Aged Care Facilities Research Articles

Improving infection control protocols in healthcare settings: Redesigning workplace safety in aged care for future pandemics

Purpose: This study examines infection prevention and control after COVID-19 in aged care organisations to identify best practices for planning and staff protection for future pandemics. It investigates how technological solutions relate to standard sanitation practices and how they affect healthcare delivery effectiveness measurements and organisational performance. Methodology: The current study was a systematic review and meta-analysis of global studies published between 2019 and 2024 in peer-reviewed journals, using standard data extraction tools and the Mixed Methods Appraisal Tool. The study used Cooper’s Taxonomy of Literature Reviews, using quantitative and qualitative synthesis methods to assess infection control policies in various healthcare institutions. Findings: Facilities implementing integrated technological solutions demonstrated reduced transmission rates and an average of 65% improvement in protocol adherence. Advanced ventilation systems combined with regular staff training led to a reduction in healthcare-associated infections. Notably, smaller facilities achieved outcomes comparable to those of larger institutions when implementing comprehensive technological solutions. Contributions: This study defines a new paradigm for infection control that considers the need to satisfy safety necessities while not utterly disregarding residents’ psychosocial needs. This paper also shows that technology-enhanced protocols are feasible in large and small settings. The results contribute to policy guidelines for minimum technological infrastructure in the organisations while offering research-based recommendations for better preparation for future pandemics in aged care facilities.

Developing and implementing a Digital Stories programme in nursing homes: a qualitative process evaluation

Abstract For older adults requiring permanent care in nursing homes (or residential aged care facilities), there can be a tendency to feel disconnected from their sense of self. Digital storytelling has the potential to improve relationships and social connectedness, and encourage a sense of self and identity; however, there is little research on the implementation of this practice. A qualitative process evaluation was conducted with a sample of 12 volunteers who delivered a Digital Stories programme. The programme connected volunteers with socially isolated residents of nursing homes with the aim of engaging the residents to reminisce and contribute toward creating a digital story about their lives. The study aimed to understand enablers of and barriers to implementing the programme in nursing homes, from the perspective of volunteers. Thematic analysis resulted in several overarching themes and sub-themes. The enablers of implementation included skills and characteristics of the volunteers (e.g. adaptable to residents’ needs), specific features of the programme (e.g. having a shared goal) and support from the nursing home staff. The barriers to implementation included individual traits of the resident (e.g. low capacity for engagement), limitations associated with the prescribed protocol, and managing perspectives regarding what stories are told. Volunteers also made suggestions for future programme development. Implications for successful future digital storytelling projects include ensuring a manualised approach to the program while allowing for flexibility in delivery, careful recruitment of residents and volunteers, and providing comprehensive training and education to volunteers.

Autoencoder-Based Neural Network Model for Anomaly Detection in Wireless Body Area Networks

In medical healthcare services, Wireless Body Area Networks (WBANs) are enabler tools for tracking healthcare conditions by monitoring some critical vital signs of the human body. Healthcare providers and consultants use such collected data to assess the status of patients in intensive care units (ICU) at hospitals or elderly care facilities. However, the collected data are subject to anomalies caused by faulty sensor readings, malicious attacks, or severe health degradation situations that healthcare professionals should investigate further. As a result, anomaly detection plays a crucial role in maintaining data quality across various real-world applications, including healthcare, where it is vital for the early detection of abnormal health conditions. Numerous techniques for anomaly detection have been proposed in the literature, employing methods like statistical analysis and machine learning to identify anomalies in WBANs. However, the lack of normal datasets makes training supervised machine learning models difficult, highlighting the need for unsupervised approaches. In this paper, a novel, efficient, and effective unsupervised anomaly detection model for WBANs is developed using the autoencoder convolutional neural network (CNN) technique. Due to their ability to reconstruct data in a completely unsupervised manner using reconstruction error, autoencoders hold great potential. Real-world physiological data from the PhysioNet dataset evaluated the suggested model’s performance. The experimental findings demonstrate the model’s efficacy, which provides high detection accuracy, as reported F1-Score is 0.96 with a batch size of 256 along with a mean squared logarithmic error (MSLE) below 0.002. Compared to existing unsupervised models, the proposed model outperforms them in effectiveness and efficiency.

Barriers and Facilitators to Physical Activity Among Older Adults in Residential Aged Care Facilities: A Mixed Methods Systematic Review Using the Social Ecological Model.

To ascertain the barriers and facilitators to physical activity (PA) for older adults in Residential Aged Care Facilities (RACFs), from the perspective of residents, staff, and family. A mixed-methods systematic review, underpinned by the Social Ecological Model (SEM). Five databases were searched from inception to May 2024. Data synthesis followed a convergent integrated approach, with relevant quantitative data 'qualitised' and synthesised with qualitative data using thematic synthesis. This review included 67 studies (40 qualitative, 16 mixed-methods, and 11 quantitative). Thematic synthesis identified 51 key themes (27 facilitators and 24 barriers), spanning all levels of the SEM. Intrapersonal factors (e.g. poor general health) were the most commonly cited barriers (n = 53 studies), and interpersonal factors (e.g. social support) the most commonly reported facilitators (n = 55 studies) to PA in RACFs. An interplay of multi-level factors must be addressed in the development and implementation of strategies to promote PA in RACFs.

Use of potentially inappropriate psychotropic medicines among older adults in 23 residential aged care facilities in Australia: a retrospective cohort study

BackgroundPsychotropic medications are frequently utilised in residential aged care facilities (RACFs). Longitudinal medication administration data can offer crucial insights into the potential inappropriate use of psychotropic medicines (PIPMs), guiding future quality improvement initiatives. This study aimed to determine the prevalence and predictors of PIPMs use and assess variation in PIPMs use by facility for residents of RACFs.MethodsWe conducted a retrospective longitudinal cohort study using routinely collected electronic health data (2020–2021) relating to 3064 residents from 23 RACFs in New South Wales, Australia. The study included permanent residents aged ≥ 65 years and median length of stay was 483 days. The prevalence of PIPMs use was estimated using updated Beers criteria 2023. The extent of exposure to PIPMs was measured using two metrics i.e., number of days residents were exposed to PIPMs and the proportion of days covered by PIPMs. We used logistic regression model to determine factors associated with PIPM use. Funnel plots to visualised variation in PIPMs use across facilities.ResultsIn total 40% (n = 1224) residents used at least one PIPM and 10% (n = 302) used ≥ 2. The most frequently used PIPMs categories were benzodiazepines and Z-drugs (27.4%), followed by first and second generation antipsychotics (17.2%). Certain diagnoses (dementia, pain, depression, anxiety, and endocrine disorders) were associated with the increased use of PIPMs. For example, residents with dementia were 1.94 times more likely to use ≥ 2 PIPMs (OR 1.94; 95% CI 1.50–2.51). The prevalence of at least one PIPM by residents in each facility ranged from 23.3 to 57.0% across facilities. The overall median number of days residents were exposed to PIPMs were 91 days (IQR 6-320) while the median proportion of days covered by at least one PIPM was 39.3% (IQR 2.6–86.6%).ConclusionsResidents in aged care facilities showed a high rate of PIPMs use with substantial variation across facilities. Quality improvement initiatives which target inappropriate psychotropic medication use are necessary, particularly considering the link between psychotropic drug use and adverse events such as falls.

Risks associated with evacuation and disaster-related death after a radiation disaster: summary of research results from Hamadori region, Fukushima.

Radiation disasters can lead to a myriad of direct and indirect health effects. The term 'disaster-related deaths' is commonly used in Japan; however, comprehensive studies in regions severely impacted by nuclear accidents are scarce. Our research primarily focuses on Minamisoma City, situated north of the Fukushima Daiichi Nuclear Power Plant (FDNPP), and aimed to study the risks associated with evacuation and disaster-related death. We introduce the following studies: (1) risks from evacuation in elderly care facilities after the FDNPP accident; (2) detailed case reports on hospital evacuation and (3) detailed reports on disaster-related deaths. A critical lesson from the FDNPP accident is the significant risk to life posed by evacuation actions taken to avoid radiation exposure. Despite evacuation being an effective measure to reduce exposure, our preparation and knowledge are insufficient for safe execution. This paper ensures that the lessons from Fukushima are leveraged in future radiation protection measures.

Advanced Care Plan Among Older Chinese in Residential Aged Care: A Retrospective Review.

Worldwide in the population of older people, ethnic diversity is prevalent and therefore warrants culturally sensitive advanced care planning. This study aimed to explore advanced care planning documentation related to the cultural needs of residents of Chinese ethnicity in Australian aged care facilities. A retrospective review of advanced care plan documentation was undertaken among 31 older Chinese residents with life-limiting illnesses across two residential aged care facilities in New South Wales, Australia. Data were analyzed using descriptive statistics. 90% of residents had advanced care planning documentation. The presence of the resident and their representative and medical care directives were well documented. Specific details on the provision of palliative care that considers the person's cultural needs and preferences were limited. Findings suggest the need for further research that explores an optimal way of embedding culture-specific information and the development of a culturally sensitive advanced care plan for people of Chinese ethnicity.

Community Palliative Care: What are the Best Models?

Palliative care seeks to address the physical, psychosocial and spiritual concerns of patients with a life limiting illness and their caregivers. Early referral to palliative care improves symptoms and is the standard of care. This paper evaluates the evidence for different models of community palliative care and looks at the effects of homecare, hospice programs and residential aged care facility (RACF) interventions on symptom management, home death rate and acute health service utilization. It also examines the impact of COVID-19, telehealth, integration and staffing models on the efficacy of community palliative care. Evidence suggests that community palliative care increases the rate of death at home and may improve satisfaction with care, but effect on symptoms and acute health care utilization are less certain. Enrolment in a hospice program may decrease hospitalizations and improve satisfaction. RACF staff training interventions to improve the quality of palliative care provided to residents show mixed results across all indicators. COVID-19 saw a relative increase in the demand for community palliative care, as people opted out of the hospital system. Models of community palliative care that facilitate integration, support primary health providers, and promote technological innovation are worthy of further research.

Air Purifiers and Acute Respiratory Infections in Residential Aged Care

The effectiveness of in-room air purification for the reduction of acute respiratory infections (ARIs) in residential aged-care facilities (RACFs) is unknown. To investigate the effectiveness of in-room air purifiers with high-efficiency particulate air (HEPA)-14 filters in reducing the incidence of ARIs among residents of RACFs. This randomized clinical trial used a multicenter, double-blind, 2-period, 2-treatment crossover design for 6 months from April 7 to October 26, 2023, in 3 RACFs with a bed capacity of 50 to 100 in New South Wales, Australia. The purposive sampling approach included permanent residents in private rooms in the enrolled RACFs. Data collection was performed every 2 weeks and required no additional follow-up beyond the final data collection on October 31, 2023. An air purifier containing a HEPA-14 filter was placed in rooms of participants in the intervention group, and an air purifier without a HEPA-14 filter was placed in rooms of the control participants. The groups crossed over after 3 months. The primary outcome was the incidence of ARIs, assessed with logistic mixed-model regression. Among 135 participants randomized (70 to the intervention-first group and 65 to the control-first group), 78 (57.8%) were female; mean (SD) age was 85.2 (8.6) years. In the intention-to-treat analysis, the use of air purifiers with HEPA-14 filters did not reduce ARIs compared with the control (OR, 0.57; 95% CI, 0.32-1.04; P = .07). Among the 104 participants who completed the entire study, the intervention reduced ARI incidence from 35.6% (37 participants) in the control group to 24.0% (25 participants) in the intervention group (OR, 0.53; 95% CI, 0.28-1.00; P = .048). In this clinical trial investigating use of air purifiers with HEPA-14 filters for reducing ARIs, no significant between-group difference was found in the intention-to-treat analysis. However, a significant reduction in ARIs was identified among participants who completed the entire study. These findings may help inform future large-scale studies of respiratory infectious diseases. ANZCTR identification: ACTRN12623000347662.

Early Warning Systems for Acute Respiratory Infections: Scoping Review of Global Evidence.

Early warning systems (EWSs) are tools that integrate clinical observations to identify patterns indicating increased risks of clinical deterioration, thus facilitating timely and appropriate interventions. EWSs can mitigate the impact of global infectious diseases by enhancing information exchange, monitoring, and early detection. We aimed to evaluate the effectiveness of EWSs in acute respiratory infections (ARIs) through a scoping review of EWSs developed, described, and implemented for detecting novel, exotic, and re-emerging ARIs. We searched Ovid MEDLINE ALL, Embase, Cochrane Library (Wiley), and CINAHL (Ebsco). The search was conducted on October 03, 2023. Studies that implemented EWSs for the detection of acute respiratory illnesses were included. Covidence was used for citation management, and a modified Critical Appraisal Skills Programme (CASP) checklist was used for quality assessment. From 5838 initial articles, 29 met the inclusion criteria for this review. Twelve studies evaluated the use of EWSs within community settings, ranging from rural community reporting networks to urban online participatory surveillance platforms. Five studies focused on EWSs that used data from hospitalization and emergency department visits. These systems leveraged clinical and admission data to effectively detect and manage local outbreaks of respiratory infections. Two studies focused on the effectiveness of existing surveillance systems, assessing their adaptability and responsiveness to emerging threats and how they could be improved based on past performance. Four studies highlighted the integration of machine learning models to improve the predictive accuracy of EWSs. Three studies explored the applications of national EWSs in different health care settings and emphasized their potential in predicting clinical deterioration and facilitating early intervention. Lastly, 3 studies addressed the use of surveillance systems in aged-care facilities, highlighting the unique challenges and needs of monitoring and responding to health threats in environments housing vulnerable populations. The CASP tool revealed that most studies were relevant, reliable, and of high value (score 6: 11/29, 38%; score 5: 9/29, 31%). The common limitations included result generalizability, selection bias, and small sample size for model validation. This scoping review confirms the critical role of EWSs in enhancing public health responses to respiratory infections. Although the effectiveness of these systems is evident, challenges related to generalizability and varying methodologies suggest a need for continued innovation and standardization in EWS development.

A Pilot Study to Assess the Feasibility of Real-Time Teledentistry in Residential Aged Care Facilities.

Unmet oral health needs of residents in residential aged care facilities (RACFs) arise due to the unique challenges of assessing oral health statuses and maintaining oral healthcare in RACFs. This pilot study assessed the feasibility of using real-time teledentistry under the guidance of a dentist to train RACF staff to undertake an oral health assessment. An oral health assessment of residents was first conducted by RACF staff at two Queensland, Australia RACFs using the Oral Health Assessment Tool, with an intra-oral camera connected to a laptop, through videoconferencing, under the guidance of a dentist. A survey recorded the views of RACF staff on the acceptability of the teledentistry method. The quality of the images obtained through the camera was assessed by the dentist. Finally, cost-effectiveness was calculated between teledentistry and traditional face-to-face assessments. Sixteen residents (mean age 79.3 ± 8.68 years) and eight staff (mean age 33.3 ± 6.16 years) participated in this study. Both RACF staff and residents found that the real-time teledentistry set-up was user-friendly, while the dentist rated the quality of the images as acceptable for diagnostic purposes. Real-time teledentistry was more cost-effective than bringing a dentist on-site, while taking the RACF residents to an off-site dental office for examination was the most expensive approach. Real-time teledentistry is feasible and cost-effective, and it is an acceptable alternative to a face-to-face clinical exam for oral health assessment in RACFs. This approach could be used in RACFs where wireless internet connectivity is available.

A Sustainable urban renovation assessment model (SURAM) for enhancing elderly-friendly environments

The rapid increase in the aging population has raised significant concerns about the living conditions and well-being of elderly residents in old communities. This study addresses these concerns by proposing a Sustainable Urban Renovation Assessment Model (SURAM) specifically designed to enhance elderly-friendly environments in Chongqing City. The model encompasses multiple dimensions, including the comfort of public facilities, service safety and convenience, medical travel services, infrastructure security, life service convenience, neighbor relations, ambulance aid accessibility, commercial service facilities, privacy protection, elderly care facilities and service supply, and medical and health facilities. By employing factor analysis, the study reduces the dimensionality of the 49 indicator factors, allowing for a more focused and comprehensive evaluation of the effectiveness of aging-friendly renovation efforts. The main factors identified in the proposed model include community infrastructure security, elderly comfort of community public facilities, completeness and convenience of surrounding living services, and security and convenience of elderly care services. The results reveal that the age-appropriate comfort of public facilities plays a significant role in achieving successful aging-appropriate renovation outcomes. The findings demonstrate that by addressing specific needs such as safety, accessibility, and convenience, communities can significantly improve the quality of life for elderly residents. Moreover, the application of SURAM provides actionable insights for policymakers, urban planners, and community stakeholders, guiding them in implementing targeted initiatives for sustainable and inclusive urban development.

A study on the spatial distribution and optimization strategies of day care centers for the elderly

Background: At present, the degree of ageing in China is becoming severe, especially in Shanghai, which is the largest city with the highest degree of aging in China. How to adjust the community to effectively meet the needs of the elderly groups has become the focus of social attention. Objectives: In this study, spatial analysis was used to explore the matching degree of the elderly population with the distribution of day care centers in Xuhui District, Shanghai, China, to explore the problems, and to propose optimization strategies with a view to providing feasible suggestions for the construction of old-age daycare. Methods: This research adopts the methods of literature study, map analysis, questionnaire survey, especially tries to use the spatial analysis software of Arc GIS in order to set up a spatial database of Xuhui District's elderly population based on street administrative territorial entity. Results: The results show that the quantity and quality of the day care centers in Xuhui District can not meet the actual needs of the elderly. Secondly, the services provided in daycare centers deviate from the actual needs of older population. Thirdly, the day care service content lists are quite homogeneous, which neglects the diversified and personalized needs . Main Contribution to Evidence-Based Practice: From the perspective of spatial distribution study, this article enriches the theory of the construction and management of the elderly care facilities in urban areas, and provides reference for the formulation of aging policy. Meanwhile, it gives some suggestions on optimizing the spatial distribution of community facilities to fulfil the actual needs for optimal matching of the elderly care resources.

Distribution of Australian dental practices in relation to residential aged care facilities: A geographic analysis.

Limited access to oral health services contributes to poor oral health in institutionalised older adults. The objective of this study was to map and analyse the distribution of residential age-care facilities (RACFs) in relation to dental practices across Australia. Age-care data were sourced from the Australian Institute of Health and Welfare. The data were categorised according to the Australian Bureau of Statistics remoteness index in each state and territory, defined by a geographic coordinate system. The structure of remoteness area data was integrated into RACF data using a geographic information system. Buffer analysis in QGIS was employed to calculate the buffer distance surrounding RACFs by identifying dental practices relative to a measuring distance. In total, Australia had 2718 RACFs and 7379 dental practices (both private 95.5% and public 4.5%). In all States, more than a third of metropolitan RACFs were within accessible reach of a private practice (ranging from 37% of RACFs in NSW to 55% in WA). However, proximity to public clinics was low, ranging from only 4% (WA) to 9% (QLD). More than one-fifth of metropolitan RACFs in NSW, QLD, WA and ACT (ranging from 20% to 24%) were not within accessible proximity of either a public or private dental clinic/practice. While more than 70% of RACFs in regional and remote Australia are reasonably close to dental practices, areas with inadequate access exist, with the highest percentage recorded in WA (6%). Ensuring an equitable distribution of dental practices relative to RACFs is crucial in bridging the service access gap in underserved areas.

Physical activity promotion in Aged care: a participatory approach

Abstract Introduction Aged care facilities (ACF) constitute an increasingly important, yet challenging setting for health promotion - given it is a highly sedentary pseudo-total institution characterized by structured daily routines within a paradigm of care for residents perceived as fragile and vulnerable. A participatory approach with residents, significant others, staff, and management might be a promising pathway to address intrapersonal, sociocultural, organizational, environmental, and political determinants of physical activity in this specific context. We will present processes and results from a research project, funded by the German Ministry of Health (2019-2023), on physical activity promotion in ACFs. Methods Our co-creation approach involved residents, significant others, staff, and management from seven nursing homes in Southern Germany. Methods included 800hrs on-site observations, semi-structured interviews (n = 31), Photovoice (n = 27 participants, n = 169 photos), as well as future workshops (n = 14) for intervention co-development (n = 14) and co-evaluation workshops (n = 7). Data analysis used reflexive thematic analysis with MaxQDA20. Results Implemented interventions (n = 57) addressed individual, social, environmental, and organizational factors. Activity promotion was integrated into care concepts and mission statements, staff work descriptions, as well as informal internal routines. Of the interventions implemented, 33% were rated as more successful, 43% as successful, and 19% as less successful than anticipated. Conclusions Participation can initiate structural and cultural change towards physical activity. However, the analyses also emphasized the critical role of staff training, along with the involvement of significant others and external service providers, as essential components for achieving sustainable change. Key messages • Participatory approaches integrate physical activity into aged care, fostering cultural shifts for resident well-being. • Success requires staff training, engaging residents’ support networks, balancing empowerment with protection.

Resuscitation of people with a do-not-resuscitate order: when does it happen and what are the outcomes?

Abstract Background Do-not-resuscitate (DNR) orders allow competent individuals to state their wishes to not receive resuscitation. Despite the existence of a DNR order, resuscitative efforts may still occur. Purpose To identify rates and outcomes of resuscitation attempts for people with DNR orders. Methods The statewide out-of-hospital cardiac arrest (OHCA) registry in Victoria, Australia (population 6.5 million) identified rates of DNR orders and resuscitative efforts in ≥60-year-olds from 2006-2021. Results Of 47,322 patients ≥60 years old with OHCA, 2,688 (5.7%) had a DNR order. DNR order was communicated to emergency call-takers in only 332 (12.4%) cases. Bystander resuscitation was commenced in 1,074 (40.0%) patients, with EMS terminating efforts in 346 (32.2%) patients on arrival but commencing resuscitation in 189 others. Strongest predictors of bystander resuscitation were shockable rhythm (OR 7.75, 95% CI 5.04-11.9) and OHCA in public location (OR 4.8, 95% CI 2.0-11.3). Predictors of EMS terminating resuscitation efforts were OHCA in residential aged care facility (OR 1.93, 95% CI 1.47-2.5) and older age (OR 1.02, 95% CI 1.00-1.04). Transfer to hospital was undertaken in 107 patients, with strongest predictors being return of spontaneous circulation (OR 91.1, 95% CI 51.7-160.7) and witnessed OHCA (OR 7.5, 95% CI 3.9-14.5). Only 7 (0.3%) transported patients survived to discharge, with 5 deceased at 12-month follow-up. Conclusion Approximately 5% of EMS-attended OHCAs in ≥60-year-olds involve a patient with a DNR order, with low rates of awareness of DNR orders. Resuscitation is commenced in 47% of patients, and 4% are transported to hospital with very poor outcomes. Strategies to communicate DNR status and respect patients’ autonomy are extremely important.

The use and usefulness of the Peninsula Health Falls Risk Assessment Tool (PHFRAT) process in residential aged care: a mixed methods study across 25 aged care facilities

BackgroundFalls remain a persistent problem in residential aged care (RAC) facilities. Fall screening and assessment tools such as the Peninsula Health Falls Risk Assessment Tool (PHFRAT) are widely used to inform falls risk and guide fall prevention interventions. However, it is unclear how it is used in practice and whether clinicians believe it supports resident care. This study aimed to measure the extent of use of PHFRAT to understand clinicians’ perceptions of its value and usefulness.MethodsThis mixed method study involved an analysis of PHFRAT assessment from 25 RAC facilities in New South Wales, Australia, and interviews with seven RAC staff about how PHFRAT information is used in practice. In the quantitative component, descriptive statistics were applied to PHFRAT data to summarise how RAC staff use the PHFRAT including the completeness and content of the three parts. In the qualitative component, thematic analysis techniques were applied to interview data.ResultsThe sample included 215 RAC residents with 703 PHFRATs, of which 617 documented fall prevention interventions. Among these 617 PHFRATs, 593 (96.1%) included strategies related to staff assistance and 283 (45.9%) recorded strategies related to device provision. While nearly all residents (96.74%) received at least one PHFRAT assessment over the study period, many PHFRAT assessments were incomplete (part 1: 11.5% of information missing; part 2: 10.8%; part 3: 17.1%). There were few variations in fall interventions prescribed to individual residents by their fall risk level. Interviews with RAC staff indicated that PHFRAT assessments are the responsibility of registered nurses with limited input from other staff or residents. While the structured process was viewed positively in guiding risk assessment and intervention assessment, a lack of input from others prevented strategies from being tailored to residents’ specific needs and preferences. A shortage of resources, lack of communication, and limited staff education were identified as the main barriers to PHFRAT guideline implementation.ConclusionThe PHFRAT provides a useful structure for clinicians to assess falls risk factors and plan falls prevention strategies. In the future, increased multidisciplinary input into fall prevention strategy development may improve the comprehensiveness of fall prevention plans.

Bridging the Appearance Domain Gap in Elderly Posture Recognition with YOLOv9

Accurate posture detection of elderly people is crucial to improve monitoring and provide timely alerts in homes and elderly care facilities. Human posture recognition is experiencing a great leap in performance with the incorporation of deep neural networks (DNNs) such as YOLOv9. Unfortunately, DNNs require large amounts of annotated data for training, which can be addressed by using virtual reality images. This paper investigates how to address the appearance domain that lies between synthetic and natural images. Therefore, four experiments (VIRTUAL–VIRTUAL; HYBRID–VIRTUAL; VIRTUAL–REAL; and HYBRID–REAL) were designed to assess the feasibility of recognising the postures of virtual or real elderly people after training with virtual and real images of elderly people. The results show that YOLOv9 achieves the most outstanding accuracy of 98.41% in detecting and discriminating between standing, sitting, and lying postures after training on a large number of virtual images complemented by a much smaller number of real images when testing on real images.

Public health rapid response in managing COVID-19 outbreaks in residential aged care facilities: a regional public health unit perspective.

We describe here the impact of managing coronavirus disease 2019 (COVID-19) outbreaks, during January-August 2022, in residential aged care facilities (RACFs) in Central Queensland, Australia, following the deployment of a public health rapid response team (PHRRT, comprising a medical officer, a communicable disease nurse, and an epidemiologist) from a regional public health unit (PHU). Our existing vaccine preventable diseases surveillance framework was used in identifying any symptomatic resident, triggering a PHRRT response. We found that the Hospital in the Home (HiTH) admission and death events were significantly lower after the introduction of the PHRRT than in the outbreaks that occurred before. Based on our experience with a PHRRT-led approach in mitigating the burden of outbreaks, we recommend regular reflection on optimising resources and practices in RACFs. Effective communication from PHUs can improve the RACFs' preparedness and capacity to respond, and can inform the best practice model to protect the highly susceptible elderly residents and their staff.

Having to ‘go beyond’: Staff perspectives on activity programs for older people living in nursing homes

Activity programs are run by many nursing homes (also known as residential aged care facilities or long-term care facilities) however little is known about how activities are chosen or how well they meet the needs of residents. The aim of this study was to learn more about activity programs currently offered to older people living in nursing homes in Victoria, Australia. Interviews were undertaken with 13 activities/lifestyle staff working across six nursing homes. Staff were asked about their role and training; how activities were chosen, run, and evaluated; and barriers to providing social participation opportunities for residents. Thematic analysis of interview transcripts revealed six main themes: the role of the activities staff is to make people happy and meet their needs; activities staff largely choose (group based) activities; evaluation of activity programs is mostly informal; activity programs are poorly resourced; staff are often required to ‘go beyond’; and catering to the unique needs of residents is challenging. Given the established importance of social interaction to physical and psychosocial health, it is essential that activity programs and staff are viewed as integral to resident wellbeing; that staff are trained and supported; and that programs are funded and resourced adequately to deliver programs that are person-centred and meet the needs and preferences of residents.