future research should assess shock-absorbing flooring with better 'push/pull' properties and explore increased faller risk. We estimate a future trial will need 33,480-52,840 person bed-days per arm.

Background: Most people with dementia are cared for by their families at home. This study investigated family carers' identification of barriers and facilitators when caring for a person with dementia at home. Design and methods: Thirteen co-resident family carers were engaged in semistructured in-depth walking interviews. Interviews were recorded, transcribed and analysed using thematic analysis. Results: Home environments can pose a number of challenges and opportunities. Aspects of the architectural and interior environment (e.g. size, condition, layout and accessibility, familiarity) are perceived as important (Theme 1) as well as a plethora of environmental strategies that encourage independence and comfort at home (Theme 2). Carers' scepticism, timing, costs, property characteristics and mistrust of services are some barriers to implementing environmental strategies (Theme 3). Conclusions: Carers often improvise solutions through trial and error. Environmental strategies can create an enabling and comfortable home environment.

Background The domestic home is the preferred site for care provision for people with dementia and their families, therefore creating a dementia and caring friendly home environment is crucial. This systematic review synthesised qualitative studies to explore the role of the home environment and identify potential barriers and facilitators in home dementia care and support to inform future practice and research. Methods A systematic search in 12 databases identified international qualitative literature on perceptions and experiences of community-dwelling people with dementia, family and formal carers regarding the role of the home environment and ways to tackle daily challenges. Results Forty qualitative studies were included and analysed using thematic synthesis. The main three themes were: 'home as a paradox', 'there is no magic formula' and 'adapting the physical space, objects and behaviour'. Findings indicate that home is an important setting and is likely to change significantly responding to the changing nature of dementia. Themes were later validated by family carers of people with dementia. Conclusions The home environment is an important setting for care and needs to remain flexible to accommodate changes and challenges. Family carers and people with dementia implement and often improvise, various environmental strategies. Continuous and tailor-made support at home is required.

Systematic synthesis of qualitative studies is widely used in health and social care. Regardless of the topic area, researchers need to consider several decisions when it comes to the planning and implementation of qualitative synthesis. As junior reviewers, we reflect on potential challenges and pitfalls in planning and conducting a synthesis of qualitative evidence. This article aims to elaborate on a number of key issues in order to provide insights and options on how to avoid or minimize these issues, especially for new reviewers and research students. This article examines difficulties in different stages and presents some examples of how intellectual and technical issues can be approached and resolved, including how to ensure effective identification of the relevant research to answer the review question? What are the potential pitfalls during the screening and evaluation process? The implications of different issues are examined and potential directions are discussed.

No abstract