Understanding Risks in the Care of People With Dementia in Acute Hospital Settings: Definitions, Types and Management Strategies-A Scoping Review.

AIMS: This scoping review explores how risk is defined, managed and mitigated in the care of people with dementia in acute hospital settings. METHODS: This scoping review followed Arksesy and O'Malley's five-stage framework (2005) and was guided by the Joanna Briggs Institute methodology. A literature search was conducted in October 2023 and updated in December 2024 across Web of Science, MEDLINE, CINAHL, Academic Search Complete and PsycINFO databases. The results were reported as per PRISMA-ScR guidelines. RESULTS: A total of 3916 articles were screened, 181 full-text articles assessed and 61 studies included in the final review. The literature on the care of people with dementia in acute hospital settings demonstrates an implicit understanding of risk, focusing mainly on physical risks with less emphasis on psychological, social and spiritual aspects. Identified risk management strategies include targeted screening, dementia-specific interventions, environmental modifications, non-pharmacological approaches, person-centred family-inclusive care and workforce competency enhancement. Limited studies address positive risk-taking, and ethical considerations are often overlooked, indicating a need for a more balanced approach to risk in the care of people with dementia in acute settings. CONCLUSION: This review highlights critical gaps in the conceptualisation and management of risk in the care of people with dementia in acute settings. A dominant focus on physical safety often overshadows other essential aspects of well-being, and ethical issues are rarely discussed. The findings underscore the urgent need for person-centred, ethically informed approaches that balance safety with autonomy and quality of life. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement was included in this review. IMPLICATIONS FOR THE PROFESSION: This review addresses significant gaps in understanding and managing risks in the care of people with dementia in acute settings. It serves as a vital resource for healthcare professionals to better understand risks in the care of people with dementia in acute settings and consolidate actionable insights that support the delivery of high-quality, person-centred care for patients with dementia. TRIAL REGISTRATION: Open Science Framework: https://doi.org/10.17605/OSF.IO/K67S4.