatened when others are too close to them [2^a]	Hospital environment [2^a]	–	–
		Changes in relatives’ behavior can decrease feelings of safety [18^a]	Coping with changes in everyday life [18^a]	–	–
	Living in relationships [19^a, 20^b]	PLWD feel safe in their relatives’ presence [20^b]	Surgical wards [20^b]	–	–
		Friendships can provide feelings of safety [19^a]	Online blogs [19^a]	–	–
	Receiving support [1^a, 2^a, 3^a, 7^c, 9^b, 13^a, 15^c]	Continuum between external control creating fear and support providing a feeling of safety [1^a]	Coping with dementia [1^a]	–	Adjustment of the nursing service (consider emotional experience, repeat information, adapt behavior, provide time and identify patients’ safety needs) [9^b, 16^c, 21^a]
	Establish relationships in care [9^b]	Adaptability and empathy of strangers (e.g. changing behavior) can lead to a feeling of safety [9^b]	Establish relationships in residential units [9^b]	–
		Approach in a nonthreatening way provides a feeling of safety [9^b]	Establish relationships in residential units [9^b]	–
		An inviting environment and considering self-determination in approaching were important for feelings of safety [9^b]	Establish relationships in residential units [9^b]	–
	Performing stressful tasks [3^a]	Other people organized stressful tasks for PLWD and thereby strengthened the feeling of safety [3^a]	Participate in a day care program [3^a]	–	Ordering transfer for the right time and space from home to public spaces [3^a]
	Access to help [1^a, 2^a, 7^c, 13^a, 15^c]	Access to care in the near surroundings gives a feeling of safety (e.g. in activities of daily living) [1^a, 2^a, 7^c, 13^a]	Coping with dementia [1^a] Changes in the living environment due to worsening of the disease [7^c] Nursing home [13^a] Hospital environment [2^a]	–	Organization of transition between home care and nursing home [7^c]
		Receiving care in activities of daily living can reduce feelings of safety (e.g. bathing by health care providers) [15^c]	PLWD and disruptive behavior [15^c]	–	–
Outer conditions related to physical aspects	Time of day [6^a]	In later times of day and darkness, PLWD did not feel safe [6^a]	Visiting in public spaces [6^a]	–	Going outside with others in situations where they feel unsafe [6^a]
	Background sounds/stress of noises [2^a, 5^a]	PLWD did not feel safe when they could not differentiate sounds and do not know which sounds to pay attention to [5^a]	Crossing roads [5^a]	–	–
		Noises from others (e.g. screaming or crying) have an impact on feelings of safety [2^a]	Hospital environment [2^a]	–	Have places to escape from the stress of noise [2^a]
	Changing living home [7^c]	Changing the home situation can result in feeling safe [7^c]	Transition between home care and nursing home [7^c]	–	–
	Private spaces [10^a, 11^a]	Private spaces in which PLWD know where things are and can design themselves lead to a feeling of safety [10^a, 11^a]	PLWD living in the community [10^a, 11^a]	Leisure by claiming private space [10^a, 11^a]	Creating a private space [10^a, 11^a]
		Private spaces in which PLWD can practice their own skills “where risk of failure was relatively minimal” was also a space of feeling safe [10^a, 11^a]	PLWD living in the community [10^a, 11^a]	–	–
	Building design [2^a, 22^c, 23^c]	Building design should enable PLWD to feel safe and maintain their mobility [22^c]	Design in nursing homes for PLWD [22^c]	–	A place of safety should afford opportunities to engage in familiar everyday activities such as going for walks [2^a]
		Aesthetics and practicality of the environment are related to feelings of safety (e.g. overcrowded corridors) [2^a]	Design for PLWD in hospital environments [2^a]	–	Creating a tidy and organized environment [2^a]
		In “a warm atmosphere”, PLWD can feel safe [23^c]	Dying well with dementia [23^c]	–	–
	Technologies [4^b, 6^a, 14^b, 24^a, 25^b]	Using technology can decrease feelings of safety if they are not adapted to the abilities and interests of PLWD [6^a, 24^a]	Playing games [24^a] Using cash machines in public spaces [6^a]	Using technological aids (mobile phone, not accepted by everyone) [4^b]	–
		Using technology can decrease feelings of safety when the purpose is unclear [24^a]	Playing games [24^a]	–	–
		Monitoring systems can enhance feelings of safety [14^b]	Sensor technology at home [14^b]	–	–
		PLWD who use Virtual Reality reported high feelings of safety [25^b]	Virtual Reality in cognitive training [25^b]	–	–
		Technology that connects the physical and social environment can provide feelings of safety [4^b]	Mobile phones in public spaces [4^b]	–	–

[1] Panke-Kochinke (2013); [2] Hung et al. (2017); [3] Brataas et al. (2010); [4] Brittain et al. (2010); [5] Brorsson et al. (2013); [6] Brorsson et al. (2011); [7] Cronfalk et al. (2017); [9] Ericsson et al. (2013); [10] Genoe and Dupuis (2011); [11] Genoe (2009); [12] Mazaheri et al. (2014); [13] Mjørud et al. (2017); [14] Nijhof et al. (2013); [15] Wang et al. (2015); [16] Wang et al. (2012); [17] Hansen et al. (2017); [18] Sørensen et al. (2008); [19] Faith (2014); [20] Hynninen et al. (2015); [21] Clare et al. (2008); [22] Hadjri et al. (2015); [23] Lawrence et al. (2011); [24] Groenewoud et al. (2017); [25] Manera et al. (2016).

^a Perspective of PLWD: [1, 2, 3, 5, 6, 10, 11, 12, 13, 18, 19, 21, 24].

^b Perspective of PLWD and others: [4, 9, 14, 20, 25].

^c Perspective of proxies: [7, 15, 16, 17, 22, 23].

Table

Step of search	Hits	Search terms
1	214,405	"dementia" [Mesh Terms] OR dementia[Title/Abstract] OR demen*[Title/Abstract] OR dementias[Title/Abstract] OR demented[Title/Abstract] OR alzheimer[Title/Abstract] OR alzheimer’s[Title/Abstract] OR alzheimers[Title/Abstract] OR alzheimer*[Title/Abstract] OR pwd[Title/Abstract] OR lewy-body-dementia[Title/Abstract] OR “lewy-body disease”[Title/Abstract] OR “lewy body disease”[Title/Abstract] OR “binswanger disease”[Title/Abstract]
2	1,257,625	"safety" [Mesh Terms] OR “patient harm” [Mesh Terms] OR “patient safety” [Mesh Terms] OR "safety management"[Mesh Terms] OR “risk management” [Mesh Terms] OR safe[Title/Abstract] OR safe*[Title/Abstract] OR safeties[Title/Abstract] OR safety[Title/Abstract] OR secure[Title/Abstract] OR secure*[Title/Abstract] OR secureness[Title/Abstract] OR safeness[Title/Abstract] OR harm[Title/Abstract] OR harms[Title/Abstract] OR threatened[Title/Abstract] OR threats[Title/Abstract] OR threat[Title/Abstract] OR threat*[Title/Abstract] OR threateningly[Title/Abstract] OR threatens[Title/Abstract] OR threatful[Title/Abstract] OR uncertain*[Title/Abstract] OR uncertain[Title/Abstract] OR uncertainty[Title/Abstract] OR unsure[Title/Abstract] OR insecure[Title/Abstract] OR unsafe[Title/Abstract]
3	1,357,497	“emotions” [Mesh Terms] OR emotions[Title/Abstract] OR emotion[Title/Abstract] OR emotion*[Title/Abstract] OR feeling[Title/Abstract] OR feelings[Title/Abstract] OR feel[Title/Abstract] OR feel*[Title/Abstract] OR emotional[Title/Abstract] OR socio-emotional[Title/Abstract] OR psychological[Title/Abstract] OR psychosocial[Title/Abstract] OR psychical[Title/Abstract] OR experience[Title/Abstract] OR experienced[Title/Abstract] OR experiences[Title/Abstract]
4	968,267	needs[Title/Abstract] OR need[Title/Abstract] OR desire[Title/Abstract] OR desires[Title/Abstract] OR wish[Title/Abstract] OR wishes[Title/Abstract]
5	341,648	“living well”[Title/Abstract] OR “live well”[Title/Abstract] OR “meaningful lives”[Title/Abstract] OR “meaningful life”[Title/Abstract] OR “good life”[Title/Abstract] OR (“give meaning”[Title/Abstract] AND life[Title/Abstract]) OR “quality of life”[Title/Abstract] OR “life quality”[Title/Abstract] OR “health-related quality of life”[Title/Abstract] OR “health related quality of life”[Title/Abstract] OR “quality of life” [Mesh Terms] OR “HRQoL”[Title/Abstract] OR “QoL”[Title/Abstract] OR well-being[Title/Abstract] OR wellbeing[Title/Abstract] OR (human[Title/Abstract] AND living[Title/Abstract])
6	1547	#1 AND #2 AND #3
7	2841	#1 AND #4 AND #3
8	732	#1 AND #2 AND #5
9	1381	#1 AND #4 AND #5
10	5221	#6 OR #7 OR #8 OR #9
11	1254	#1 AND #2 AND #4
12	2440	#1 AND #3 AND #5
13	3611	#11 OR #12
14	6435	(#10 OR #13) AND medline[sb]
15	3870	(#10 OR #13) AND medline[sb] AND (\"2007/11/01\"[PDAT]: \"2017/10/31\"[PDAT])")

Table

Step of search	Hits	Search terms
1	218,062	"dementia" [Mesh Terms] OR dementia[Title/Abstract] OR demen*[Title/Abstract] OR dementias[Title/Abstract] OR demented[Title/Abstract] OR alzheimer[Title/Abstract] OR alzheimer’s[Title/Abstract] OR alzheimers[Title/Abstract] OR alzheimer*[Title/Abstract] OR pwd[Title/Abstract] OR lewy-body-dementia[Title/Abstract] OR “lewy-body disease”[Title/Abstract] OR “lewy body disease”[Title/Abstract] OR “binswanger disease”[Title/Abstract]
2	48,903	insecurity[Title/Abstract] OR security[Title/Abstract] OR securi*[Title/Abstract] OR insecuri*[Title/Abstract]
3	1,378,008	“emotions” [Mesh Terms] OR emotions[Title/Abstract] OR emotion[Title/Abstract] OR emotion*[Title/Abstract] OR feeling[Title/Abstract] OR feelings[Title/Abstract] OR feel[Title/Abstract] OR feel*[Title/Abstract] OR emotional[Title/Abstract] OR socio-emotional[Title/Abstract] OR psychological[Title/Abstract] OR psychosocial[Title/Abstract] OR psychical[Title/Abstract] OR experience[Title/Abstract] OR experienced[Title/Abstract] OR experiences[Title/Abstract]
4	985,297	needs[Title/Abstract] OR need[Title/Abstract] OR desire[Title/Abstract] OR desires[Title/Abstract] OR wish[Title/Abstract] OR wishes[Title/Abstract]
5	348,791	“living well”[Title/Abstract] OR “live well”[Title/Abstract] OR “meaningful lives”[Title/Abstract] OR “meaningful life”[Title/Abstract] OR “good life”[Title/Abstract] OR (“give meaning”[Title/Abstract] AND life[Title/Abstract]) OR “quality of life”[Title/Abstract] OR “life quality”[Title/Abstract] OR “health-related quality of life”[Title/Abstract] OR “health related quality of life”[Title/Abstract] OR “quality of life” [Mesh Terms] OR “HRQoL”[Title/Abstract] OR “QoL”[Title/Abstract] OR well-being[Title/Abstract] OR wellbeing[Title/Abstract] OR (human[Title/Abstract] AND living[Title/Abstract])
6	83	#1 AND #2 AND #3
7	38	#1 AND #2 AND #5
8	98	#6 OR #7
9	73	#1 AND #2 AND #4
10	114	(#8 OR #9) AND medline[sb]
11	75	(#8 OR #9) AND medline[sb] AND (\"2007/11/01\"[PDAT]: \"2017/10/31\"[PDAT])")

Table

Step of search	Hits	Search terms
1	71,755	TITLE-ABS (dementia OR demen* OR dementias OR demented OR alzheimer OR alzheimers OR alzheimer* OR pwd OR “lewy-body-dementia” OR “lewy body disease” OR “lewy-body disease” OR “binswanger disease”) AND NOT INDEX(medline)
2	1,733,027	TITLE-ABS (safe OR safe* OR safeties OR safety OR secure OR secure* OR secureness OR safeness OR harm OR harms OR threatened OR threats OR threat OR threateningly OR threatens OR threatful OR threat* OR uncertain OR uncertain* OR uncertainty OR unsure OR insecure OR unsafe) AND NOT INDEX(medline)
3	1,587,762	TITLE-ABS (emotion* OR emotion OR emotions OR feeling OR feelings OR feel OR feel* OR emotional OR socio-emotional OR psychological OR psychosocial OR psychical OR experience OR experienced OR experiences) AND NOT INDEX(medline)
4	1,842,543	TITLE-ABS (needs OR need OR desire OR desires OR wish OR wishes) AND NOT INDEX(medline)
5	212,159	TITLE-ABS (“living well” OR “live well” OR “meaningful lives” OR “meaningful life” OR “good life” OR (“give meaning” AND life) OR “quality of life” OR “life quality” OR “health-related quality of life” OR “health related quality of life” OR HRQoL OR QoL OR well-being OR wellbeing OR (human AND living)) AND NOT INDEX(medline)
6	562	#1 AND #2 AND #3
7	1479	#1 AND #4 AND #3
8	312	#1 AND #2 AND #5
9	682	#1 AND #4 AND #5
10	2433	6 OR 7 OR 8 OR 9
11	546	#1 AND #2 AND #4
12	1106	#1 AND #3 AND #5
13	1606	#11 OR #12
14	2571	#10 OR #13 (LIMIT-TO ( PUBYEAR ,  2017 )  OR  LIMIT-TO ( PUBYEAR ,  2016 )  OR  LIMIT-TO ( PUBYEAR ,  2015 )  OR  LIMIT-TO ( PUBYEAR ,  2014 )  OR  LIMIT-TO ( PUBYEAR ,  2013 )  OR  LIMIT-TO ( PUBYEAR ,  2012 )  OR  LIMIT-TO ( PUBYEAR ,  2011 )  OR  LIMIT-TO ( PUBYEAR ,  2010 )  OR  LIMIT-TO ( PUBYEAR ,  2009 )  OR  LIMIT-TO ( PUBYEAR ,  2008 )  OR  LIMIT-TO ( PUBYEAR ,  2007 )

Table

Step of search	Hits	Search terms
1	73,203	TITLE-ABS (dementia OR demen* OR dementias OR demented OR alzheimer OR alzheimers OR alzheimer* OR pwd OR “lewy-body-dementia” OR “lewy body disease” OR “lewy-body disease” OR “binswanger disease”) AND NOT INDEX(medline)
2	482,930	TITLE-ABS (security OR insecurity OR secure* OR insecuri*) AND NOT INDEX(medline)
3	1,617,616	TITLE-ABS (emotion* OR emotion OR emotions OR feeling OR feelings OR feel OR feel* OR emotional OR socio-emotional OR psychological OR psychosocial OR psychical OR experience OR experienced OR experiences) AND NOT INDEX(medline)
4	1,878,690	TITLE-ABS (needs OR need OR desire OR desires OR wish OR wishes) AND NOT INDEX(medline)
5	217,186	TITLE-ABS (“living well” OR “live well” OR “meaningful lives” OR “meaningful life” OR “good life” OR (“give meaning” AND life) OR “quality of life” OR “life quality” OR “health-related quality of life” OR “health related quality of life” OR HRQoL OR QoL OR well-being OR wellbeing OR (human AND living)) AND NOT INDEX(medline)
6	82	#1 AND #2 AND #3
7	44	#1 AND #2 AND #5
8	71	#1 AND #2 AND #4
9	143	#6 OR #7 OR #8
10	104	#9 (LIMIT-TO ( PUBYEAR ,  2017 )  OR  LIMIT-TO ( PUBYEAR ,  2016 )  OR  LIMIT-TO ( PUBYEAR ,  2015 )  OR  LIMIT-TO ( PUBYEAR ,  2014 )  OR  LIMIT-TO ( PUBYEAR ,  2013 )  OR  LIMIT-TO ( PUBYEAR ,  2012 )  OR  LIMIT-TO ( PUBYEAR ,  2011 )  OR  LIMIT-TO ( PUBYEAR ,  2010 )  OR  LIMIT-TO ( PUBYEAR ,  2009 )  OR  LIMIT-TO ( PUBYEAR ,  2008 )  OR  LIMIT-TO ( PUBYEAR ,  2007 )

Table

Step of search	Hits	Search terms
1	67,339	(MH "Dementia+") OR TI dementia OR AB dementia OR TI demen* OR AB demen* OR TI dementias OR AB dementias OR TI demented OR AB demented OR TI alzheimer OR AB alzheimer OR TI alzheimer’s OR AB alzheimer’s OR TI alzheimers OR AB alzheimers OR TI alzheimer* OR AB alzheimer* OR TI pwd OR AB pwd OR TI “lewy-body-dementia” OR AB “lewy-body-dementia” OR TI “lewy body disease” OR AB “lewy body disease” OR TI “lewy-body disease” OR AB “lewy-body disease” OR TI “binswanger disease” OR AB “binswanger disease”
2	355,762	(MH "Safety+") OR (MH "Patient Safety+") OR (MH "Risk Management+") OR TI safe OR AB safe OR TI safe* OR AB safe* OR TI safeties OR AB safeties OR TI safety OR AB safety OR TI secure OR AB secure OR TI secure* OR AB secure* OR TI secureness OR AB secureness OR TI safeness OR AB safeness OR TI harm OR AB harm OR TI harms OR AB harms OR TI threatened OR AB threatened OR TI threats OR AB threats OR TI threat OR AB threat OR TI threateningly OR AB threateningly OR TI threatens OR AB threatens OR TI threatful OR AB threatful OR TI threat* OR AB threat* OR TI uncertain OR AB uncertain OR TI uncertain* OR AB uncertain* OR TI uncertainty OR AB uncertainty OR TI unsure OR AB unsure OR TI insecure OR AB insecure OR TI unsafe OR AB unsafe
3	454,077	(MH "Emotions+") OR TI emotion* OR AB emotion* OR TI emotion OR AB emotion OR TI emotions OR AB emotions OR TI feeling OR AB feeling OR TI feelings OR AB feelings OR TI feel OR AB feel OR TI feel* OR AB feel* OR TI emotional OR AB emotional OR TI socio-emotional OR AB socio-emotional OR TI psychological OR AB psychological OR TI psychosocial OR AB psychosocial OR TI psychical OR AB psychical OR TI experience OR AB experience OR TI experienced OR AB experienced OR TI experiences OR AB experiences
4	305,667	TI needs OR AB needs OR TI need OR AB need OR TI desire OR AB desire OR TI desires OR AB desires OR TI wish OR AB wish OR TI wishes OR AB wishes
5	151,193	(MH "Quality of Life+") OR TI “living well” OR AB “living well” OR TI “live well” OR AB “live well” OR TI “meaningful lives” OR AB “meaningful lives” OR TI “meaningful life” OR AB “meaningful life” OR TI “good life” OR AB “good life” OR ((TI “give meaning” OR AB “give meaning”) AND (TI life OR AB life)) OR TI “quality of life” OR AB “quality of life” OR TI “life quality” OR AB “life quality” OR TI “health-related quality of life” OR AB “health-related quality of life” OR TI “health related quality of life” OR AB “health related quality of life” OR TI HRQoL OR AB HRQoL OR TI QoL AB QoL OR TI well-being OR AB well-being OR TI wellbeing OR AB wellbeing OR ((TI human OR AB human) AND (TI living OR AB living))
6	716	S1 AND S2 AND S3
7	1820	S1 AND S4 AND S3
8	363	S1 AND S2 AND S5
9	832	S1 AND S4 AND S5
10	2964	S6 OR S7 OR S8 OR S9
11	589	S1 AND S2 AND S4
12	1512	S1 AND S3 AND S5
13	2055	S11 OR S12
14	1797	S10 OR S13 (Limiters: Excluded Medline Records)
15	1256	S14 (Limiters: Exclude Medline Records AND Published Date: 20071101-20171031)

Table

Step of search	Hits	Search terms
1	68,334	(MH "Dementia+") OR TI dementia OR AB dementia OR TI demen* OR AB demen* OR TI dementias OR AB dementias OR TI demented OR AB demented OR TI alzheimer OR AB alzheimer OR TI alzheimer’s OR AB alzheimer’s OR TI alzheimers OR AB alzheimers OR TI alzheimer* OR AB alzheimer* OR TI pwd OR AB pwd OR TI “lewy-body-dementia” OR AB “lewy-body-dementia” OR TI “lewy body disease” OR AB “lewy body disease” OR TI “lewy-body disease” OR AB “lewy-body disease” OR TI “binswanger disease” OR AB “binswanger disease”
2	15,083	TI insecurity OR AB insecurity OR TI security OR AB security OR TI securi* OR AB securi* OR TI insecuri* OR AB insecuri*
3	463,548	(MH "Emotions+") OR TI emotion* OR AB emotion* OR TI emotion OR AB emotion OR TI emotions OR AB emotions OR TI feeling OR AB feeling OR TI feelings OR AB feelings OR TI feel OR AB feel OR TI feel* OR AB feel* OR TI emotional OR AB emotional OR TI socio-emotional OR AB socio-emotional OR TI psychological OR AB psychological OR TI psychosocial OR AB psychosocial OR TI psychical OR AB psychical OR TI experience OR AB experience OR TI experienced OR AB experienced OR TI experiences OR AB experiences
4	313,110	TI needs OR AB needs OR TI need OR AB need OR TI desire OR AB desire OR TI desires OR AB desires OR TI wish OR AB wish OR TI wishes OR AB wishes
5	154,068	(MH "Quality of Life+") OR TI “living well” OR AB “living well” OR TI “live well” OR AB “live well” OR TI “meaningful lives” OR AB “meaningful lives” OR TI “meaningful life” OR AB “meaningful life” OR TI “good life” OR AB “good life” OR ((TI “give meaning” OR AB “give meaning”) AND (TI life OR AB life)) OR TI “quality of life” OR AB “quality of life” OR TI “life quality” OR AB “life quality” OR TI “health-related quality of life” OR AB “health-related quality of life” OR TI “health related quality of life” OR AB “health related quality of life” OR TI HRQoL OR AB HRQoL OR TI QoL AB QoL OR TI well-being OR AB well-being OR TI wellbeing OR AB wellbeing OR ((TI human OR AB human) AND (TI living OR AB living))
6	34	S1 AND S2 AND S3
7	13	S1 AND S2 AND S5
8	41	S6 OR S7
9	33	S1 AND S2 AND S4
10	1797	S8 OR S9 (Limiters: Excluded Medline Records)
11	22	S10 (Limiters: Exclude Medline Records AND Published Date: 20071101-20171031)

Table

Step of search	Hits	Search terms
1	94,233	DE "Dementia" OR DE "Dementia with Lewy Bodies" OR TI dementia OR AB dementia OR TI demen* OR AB demen* OR TI dementias OR AB dementias OR TI demented OR AB demented OR TI alzheimer OR AB alzheimer OR TI alzheimer’s OR AB alzheimer’s OR TI alzheimers OR AB alzheimers OR TI alzheimer* OR AB alzheimer* OR TI pwd OR AB pwd OR TI “lewy-body-dementia” OR AB “lewy-body-dementia” OR TI “lewy body disease” OR AB “lewy body disease” OR TI “lewy-body disease” OR AB “lewy-body disease” OR TI “binswanger disease” OR AB “binswanger disease”
2	227,078	DE "Safety" OR DE "Patient Safety" OR DE "Risk Management" OR TI safe OR AB safe OR TI safe* OR AB safe* OR TI safeties OR AB safeties OR TI safety OR AB safety OR TI secure OR AB secure OR TI secure* OR AB secure* OR TI secureness OR AB secureness OR TI safeness OR AB safeness OR TI harm OR AB harm OR TI harms OR AB harms OR TI threatened OR AB threatened OR TI threats OR AB threats OR TI threat OR AB threat OR TI threateningly OR AB threateningly OR TI threatens OR AB threatens OR TI threatful OR AB threatful OR TI threat* OR AB threat* OR TI uncertain OR AB uncertain OR TI uncertain* OR AB uncertain* OR TI uncertainty OR AB uncertainty OR TI unsure OR AB unsure OR TI insecure OR AB insecure OR TI unsafe OR AB unsafe
3	1,144,032	DE "Emotions" OR TI emotion* OR AB emotion* OR TI emotion OR AB emotion OR TI emotions OR AB emotions OR TI feeling OR AB feeling OR TI feelings OR AB feelings OR TI feel OR AB feel OR TI feel* OR AB feel* OR TI emotional OR AB emotional OR TI socio-emotional OR AB socio-emotional OR TI psychological OR AB psychological OR TI psychosocial OR AB psychosocial OR TI psychical OR AB psychical OR TI experience OR AB experience OR TI experienced OR AB experienced OR TI experiences OR AB experiences
4	458,200	TI needs OR AB needs OR TI need OR AB need OR TI desire OR AB desire OR TI desires OR AB desires OR TI wish OR AB wish OR TI wishes OR AB wishes
5	149,870	(DE "Quality of Life") OR TI “living well” OR AB “living well” OR TI “live well” OR AB “live well” OR TI “meaningful lives” OR AB “meaningful lives” OR TI “meaningful life” OR AB “meaningful life” OR TI “good life” OR AB “good life” OR ((TI “give meaning” OR AB “give meaning”) AND (TI life OR AB life)) OR TI “quality of life” OR AB “quality of life” OR TI “life quality” OR AB “life quality” OR TI “health-related quality of life” OR AB “health-related quality of life” OR TI “health related quality of life” OR AB “health related quality of life” OR TI HRQoL OR AB HRQoL OR TI QoL AB QoL OR TI well-being OR AB well-being OR TI wellbeing OR AB wellbeing OR ((TI human OR AB human) AND (TI living OR AB living))
6	908	S1 AND S2 AND S3
7	2367	S1 AND S4 AND S3
8	335	S1 AND S2 AND S5
9	988	S1 AND S4 AND S5
10	3753	S6 OR S7 OR S8 OR S9
11	622	S1 AND S2 AND S4
12	1933	S1 AND S3 AND S5
13	2514	S11 OR S12
14	3453	S10 OR S13 AND (Published Date: November 2007–October 2017)

Table

Step of search	Hits	Search terms
1	95,582	DE "Dementia" OR DE "Dementia with Lewy Bodies" OR TI dementia OR AB dementia OR TI demen* OR AB demen* OR TI dementias OR AB dementias OR TI demented OR AB demented OR TI alzheimer OR AB alzheimer OR TI alzheimer’s OR AB alzheimer’s OR TI alzheimers OR AB alzheimers OR TI alzheimer* OR AB alzheimer* OR TI pwd OR AB pwd OR TI “lewy-body-dementia” OR AB “lewy-body-dementia” OR TI “lewy body disease” OR AB “lewy body disease” OR TI “lewy-body disease” OR AB “lewy-body disease” OR TI “binswanger disease” OR AB “binswanger disease”
2	34,119	TI insecurity OR AB insecurity OR TI security OR AB security OR TI securi* OR AB securi* OR TI insecuri* OR AB insecuri*
3	1,159,720	DE "Emotions" OR TI emotion* OR AB emotion* OR TI emotion OR AB emotion OR TI emotions OR AB emotions OR TI feeling OR AB feeling OR TI feelings OR AB feelings OR TI feel OR AB feel OR TI feel* OR AB feel* OR TI emotional OR AB emotional OR TI socio-emotional OR AB socio-emotional OR TI psychological OR AB psychological OR TI psychosocial OR AB psychosocial OR TI psychical OR AB psychical OR TI experience OR AB experience OR TI experienced OR AB experienced OR TI experiences OR AB experiences
4	465,563	TI needs OR AB needs OR TI need OR AB need OR TI desire OR AB desire OR TI desires OR AB desires OR TI wish OR AB wish OR TI wishes OR AB wishes
5	153,131	(DE "Quality of Life") OR TI “living well” OR AB “living well” OR TI “live well” OR AB “live well” OR TI “meaningful lives” OR AB “meaningful lives” OR TI “meaningful life” OR AB “meaningful life” OR TI “good life” OR AB “good life” OR ((TI “give meaning” OR AB “give meaning”) AND (TI life OR AB life)) OR TI “quality of life” OR AB “quality of life” OR TI “life quality” OR AB “life quality” OR TI “health-related quality of life” OR AB “health-related quality of life” OR TI “health related quality of life” OR AB “health related quality of life” OR TI HRQoL OR AB HRQoL OR TI QoL AB QoL OR TI well-being OR AB well-being OR TI wellbeing OR AB wellbeing OR ((TI human OR AB human) AND (TI living OR AB living))
6	80	S1 AND S2 AND S3
7	31	S1 AND S2 AND S5
8	94	S6 OR S7
9	51	S1 AND S2 AND S4
10	111	S8 OR S9
11	65	S10 AND (Published Date: November 2007 – October 2017)

Table

Step of search	Hits	Search terms
1	12,566	[mh dementia] OR (“dementia” OR demen* OR “dementias” OR “demented” OR “alzheimer” OR “alzheimer’s” OR “alzheimers” OR “alzheimer*” OR “pwd” OR “lewy-body-dementia” OR “lewy body disease” OR “lewy-body disease” OR “binswanger disease”):ti,ab
2	150,557	[mh safety] OR [mh “safety management”] OR [mh “patient harm”] OR [mh “patient safety”] OR [mh “risk management”] OR (“safe” OR safe OR “safeties” OR “safety” OR “secure” OR secure OR “secureness” OR “safeness” OR “harm” OR “harms” OR “threatened” OR “threats” OR “threat” OR “threateningly” OR “threatens” OR “threatful” OR threat OR “uncertain” OR uncertain OR “uncertainty” OR “unsure” OR “insecure” OR “unsafe”):ti,ab
3	103,023	[mh emotions] OR (emotion OR “emotion” OR “emotions” OR “feeling” OR “feelings” OR “feel” OR feel OR “emotional” OR “socio-emotional” OR “psychological” OR “psychosocial” OR “psychical” OR “experience” OR “experienced” OR “experiences”):ti,ab
4	52,186	(“needs“ OR “need“ OR “desire“ OR “desires“ OR “wish“ OR “wishes“):ti,ab
5	58,206	[mh “Quality of Life”] OR (“living well” OR “live well” OR “meaningful lives” OR “meaningful life” OR “good life” OR (“give meaning” AND “life”) OR “quality of life” OR “life quality” OR “health-related quality of life” OR “health related quality of life” OR “HRQoL” OR “QoL” OR “well-being” OR “wellbeing” OR (“human” AND “living”)):ti,ab
6	278	#1 AND #2 AND #3
7	249	#1 AND #4 AND #3
8	202	#1 AND #2 AND #5
9	197	#1 AND #4 AND #5
10	720	#6 OR #7 OR #8 OR #9
11	143	#1 AND #2 AND #4
12	459	#1 AND #3 AND #5
13	593	#11 OR #12
14	68	#10 OR #13 (Published Date: November 2007 – October 2017)

Table

Step of search	Hits	Search terms
1	12,705	[mh dementia] OR (“dementia” OR demen* OR “dementias” OR “demented” OR “alzheimer” OR “alzheimer’s” OR “alzheimers” OR “alzheimer*” OR “pwd” OR “lewy-body-dementia” OR “lewy body disease” OR “lewy-body disease” OR “binswanger disease”):ti,ab
2	2595	(“insecurity” OR “security” OR “secure*” OR “insecuri*”):ti,ab
3	104,689	[mh emotions] OR (emotion OR “emotion” OR “emotions” OR “feeling” OR “feelings” OR “feel” OR feel OR “emotional” OR “socio-emotional” OR “psychological” OR “psychosocial” OR “psychical” OR “experience” OR “experienced” OR “experiences”):ti,ab
4	53,105	(“needs“ OR “need“ OR “desire“ OR “desires“ OR “wish“ OR “wishes“):ti,ab
5	59,519	[mh “Quality of Life”] OR (“living well” OR “live well” OR “meaningful lives” OR “meaningful life” OR “good life” OR (“give meaning” AND “life”) OR “quality of life” OR “life quality” OR “health-related quality of life” OR “health related quality of life” OR “HRQoL” OR “QoL” OR “well-being” OR “wellbeing” OR (“human” AND “living”)):ti,ab
6	4	#1 AND #2 AND #3
7	4	#1 AND #2 AND #5
8	6	#6 OR #7
9	3	#1 AND #2 AND #4
10	6	#8 OR #9
11	4	#10 (Published Date: November 2007 – October 2017)

Table

Step of search	Hits	Search terms
1	62,274	(dementia OR demen* OR dementias OR demented OR alzheimer OR alzheimers OR alzheimer* OR pwd OR lewy-body-dementia OR lewy body disease OR lewy-body disease OR binswanger disease).ti,ab.
2	328,735	(safe OR safe* OR safeties OR safety OR secure OR secure* OR secureness OR safeness OR harm OR harms OR threatened OR threats OR threat OR threateningly OR threatens OR threatful OR threat* OR uncertain OR uncertain* OR uncertainty OR unsure OR insecure OR unsafe).ti,ab.
3	583,167	(emotion* OR emotion OR emotions OR feeling OR feelings OR feel OR feel* OR emotional OR socio-emotional OR psychological OR psychosocial OR psychical OR experience OR experienced OR experiences).ti,ab.
4	283,606	(needs OR need OR desire OR desires OR wish OR wishes).ti,ab.
5	556,441	(live well OR well-being OR wellbeing OR (human AND living)).ti,ab.
6	405	1 AND 2 AND 3
7	914	1 AND 4 AND 3
8	563	1 AND 2 AND 5
9	712	1 AND 4 AND 5
10	2099	6 OR 7 OR 8 OR 9
11	327	1 AND 2 AND 4
12	1130	1 AND 3 AND 5
13	1418	11 OR 12
14	2052	10 OR 13 (limit last 10 years)

Table

Step of search	Hits	Search terms
1	64,294	(dementia OR demen* OR dementias OR demented OR alzheimer OR alzheimers OR alzheimer* OR pwd OR lewy-body-dementia OR lewy body disease OR lewy-body disease OR binswanger disease).ti,ab.
2	17,984	(security OR insecurity OR secure* OR insecuri*).ti,ab.
3	591,986	(emotion* OR emotion OR emotions OR feeling OR feelings OR feel OR feel* OR emotional OR socio-emotional OR psychological OR psychosocial OR psychical OR experience OR experienced OR experiences).ti,ab.
4	288,944	(needs OR need OR desire OR desires OR wish OR wishes).ti,ab.
5	564,154	(live well OR well-being OR wellbeing OR (human AND living)).ti,ab.
6	27	1 AND 2 AND 3
7	13	1 AND 2 AND 5
8	34	6 OR 7
9	28	1 AND 2 AND 4
10	45	8 OR 9
11	32	10 (limit 2007-2017)

Table

First combination
dementia OR …	AND
safety OR… needs OR …
emotion OR … well-being OR …
Second combination
dementia OR …	AND
safety OR …
needs OR …
Third combination
dementia OR …	AND
emotion OR …
well-being OR …

Brataas, H. V., Bjugan, H., Wille, T., & Hellzen, O. (2010). Experiences of day care and collaboration among people with mild dementia. Journal of Clinical Nursing, 19(19–20), 2839–2848. https://doi.org/10.1111/j.1365-2702.2010.03270.x

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