Adults In Care Homes Research Articles

Home Care Resiliency during the COVID-19 Pandemic: Older Adult-Home Care Aide Dyads’ Perspectives

Homecare has increased its value as an alternative to nursing homes and adapted to evolving COVID-19 challenges. However, little is known about how COVID-19 has impacted community-dwelling older adults who need assistance with daily activities, including dressing, cooking, and shopping. Guided by the stress process framework, this mixed-method study examined how older homecare recipients experienced the acute and chronic stress during the first eight months of the pandemic, focusing on the role of home care aides (HCAs) in the context of Medicaid-funded in-home services. Thirty-five dyads of care recipients and HCAs participated in a COVID telephone survey as part of a larger study. Care recipients were typically older minority (40% African American, 31% Latinx) women (77%). Their COVID-related anxiety level, assessed by a 6-item Spielberger State Anxiety Inventory (1 “not at all” to 4 “very much”), was 2.2 (SD=0.9). While COVID-19 drastically reduced contacts with family members and healthcare providers, HCAs continued to provide care in person. One care recipient said, “Fortunately, I still have my HCA come and that keeps me sane.” HCAs showed resilience while facing their own family- and work-related stress: “I have followed the rules and just adapted. (COVID) did not affect the activities for my client.” Some dyads, however, experienced care disruptions because of COVID infection or fear in one or both parties. COVID-19 has demonstrated homecare resilience at the person-, dyad-, and organization-levels, calling for equitable, sustainable home-based care for a growing number of older adults who desire to stay in the home.

Falls Detection and Prevention Systems in Home Care for Older Adults: Myth or Reality?

There is an exponential increase in the range of digital products and devices promoting aging in place, in particular, devices aiming at preventing or detecting falls. However, their deployment is still limited and only few studies have been carried out in population-based settings owing to the technological challenges that remain to be overcome and the barriers that are specific to the users themselves, such as the generational digital divide and acceptability factors specific to the older adult population. To date, scarce studies consider these factors. To capitalize technological progress, the future step should be to better consider these factors and to deploy, in a broader and more ecological way, these technologies designed for older adults receiving home care to assess their effectiveness in real life.

Hydration Practices in Older Adult Residential Care Homes: A Scoping Review

Older people may be unable to maintain adequate hydration due to decreased fluid intake and increased fluid loss. Residents in care home settings are particularly vulnerable and at an increased risk of dehydration. This is associated with poor outcomes and can lead to severe consequences. Local data on hydration practices within residential care homes is scarce. We therefore sought out to explore evidence on hydration practices, with a view to inform local practice and identify any gaps for future research. A scoping review was conducted and guided by the methodological framework of Arksey and OMalley (2005). A search of ten databases: CINAHL, ProQuest: Health Research Premium Collection, SAGE Premier, Cochrane Library, Springer Journals, WILEY Interscience, BioMed Central, Science Direct Freedom Collection, PubMed (Medline), and Northumbria University Library Search, yielded 36,692 citations, of which 11 papers were selected. Articles from 2015, available in full-text and English language, conducted in Europe and published in peer-reviewed journals, were included in the review. The final 11 papers were subjected to data charting, followed by qualitative thematic analysis, and presented as a narrative synthesis. The three main emerging themes include strategies to promote hydration, assessment of hydration status and interventions that promote hydration. Challenges in reducing dehydration, implementing consistent assessment techniques and interventions remain heterogeneous, thus leaving gaps and uncertainty in standards and benchmarks that will support hydration practices in residential care home settings. Future research on addressing individual needs of residents adopting a person-centred approach is highly recommended.

Oral Environment Status and Related Factors among Older Adult Home Care Patients Who Use Visiting Nursing Services

Oral Environment Status and Related Factors among Older Adult Home Care Patients Who Use Visiting Nursing Services

Homebound status among older adult home care recipients in Ontario, Canada.

Homebound status is associated with an increased risk of morbidity and mortality in older adults, yet little is known about homebound older adults in Canada. Our objectives were to describe time trends in the prevalence of homebound status among community-dwelling long-term home care recipients and the characteristics associated with homebound status. This was a retrospective cross-sectional and cohort study using linked health administrative data in Canada's most populous province, Ontario. We included adults aged 65 years and older who received at least one long-term home care assessment from 2006 to 2017 (N= 666,514). Homebound individuals were those who exited the home an average of 0-1 days/week over the previous 30 days; not homebound comparators exited the home 2-7 days per week. We compared baseline characteristics between groups and estimated the association between these characteristics and homebound status at baseline and over time. From 2006 to 2017, the annual proportion of long-term home care recipients who were homebound increased from 48% to 65%. At first assessment, 50% of the cohort (331,836 of 666,514) were homebound. Among those with a 4-12 month repeat assessment, homebound status persisted over time for 80%, and developed anew in 24%. Dependency on others for locomotion, use of an assistive device, poor access to dwelling, older age, and female sex were most strongly associated with homebound status at baseline, as well as its development and persistence over time. We found that half of Ontario older adult long-stay home care clients were homebound at the time of their first assessment, and that the prevalence of homebound status among home care recipients rose steadily from 2006 to 2017. This informs further research and policy development to ensure the adequacy of supports for older homebound persons.

Smart Clothing as a Noninvasive Method to Measure the Physiological Cardiac Parameters.

In response to global aging, there have been improvements in healthcare, exercise therapy, health promotion, and other areas. There is a gradually increasing demand for such equipment for health purposes. The main purpose of smart clothing is to monitor the physical health status of the user and analyze the changes in physiological signals of the heart. Therefore, this study aimed to examine the factors that affect the measurement of the heart’s physiological parameters and the users’ comfort while wearing smart clothing as well as to validate the data obtained from smart clothing. This study examined the subjective feelings of users (aged 20–60 years) regarding smart clothing comfort (within 12 h); the median values were comfortable and above (3.4–4.5). The clothing was combined with elastic conductive fiber and spandex to decrease the relative movement of the fiber that acts as a sensor and increase the user’s comfort. Future studies should focus on the optimization of the data obtained using smart clothing. In addition to its use in medical care and post-reconstructive surgery, smart clothing can be used for home care of older adults and infants.

Care home residents’ quality of life and its association with CQC ratings and workforce issues: the MiCareHQ mixed-methods study

BackgroundCare home staff have a critical bearing on quality. The staff employed, the training they receive and how well they identify and manage residents’ needs are likely to influence outcomes. The Care Act 2014 (Great Britain.The Care Act 2014. London: The Stationery Office; 2014) requires services to improve ‘well-being’, but many residents cannot self-report and are at risk of exclusion from giving their views. The Adult Social Care Outcomes Toolkit enables social care-related quality of life to be measured using a mixed-methods approach. There is currently no equivalent way of measuring aspects of residents’ health-related quality of life. We developed new tools for measuring pain, anxiety and depression using a mixed-methods approach. We also explored the relationship between care home quality, residents’ outcomes, and the skill mix and employment conditions of the workforce who support them.ObjectivesThe objectives were to develop and test measures of pain, anxiety and depression for residents unable to self-report; to assess the extent to which regulator quality ratings reflect residents’ care-related quality of life; and to assess the relationship between aspects of the staffing of care homes and the quality of care homes.DesignThis was a mixed-methods study.SettingThe setting was care homes for older adults in England.ParticipantsCare home residents participated.ResultsThree measures of pain, anxiety and low mood were developed and tested, using a mixed-methods approach, with 182 care home residents in 20 care homes (nursing and residential). Psychometric testing found that the measures had good construct validity. The mixed-methods approach was both feasible and necessary with this population, as the majority of residents could not self-report. Using a combined data set (n = 475 residents in 54 homes) from this study and the Measuring Outcomes in Care Homes study (Towers AM, Palmer S, Smith N, Collins G, Allan S. A cross-sectional study exploring the relationship between regulator quality ratings and care home residents’ quality of life in England.Health Qual Life Outcomes2019;17:22) we found a significant positive association between residents’ social care-related quality of life and regulator (i.e. Care Quality Commission) quality ratings. Multivariate regression revealed that homes rated ‘good/outstanding’ are associated with a 12% improvement in mean current social care-related quality of life among residents who have higher levels of dependency. Secondary data analysis of a large, national sample of care homes over time assessed the impact of staffing and employment conditions on Care Quality Commission quality ratings. Higher wages and a higher prevalence of training in both dementia and dignity-/person-centred care were positively associated with care quality, whereas high staff turnover and job vacancy rates had a significant negative association. A 10% increase in the average care worker wage increased the likelihood of a ‘good/outstanding’ rating by 7%.LimitationsNo care homes rated as inadequate were recruited to the study.ConclusionsThe most dependent residents gain the most from homes rated ‘good/outstanding’. However, measuring the needs and outcomes of these residents is challenging, as many cannot self-report. A mixed-methods approach can reduce methodological exclusion and an over-reliance on proxies. Improving working conditions and reducing staff turnover may be associated with better outcomes for residents.Future workFurther work is required to explore the relationship between pain, anxiety and low mood and other indicators of care homes quality and to examine the relationship between wages, training and social care outcomes.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 9, No. 19. See the NIHR Journals Library website for further project information.

Eldercare services for people with and without a dementia diagnosis: an analysis of Swedish registry data

BackgroundThe growing number of people living with dementia (PlwD) implies an increase in the demand for eldercare services in Sweden like in many other countries. Few studies have analyzed the use of eldercare services for PlwD. The aim of the present study is to investigate the association between demographic factors (age, sex, cohabiting status) and the use of municipal eldercare services (including both home care and residential care) for older adults with dementia compared to older adults without dementia in Sweden.MethodsThis study used several nationwide Swedish registers targeting all individuals aged 65 and above living in Sweden in 2014 and still alive 31st of March 2015 (n = 2,004,409). The primary outcomes variables were different types of eldercare service, and all participants were clustered based on age, sex, cohabiting status, and dementia diagnosis. In addition to descriptive statistics, we performed multivariate logistic regression models for binary outcomes and linear regression models for continuous outcomes.ResultsResults showed that (1) older age is a significantly strong predictor for the use of eldercare services, although PlwD start using eldercare at an earlier age compared with people without dementia; (2) women tend to receive more eldercare services than men, especially in older age, although men with dementia who live alone are more likely than women living alone to receive eldercare; (3) having a dementia diagnosis is a strong predictor for receiving eldercare. However, it was also found that a substantial proportion of men and women with dementia did not receive any eldercare services.ConclusionsWe found that people with a dementia diagnosis use more as well as start to use eldercare services at an earlier age than people without dementia. However, further research is needed to investigate why a substantial part of people with a dementia diagnosis does not have any eldercare at all and what the policy implications of this might be.

Potential, challenges and pitfalls of pay-for-performance schemes: a narrative review evaluating the merits for the Australian home care sector

PurposeThis qualitative narrative review aims to identify and evaluate the potential, challenges and pitfalls of pay-for-performance (P4P) schemes for the home care of adults with a disability. Due to a limited experimentation with P4P schemes in the context of the home and disability care sectors, the authors conducted a narrative review focusing on related areas of care, primarily nursing home care, to better understand the effectiveness of P4P schemes as a care intervention and evaluate the challenges associated with the introduction of these schemes.Design/methodology/approachThe authors employed a narrative review approach to examine the effectiveness of P4P schemes as a care intervention. The approach included a manual content analysis of the relevant academic and grey literature, focusing on the potential, challenges and pitfalls of P4P for care funders and providers.FindingsThere is some, albeit limited, evidence from other related areas of care to support the effectiveness of P4P to improve the quality of care or the efficiency of its delivery for the home care sector. The results of prior studies are, however, often mixed and inconclusive, due to flaws with the design of schemes, including the nature of the incentives. Limited duration and poor-quality evaluations have further hampered the ability of studies to demonstrate the effectiveness of P4P schemes, which diminishes the credibility of these care interventions. When undertaken systematically, there seems to be some evidence that P4P can work; however, it requires careful design, implementation, measurement and evaluation.Practical implicationsBased on the challenges associated with the successful implementation of P4P schemes, the authors identified lessons for the design, implementation, measurement and evaluation of P4P schemes for care funders and policymakers.Originality/valueThis study critically evaluates the potential of P4P as a care intervention for the home care and disability sectors. By evaluating the potential, challenges and pitfalls associated with P4P in related areas of care, the study provides guidance to home care funders, providers and policymakers in care settings.

Ethics of enforcing the vaccine on healthcare staff

British Journal of Healthcare AssistantsVol. 15, No. 7 ProfessionalEthics of enforcing the vaccine on healthcare staffSarah Jane PalmerSarah Jane PalmerRegistered Nurse and Freelance WriterSearch for more papers by this authorSarah Jane PalmerPublished Online:9 Aug 2021https://doi.org/10.12968/bjha.2021.15.7.354AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Bradfield OM, Giubilini A. Spoonful of honey or a gallon of vinegar? A conditional COVID-19 vaccination policy for front-line healthcare workers. J Med Ethics. 2021 May 11;medethics-2020-107175. doi: https://doi.org/10.1136/medethics-2020-107175. Online ahead of print Google ScholarDepartment of Health and Social Care. Consultation outcome: making vaccination a condition of deployment in older adult care homes. 16 June 2021. https://www.gov.uk/government/consultations/making-vaccination-a-condition-of-deployment-in-older-adult-care-homes/making-vaccination-a-condition-of-deployment-in-older-adult-care-homes (accessed 12 July 2021) Google ScholarRoyal College of Nursing. Consultation response: making vaccination a condition of deployment in older adult care homes. 2021. https://www.rcn.org.uk/about-us/our-influencing-work/policy-briefings/cpc-053-21 (accessed 12 July 2021) Google Scholar FiguresReferencesRelatedDetailsCited byMandatory COVID-19 vaccination for healthcare workers: A discussion paperInternational Journal of Nursing Studies, Vol. 138 2 August 2021Volume 15Issue 7ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 9 August 2021 Published in print 2 August 2021 Information© MA Healthcare LimitedPDF download

Regulation of Long-Term Care Homes for Older Adults in India.

The rising aging population in India has led to an increased caregiving burden, and accordingly, the number of residential care facilities is also burgeoning. There is no regulatory framework or registration authority specifically for residential care homes in India. The article’s objective is to understand the need for a regulatory framework in India in the context of historic and global experiences in the UK, USA, and Europe. Although there is a lack of literature comparing the community home-based care and residential care, one study reported a preference for home-based care in the South Asian context. Elder abuse and deprivation of rights of seniors are common, and there is a need to bring in more safeguards to prevent these from the perspective of the older adults, their family members, the care providers, and the state. While the main priority of meeting care needs in long-term care is a challenge given the lack of trained care staff, the quality control mechanisms also need to evolve. A review of adverse incidents, complaints, and litigations also highlights the need for regulation to improve the standards and quality of care. The article explores lacunae of residential care facilities in the Indian context and provides recommendatory parameters for evaluating the quality of care provided. Relevant sections of the statutory new Mental Healthcare Act of 2017 in India could provide a regulatory framework ensuring rights and liberties of the residents are upheld. The authors propose a state-run model for elderly care homes and commencement of framing regulations appropriate to the Indian context.

Mandatory COVID-19 vaccination for frontline care home staff soon to become law

British Journal of Healthcare AssistantsVol. 15, No. 6 Health MattersMandatory COVID-19 vaccination for frontline care home staff soon to become lawAlan GlasperAlan GlasperEmeritus Professor of Nursing, University of SouthamptonSearch for more papers by this authorAlan GlasperPublished Online:11 Jul 2021https://doi.org/10.12968/bjha.2021.15.6.296AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Albert A. Care homes fear mandatory vaccination will lead to exodus of workers. 26 April 2021. https://www.carehome.co.uk/news/article.cfm/id/1647914/Fears-grow-mandatory-staff-vaccination-could-make-care-home-workers-unemployable (accessed 23 June 2021) Google ScholarAllegretti A. Ministers urged not to ‘threaten’ NHS staff over mandatory COVID jab. 30 May 2021. https://www.theguardian.com/politics/2021/may/30/ministers-urged-not-to-threaten-nhs-staff-over-mandatory-covid-jab (accessed 23 June 2021) Google ScholarAllegretti A. UK rights watchdog endorses compulsory COVID jabs for care home staff https://www.theguardian.com/society/2021/jun/02/uk-rights-watchdog-endorses-compulsory-covid-jabs-for-care-home-staff (accessed 23 June 2021) Google ScholarAragbonfoh Abumere F. Utilitarianism. 2019. https://press.rebus.community/intro-to-phil-ethics/chapter/utilitarianism/ (accessed 23 June 2021) Google ScholarBerger D. Up the line to death: COVID-19 has revealed a mortal betrayal of the world’s healthcare workers. 29 January 2021. https://blogs.bmj.com/bmj/2021/01/29/up-the-line-to-death-covid-19-has-revealed-a-mortal-betrayal-of-the-worlds-healthcare-workers/ (accessed 23 June 2021) Google ScholarBooth R, Rawlinson K. A third of care home staff in some London areas have not had COVID jab. 16 June 2021. https://www.theguardian.com/society/2021/jun/16/all-care-home-staff-in-england-should-have-covid-vaccine-says-minister (accessed 23 June 2021) Google ScholarBrowne Salas J, Comas-Herrera A, Drou Roget G et al. National discussions on mandatory vaccination for long-term care staff in 24 countries. LTCcovid international overviews of long-term care policies and practices in relation to Covid-19 (No. 1, May 2021). 2021. https://ltccovid.org/2021/05/25/national-discussions-on-mandatory-vaccination-among-long-term-care-staff-in-23-countries-ltccovid-international-overviews-of-long-term-care-policies-and-practices-in-relation-to-covid-19-no-1-may/() Google ScholarDepartment of Health and Social Care. Consultation launched on staff COVID-19 vaccines in care homes with older adult residents. 2021a. https://www.gov.uk/government/news/consultation-launched-on-staff-covid-19-vaccines-in-care-homes-with-older-adult-residents (accessed 23 June 2021) Google ScholarDepartment of Health and Social Care. Making vaccination a condition of deployment in older adult care homes. 2021b. https://www.gov.uk/government/consultations/making-vaccination-a-condition-of-deployment-in-older-adult-care-homes (accessed 23 June 2021) Google ScholarField RI. Mandatory vaccination of health care workers: whose rights should come first? PT. 2009;34(11):615–618 Google ScholarGoldstein A. Should health-care workers be required to get coronavirus shots? Companies grapple with mandates. 5 April 2021. https://www.washingtonpost.com/health/should-health-care-workers-be-required-to-get-coronavirus-shots-companies-grapple-with-mandates/2021/04/04/2369048e-92f2-11eb-a74e-1f4cf89fd948_story.html (accessed 23 June 2021) Google ScholarHassan C. Employees protest against Houston hospital’s policy that all staff must be vaccinated against COVID-1. 9 June 2021. https://edition.cnn.com/2021/06/08/us/houston-hospital-staff-protest-vaccine-mandate/index.html (accessed 23 June 2021) Google ScholarHoltug N. The harm principle. Ethical Theory Moral Pract. 2002;5(4):357–389 Crossref, Google ScholarKhinkulova K. Alarming COVID surge cools Russia’s football fever. 19 June 2021. https://www.bbc.co.uk/news/world-europe-5751135 (accessed 23 June 2021) Google ScholarLocke T. UK COVID-19 update: cases ‘rising exponentially’, mandatory NHS jabs divide opinion in Medscape UK poll. 2021. https://www.medscape.com/viewarticle/953270 (accessed 23 June 2021) Google ScholarNightingale F. Notes on nursing: what it is, and what it is not. London: Harrison; 1860 Google ScholarPaterlini M. COVID-19: Italy makes vaccination mandatory for healthcare workers. BMJ 2021; 373: n905 doi: https://doi.org/10.1136/bmj.n905 Google ScholarRoberts L. Nurse who spread Covid conspiracy theories that vaccines will ‘kill you’ struck off. 3 June 2021. https://www.telegraph.co.uk/news/2021/06/03/nurse-spread-covid-conspiracy-theories-vaccines-will-kill-struck/ (accessed 23 June 2021) Google ScholarRoyal College of Nursing. RCN position on mandating vaccination for health and social care staff. 2021. https://www.rcn.org.uk/about-us/our-influencing-work/position-statements/rcn-position-on-mandating-vaccination-for-health-and-social-care-staff() Google ScholarWalker P, Campbell D, Booth R. Plan to oblige care staff to have Covid jab and England easing delay confirmed. 16 Jun 2021. https://www.theguardian.com/politics/2021/jun/16/matt-hancock-confirms-plan-to-require-care-staff-to-have-covid-vaccine (accessed 23 June 2021) Google Scholar FiguresReferencesRelatedDetails 2 July 2021Volume 15Issue 6ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 11 July 2021 Published in print 2 July 2021 Information© MA Healthcare LimitedPDF download

Use of Home Care Services Reduces Care-Related Strain in Long-Distance Caregivers.

Prior work examining the role of older adult home care service use in alleviating strain in family caregivers has resulted in contradictory findings. However, prior research has been entirely limited to caregivers who live within close geographical proximity to their care recipients. Long-distance caregivers are a unique caregiving subgroup that has remained understudied. Guided by the stress process model, this study examined if the association between primary caregiving stressors (the care recipient's functional and cognitive status) and secondary stressors (perceived role strains related to work and to other family responsibilities) in long-distance caregivers was mediated by the care recipient's utilization of home care services. The sample included 166 long-distance caregivers in the United States who provide and manage care to a community-dwelling care recipient living 2 or more hours away. Participants reported on their care recipient's cognitive and functional status, perceived interference of caregiving with work and other family responsibilities, and the care recipient's use of home care services. Path analyses show that home care use by the care recipient fully mediated the association between care recipients' functional impairment and caregiver strains (work and family). Furthermore, home care use partially mediated the effects of care recipients' cognitive impairment on caregiver strains. Results indicate that the care recipient's home care service utilization may serve as a protective factor against care-related strain in long-distance caregivers. These findings can be used to inform intervention efforts focused on a family-centered care approach that can be specifically tailored to long-distance caregivers.

Anxiety, isolation and diminishing resources: the impact of COVID-19 pandemic on residential care home facilities for older people in south-east Nigeria

Purpose Institutionalized older adults in care homes and long-care facilities have been identified as being at greater risk of COVID-19 related morbidity and mortality. Thus, this paper aims to explore the impact of COVID-19 on care homes in south-east Nigeria given the recent increasing popularity of care homes in Nigeria. Design/methodology/approach The study adopted qualitative research method, and data was collected from 10 older residents and 5 caregivers using interviews from two care homes, while ensuring the safety of the researcher and participants. The collected data was analyzed using thematic analysis. Findings Findings revealed that the physical health impact of the COVID-19 pandemic is not a major problem in the homes. However, fear and anxiety, social disconnection and economic hardship were the major problems identified by the older residents and caregivers in the homes. Originality/value The popularity of care homes in Nigeria is growing as family structures continue to change. However, previous studies which have revealed devastating effect of COVID-19 on institutionalized older adults have been from the global north. This is the first study designed to bridge the gap in literature and contribute to knowledge on this topic from Nigeria and Sub-Saharan Africa.

Staff's Psychological Well-Being and Coping Mechanisms During COVID-19 Lockdown in Care Homes for Older Adults: A Structural Equation Modeling Analysis.

The current study investigated the psychological well-being and coping mechanisms of care home staff during the coronavirus disease 2019 (COVID-19) lockdown. Among 147 staff members, 21.8%, 24.5%, and 12.9% reported depression, anxiety, and stress, respectively. The results of structural equation modeling showed that self-efficacy and coping strategies had direct effects on psychological well-being. In the paths from self-perceived caregiving to psychological well-being, self-efficacy and positive coping strategies played mediating roles independently and together, and social support played a mediating role together with coping strategies. Care home staff's psychological well-being was undermined during the COVID-19 lockdown. Interventions aimed at improving staff's self-efficacy, adoption of positive coping strategies, and avoidance of negative coping strategies or considerations of social support along with coping strategies are suggested to decrease exhibited symptoms of depression, anxiety, and stress. [Research in Gerontological Nursing, 14(4), 180-190.].

Experiences of black women adult foster care providers for aging adults: negotiating power and care

ABSTRACT This study explored experiences of 23 Black women owners and operators of Adult Foster Care (AFC) homes for midlife and older adults. Semi-structured interview data focusing on multiple dimensions of the care context were analyzed using grounded theory methods. Women leveraged their resources as they invested their expertise, time, and relationships to support their residents and embraced the value of residents for their contribution to the success of AFC settings. The findings underline the critical roles of these AFC providers in maintaining safe and home-like care contexts for aging adults, in the face of systemic challenges.

The CARESSES Randomised Controlled Trial: Exploring the Health-Related Impact of Culturally Competent Artificial Intelligence Embedded Into Socially Assistive Robots and Tested in Older Adult Care Homes

This trial represents the final stage of the CARESSES project which aimed to develop and evaluate a culturally competent artificial intelligent system embedded into social robots to support older adult wellbeing. A parallel group, single-blind randomised controlled trial was conducted across older adult care homes in England and Japan. Participants randomly allocated to the Experimental Group or Control Group 1 received a Pepper robot for up 18 h across 2 weeks. Two versions of the CARESSES artificial intelligence were tested: a fully culturally competent system (Experimental Group) and a more limited version (Control Group 1). Control Group 2 (Care As Usual) participants did not receive a robot. Quantitative outcomes of interest reported in the current paper were health-related quality of life (SF-36), loneliness (ULS-8), and perceptions of robotic cultural competence (CCATool-Robotics). Thirty-three residents completed all procedures. The difference in SF-36 Emotional Wellbeing scores between Experimental Group and Care As Usual participants over time was significant (F[1] = 6.614, sig = .019, ηp2 = .258), as was the comparison between Any Robot used and Care As Usual (F[1] = 5.128, sig = .031, ηp2 = .146). There were no significant changes in SF-36 physical health subscales. ULS-8 loneliness scores slightly improved among Experimental and Control Group 1 participants compared to Care As Usual participants, but this was not significant. This study brings new evidence which cautiously supports the value of culturally competent socially assistive robots in improving the psychological wellbeing of older adults residing in care settings.

Management of the Care Homes for Older Adults During COVID-19 Pandemic

The older adults are one of the categories of the population that is particularly vulnerable to the COVID-19 virus, both in terms of infection rate and mortality rate. Therefore, in the age of a global pandemic, is particularly complex the management of the care homes, which can become hotspots of the virus. Managing of the care homes for older adults during COVID-19 pandemic is facing with number of challenges, the most important are: 1) lack of protocols and guidelines for care homes with clear and applicable measures and activities; 2) lack of measures to deal with the economic consequences of the crisis. However, despite these shortcomings, the managers of care homes in the Republic of North Macedonia, until the end of April, successfully dealt with the pandemic and did not allow the spread of the virus among care homes residents and employees. The data shows that in 18 from total 30 care homes, have only five registered cases positive for COVID-19 (2 care homes residents and 3 employees), which is 0.33% of the total registered cases in the country. This shows that the management and employees have taken appropriate measures and activities in order to protect against the spread of the virus in the care homes in the Republic of North Macedonia.

Examination of Chinese Older Adults’ Attitudes Toward Senior Living Institutions

Amid population aging, the senior living industry has become an important sector of the service industry, especially in China. Population control throughout the past four decades has led to the quintessential “sandwich” family, wherein a young couple faces pressure to care for four elderly parents as well as their own child(ren). A lack of proper home care for older adults in China has thus accelerated social and economic demand for senior living institutions (SLIs). Although a growing number of SLIs are being built in the country, occupancy rates remain low. It is therefore crucial to explore why older adults are not accepting SLIs as a solution to their needs. This study broaches this topic by investigating the mechanism underlying the impact of family support for choosing an SLI on older adults’ attitudes toward these institutions. Specifically, a mediation model was proposed to investigate the roles of life satisfaction and older adults’ subjective knowledge of SLIs among 1,723 older Chinese adults. Multigroup path analysis was also carried out to test applicable sociodemographic differences. Findings revealed a significant suppressing effect of life satisfaction and a partial mediating effect of subjective knowledge along with group differences. Overall, this study provides meaningful implications for SLI marketing.

Measuring safety in older adult care homes: a scoping review of the international literature

BackgroundSafety is a key concern in older adult care homes. However, it is a less developed concept in older adult care homes than in healthcare settings. As part of study...