Elderly Home Care Research Articles

Empowering citizens or mining resources? The contested domain of citizen engagement in professional care services

When studying individual attempts to foster citizen engagement, scholars have pointed to the coexistence of competing rationales. Thus far, however, current literature barely elaborates on the socio-political processes through which employees of professional organizations deal with such disparate considerations. To address this gap, this article builds on an ethnographic study, conducted in the Netherlands between 2013 and 2016, of a professional care organization's attempts to engage local citizens in one of its elderly care homes. To investigate how citizen engagement is ‘done’ in the context of daily organizing, we followed employees as they gradually created and demarcated the scope for such engagement by approaching citizens as either strategic partners (pursuing ‘democratic’ rationales) or as operational volunteers (pursuing ‘instrumental’ rationales). In order to deal with such potentially incongruent orientations, we found that employees used discursive strategies to influence the balance that was struck between competing rationales; either through depoliticization—i.e., the downplaying of incongruities and the framing of disparate considerations as being complementary within the pursuit of a shared, overarching goal—or through politicization, i.e., the active challenging of how their colleagues prioritized one consideration over another. By showing how the successful conveyance of such (de)politicized accounts helped employees either defend or redraw the boundaries of what citizen engagement was (not) about, we contribute to extant theorization by (1) developing a processual approach to studying citizen engagement that (2) is sensitive to organizational politics.

Diagnosis of Sarcopenia in Long-Term Care Homes for the Elderly: the Sensitivity and Specificity of Two Simplified Algorithms with Respect to the EWGSOP Consensus.

To analyze the prevalence of sarcopenia in elderly care homes using the algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP) and to evaluate the applicability, sensitivity, and specificity of two simplified algorithms that do not include gait speed measurement. Cross-sectional study. Long-term care homes. 249 residents (187 females and 62 males) with a mean age of 84.9 ± 6.7 years (range, 70-106 yrs). Cognitive impairment was evaluated with the Pfeiffer test, functional capacity with the Barthel index, walking ability by the Functional Ambulation Classification, muscle mass by bioelectrical impedance analysis, muscle strength by handgrip dynamometry and, gait speed over a distance of 4 m. Sarcopenia was assessed using the EWGSOP-recommended algorithm and two simplified algorithms (A and B). Algorithms A and B were validated with respect to the EWGSOP algorithm using the MacNemar test and obtaining the sensitivity and specificity, kappa coefficient, and area under the receiver operating characteristic curve (AUC). Total or severe dependence was recorded in 67% of the 249 residents, severe or moderate cognitive impairment in 64%, inability to walk in 49%, and capacity to walk only with the aid of an ambulator or two people in 21%. The prevalence of sarcopenia was 63.0% by the EWGSOP algorithm, 62.9% by algorithm A and 63.2% by algorithm B (P = 1.000); 143 participants were diagnosed with sarcopenia by all three methods (P =1.000, K = 1.000). Further studies that include residents with functional and/or cognitive impairment are required to validate these results, comparing the diagnostic performance of the EGWSOP algorithm with that of the simplified algorithms validated in the present report.

The experience of older people living in an elderly residential home (Panti Sosial Tresna Werdha): a phenomenology

The aim of this study was to gain an overview of the experiences of older people living in an elderly residential home (Panti Sosial Tresna Werdha [PSTW]). The study used qualitative method with the descriptive phenomenology approach. The participants consisted of six older people who live in institutions. Data were collected through in-depth interviews in accordance with the purpose of the research, and an analysis of the data from the interviews was performed using the analysis stage by Collaizi. Three themes emerged from this study, namely independent living needs and support systems as a reason for staying at PSTW, the adaptive response to life in PSTW, and family support as a contributing factor to remaining at PSTW. Most of the elderly's support came from their children or nephews and nieces. Receiving full emotional support from relatives through family visits was deemed necessary for the elderly, as it made them feel happy to continue the rest of their lives in the elderly care home.

Tactile care, mechanical Hugs: Japanese caregivers and robotic lifting devices

This article explores the attempted introduction of a lifting robot called “Hug” into an elderly care home in Japan. As demand for institutional elderly care in Japan escalates due to population aging and a move away from familial care, the shortage of professional care staff is also intensifying. Attributing this shortage partly to carers’ endemic back pain, the Japanese government and corporations have poured resources into developing high-tech robotic lifting devices. Yet contrary to their expectation, many Japanese caregivers seem reluctant or even hostile to the idea of using such devices. I use fieldwork data to explore why this is the case, and find that lifting is situated within a practice of tactile, joking care aimed at ensuring anshin (安心; “peace of mind”) for both care staff and residents. Mechanical replacement of this tactile connection was strongly resisted as “disrespectful” by care staff.

Group work training program to develop social workers' knowledge of creative methods in maintaining elderly people's life quality

The purpose of this study was to determine the effectiveness of the group work training program to develop social workers' knowledge of creative methods in maintaining elderly people's life quality. Eighteen social workers were assigned as one group pre- posttest design, (intentional sample from social workers at the association) working at the social care association in Karmouz, Alexandria which has twenty four residents. The 18 social workers were asked to complete three forms of measurement (pre, post and following). Firstly, a measurement was used to assess the social workers’ knowledge of the creative methods to maintain elderly people's life quality. Secondly, the observation form assessed the changes inresidents at the elderly care home during the experiment. The social workers in the experimental group were introduced to the group work training program to develop their knowledge of creative methods in maintaining elderly people’s life quality. The intervention lasted for 15 weeks. The results emphasise the success of the group work training program to develop social workers' knowledge of creative methods in maintaining elderly people's life quality

The green and sustainable care facilities of elderly care home: An exploratory study of rumah seri kenangan cheras, Selangor

The terminologies of “Green Building” and “Sustainable Building” explore the practice of creating structures by using processes that are environmentally responsible and resource efficient. This is done through examining a building's life-cycle that is related with economy, utility, durability, and comfort of occupants. In Malaysia, “Green Building” and “Sustainable Building” for Care Facilities of Elderly Care Homes are still in its infancy. Elderly Care Home is a long term care facility that provides permanent living space and support for the elderly, with the activities of daily living that offers personal care and support. This research explores the Green and Sustainable Care Facilities of Elderly Care Home-Rumah Seri Kenangan (RSK) in Cheras, Selangor (GSch-RSK). RSK is established to provide care, treatment and shelter to the elderly poor, aged 60 years and above. It provides care and protection services; guidance and counselling; recreational activities; medical treatment; occupational therapy; and physiotherapy for the elderly to live in peace and enjoy a good quality of life. This research adopts observation, interview, and document review methods in gathering data. The findings indicate six characteristics of GSch-RSK which consists of (1) Location and Surrounding area of RSK which is explored and consisted of road, RSK building and green landscape; (2) Integrated Operation of Operations and Maintenance in daily cleaning and monthly elevator maintenance; (3) Healthy Environment of Atmosphere and Well-being that consist of bright colours and ventilation system (modern windows and exhaust fan); (4) Waste Management System that includes garbage removal and designated sewerage; (5) Energy Efficiency characteristic that is the installation of the Energy Efficiency Appliances and Solar Panel System; and (6) Sustainable and Green Management of Green Landscape which has been practiced by setting up Rain Garden and planting Edible Green leaves and flowers. All these characteristics are vital in developing the theoretical framework of Green and Sustainable Care Facilities of Elderly Care Homes in Malaysia. Finally, these characteristics will be used for the development framework of existing buildings of Elderly Care Homes in Malaysia.

Anomaly detection for elderly home care

In this paper, we propose a model for detecting anomalies in elderly home care. Two scenarios are investigated in detecting anomalies: 1) the elderly person's vital signs and their surrounding environment; 2) the mobility patterns of the elderly. We evaluated our proposed model by employing the isolation forest which detects anomalies using an isolation approach on a random forest of decision trees. We compare isolation forest on unlabeled data with statistical methods on labelled data. Subsequently, to show the reliability of the isolation concept, we compare it with a distance measure concept. The experiment shows that isolation forest has higher detection accuracy and lower error prediction for two attributes in the first scenario: skin temperature and heart rate, whereas, in the second scenario, multi-covariance determinant has a slightly better accuracy compared to isolation forest (3.9% difference in accuracy) and has a small number of prediction errors compared to isolation forest.

The Discourse on the Integration of Male ‘Refugees’ into Public and Private Elderly Care Homes in the Context of the Current Care Crisis in Germany

Against the background of increased immigration in Germany since 2015, there is a largely negative public discourse on ‘refugees’ (especially Muslim young men), who are assumed to pose a threat to society and struggle to integrate due to their supposedly ancient, undemocratic and misogynist values. Due to the severe lack of elderly care workers in Germany, integration projects have been established that train ‘refugees’ for elderly care work in homes. The discourse on participants runs counter to the image of ‘dangerous foreign masculinity’ and constructs male ‘refugees’ as ideal elderly care workers. Based on the theoretical concept of othering, this article shows how by intermingling culture, religion and gender a subaltern masculinity is constructed to depict ‘refugees’’ suitability for elderly care work. It is suggested that these young men respect and subordinate themselves to the elderly as if they were their own relatives. The image of the devoted care worker seems to contrast the perception of young Muslim men as being dangerous, although both interpretations prompt the notion of a traditionalist value system that is assumed to be the essential and static characteristic of migrants from ‘Muslim countries’. Presenting the success of integrating ‘refugees’ in elderly care work allows the German society and more specifically elderly care providers to position themselves through “welfare narratives” as charitable actors who offer ‘refugees’ a chance of integration into the labour market. Accordingly, it is de-thematised that ‘refugees’ provide extensive unpaid or low-paid work in the name of integration and training, as well as covering necessary tasks in the understaffed care system.

El trabajo de cuidado en instituciones geriátricas y domiciliario

ABSTRACT
 
 The present contribution focuses on the care of the elderly dependents in geriatric institutions and at home. Based on existing studies of the meaning of work, the importance of the collective and the defenses strategies deployed by the workers in the institutions, our study is particularly interested on the kind of resources which mobilized home caregivers who are deprived of the possibilities of relying on colleagues and groups use to deal with the problems they meet in their activities. In the extreme case of “live in” elderly home care the dedication and the temporality of care are important because the isolation can be both very harmful and authorize the deployment of the work that could be valued by the worker herself.
 Key words: care work; work collectives; isolated worker; sense of work; geriatric institutions; home care work.

The tree structure — A general framework for food waste quantification in food services

Food waste in the food services industry has been identified as an important unsustainability hotspot, but standardised methods for food waste quantification are lacking. Existing studies on waste quantity assessments have several limitations, such as short and infrequent quantifications times, large methodological variations ranging from physical measurements to visual observations, and lack of comparability across catering unit types. Since lack of comparable waste figures can lead to error-prone analysis, a general framework is needed for waste quantification in food services. This paper presents one such framework that allows data comparisons when overlapping observations are included. The framework was tested in six case studies in professional (public and private) catering units in Sweden. Data were collected from different schools, elderly care homes and hotels and fitted into the framework. The results from these case studies indicate that the framework enables catering units to focus waste quantification on their individual problem areas. It also provides the possibility to extend waste quantification over time without any loss of generalisability. A graphical representation of the framework fits the traditional tree structure and was found to act as a suitable foundation for food waste quantification in food services by structuring collected data. In order to fully utilise the potential of the tree structure, it should be supplemented with precise definitions to create a catering food waste quantification standard.

The Effects of Information Literacy of Social Service Users’ on Service Quality and Satisfaction: Based on Elderly Home Care Services

The Effects of Information Literacy of Social Service Users’ on Service Quality and Satisfaction: Based on Elderly Home Care Services

Relationship between stride interval variability and aging: use of linear and non-linear estimators for gait variability assessment in assisted living environments

The aim of this study is to assess the impact of aging process in gait variability. Stride interval variability is estimated by using two approaches: (1) a non-linear fractal analysis (detrended fluctuation analysis) which evaluates the presence of long-range correlations in stride interval time series; and (2) a statistical dispersion measure (coefficient of variation) to quantify the magnitude of the stride interval fluctuations. Two groups of physically independent older adults, with different walking ability, have participated in the gait trials performed in an elderly care home. The estimated stride interval variability of the elders is compared to each other and to the variability coming from a young adult group used as control. To accomplish this, an infrastructure which uses wearables to acquire inertial data from the trunk of each participant is provided. Stride interval time series are made up of the estimated heel-strike events from previous inertial data. In addition, a service segments straight paths within the gait trials, discarding turns. The stride intervals from the segmented straight paths are stitched together to produce the long time series required to analyze gait variability. Despite the study has not provided conclusive results from an individual perspective, finding older adults who have less stride interval variability than younger ones. The inter-class analysis conducted has shown interesting findings about the relation between the subjective characterization of gait, aging and stride interval variability estimated through the two proposed approaches.

Homecare Service Providers as an Organizational Form of Support for the Elderly: Establishment and Planning of Optimal Capacity

AbstractBackground and Purpose: Different studies have highlighted health care allocation problems in Slovenia that indicate the increased need for homecare services for the elderly. It was also found that Slovenian municipalities differ dramatically in the availability of elder care services. A number of older people with diverse unmet needs for care remains. Therefore, the need for the establishment of an additional type of formal homecare services for the elderly exists.Design/Methodology/Approach: Although many positive effects of home elder care against institutional care are stressed in the literature, the results of many studies performed in recent years have indicated that accessibility of homecare for elderly in Slovenia remains scarce, and it is not equally accessible throughout the country. To mitigate this problem, a new organizational form called “elder homecare service provider” is indicated. The aim of the provider is to offer a variety of different services for the elderly (e.g. homemaking, social networking, transfer services, basic life needs, basic health services, etc.). The establishment of such an organization needs to be designed carefuly, while the unique characteristics and specific needs of the target population must be addressed to optimize desired outcomes.Results: The aim of the paper is to provide fundamental guidelines for the establishment of elder homecare service provider. All essential characteristics of such an organization are defined. To ensure an appropriate level of service quality, the primarly focus is oriented towards the planning of personnel team capacity. For this purpose, the service provider was described using the stochastic queueing model, which enables service capacity optimization considering different performance measures. The usefulness of the model was illustrated with a numerical example, which has shown that the results obtained provide valuable information for decision support.Conclusion: The establishment of a homecare service provider network would have many positive effects on society in general. The quality of the everyday life of the elderly is expected to be improved considerably, particularly in the rural areas where a lack of institutional care support is reported. Guidelines proposed in the paper together with the quantitave model for planning of its optimal capacity provide useful information, which are especially relevant in the preliminary phase of the establishment of service providers.

Measuring frailty and detecting falls for elderly home care using depth camera

This work concerns the development of low-cost am- bient systems for helping elderly to stay at home. Depth cameras allow a real-time analysis of the dis- placement of the person. We show that it is possible to recognize the activity of the person and to measure gait parameters from the analysis of simple features extracted from depth images. Activity recognition is based on Hidden Markov Models and performs fall detection. When a person is walking, the analysis of the trajectory of her centre of mass allows to mea- sure gait parameters that can then be used for frailty evaluation. We show that the proposed models are robust enough for activity classification, and that gait parameters measurement is accurate. We believe that such a system could be installed in the home of the elderly, while respecting privacy, since it relies on a local processing of depth images. Our system would be able to provide daily information on the person’s activity, the evolution of her gait parameters, and her habits, information that is useful for securing her and evaluating her frailty.

A Comparative Study of Elderly Home Care Service Support in East Asia - Focusing on Japan and Chin

A Comparative Study of Elderly Home Care Service Support in East Asia - Focusing on Japan and Chin

An In-home Advanced Robotic System to Manage Elderly Home-care Patients’ Medications: A Pilot Safety and Usability Study

PurposeWe examined the safety profile and usability of an integrated advanced robotic device and telecare system to promote medication adherence for elderly home-care patients. MethodsThere were two phases. Phase I aimed to verify under controlled conditions in a single nursing home (n = 17 patients) that no robotic malfunctions would hinder the device’s safe use. Phase II involved home-care patients from 3 sites (n = 27) who were on long-term medication. On-time dispensing and missed doses were recorded by the robotic system. Patients’ and nurses’ experiences were assessed with structured interviews. FindingsThe 17 nursing home patients had 457 total days using the device (Phase I; mean, 26.9 per patient). On-time sachet retrieval occurred with 97.7% of the alerts, and no medication doses were missed. At baseline, Phase II home-dwelling patients reported difficulty remembering to take their medicines (23%), and 18% missed at least 2 doses per week. Most Phase II patients (78%) lived alone. The device delivered and patients retrieved medicine sachets for 99% of the alerts. All patients and 96% of nurses reported the device was easy to use. ImplicationsThis trial demonstrated the safety profile and usability of an in-home advanced robotic device and telecare system and its acceptability to patients and nurses. It supports individualized patient dosing schedules, patient–provider communications, and on-time, in-home medication delivery to promote adherence. Real time dose-by-dose monitoring and communication with providers if a dose is missed provide oversight generally not seen in home care.

Social Workers' Attempts to Navigate Among the Elderly, Their Families, and Foreign Home Care Workers in the Haredi Community.

The study's aim is to examine social workers' experience in facilitating the integration of foreign home care workers (FHCWs) into the ultraorthodox Jewish (UOJ) community for the purpose of treating older adults. Using the qualitative-phenomenological approach, semistructured, in-depth interviews were conducted with 18 social workers in daily contact with UOJ older adult clients in the process of integrating FHCWs. Data analysis revealed three central themes-integrating FHCWs into the aging UOJ family: barriers and challenges in the interaction between the two worlds; "even the rabbi has a FHCW": changing trends in caring for older adults; and the social worker as mediator and facilitator of a successful relationship. Social workers play a central role, serving as a cultural bridge in the process of integrating FHCWs, as a way of addressing the needs of ultraorthodox elderly and their families, while also considering the needs of the foreign workers.

Quantification of food waste in public catering services – A case study from a Swedish municipality

Food waste is a major problem that must be reduced in order to achieve a sustainable food supply chain. Since food waste valorisation measures, like energy recovery, have limited possibilities to fully recover the resources invested in food production, there is a need to prevent food waste. Prevention is most important at the end of the value chain, where the largest number of sub-processes have already taken place and occur in vain if the food is not used for its intended purpose, i.e. consumption. Catering facilities and households are at the very end of the food supply chain, and in Sweden the public catering sector serves a large number of meals through municipal organisations, including schools, preschools and elderly care homes. Since the first step in waste reduction is to establish a baseline measurement in order to identify problems, this study sought to quantify food waste in schools, preschools and elderly care homes in one municipality in Sweden. The quantification was conducted during three months, spread out over three semesters, and was performed in all 30 public kitchen units in the municipality of Sala. The kitchen staff used kitchen scales to quantify the mass of wasted and served food divided into serving waste (with sub-categories), plate waste and other food waste.The food waste level was quantified as 75g of food waste per portion served, or 23% of the mass of food served. However, there was great variation between kitchens, with the waste level ranging from 33g waste per portion served (13%) to 131g waste per portion served (34%). Wasted food consisted of 64% serving waste, 33% plate waste and 3% other food waste. Preschools had a lower waste level than schools, possibly due to preschool carers eating together with the children. Kitchens that received warm food prepared in another kitchen (satellite kitchens) had a 42% higher waste level than kitchens preparing all food themselves (production units), possibly due to the latter having higher flexibility in cooking the right amount of food and being able to chill and save surplus food. The large variation between kitchens indicates that they have different causes of food waste, but also different opportunities to reduce it. Detailed waste quantification for each kitchen can therefore be the first step in the process of waste reduction.

Impact of home care versus alternative locations of care on elder health outcomes: an overview of systematic reviews

BackgroundMany elders struggle with the decision to remain at home or to move to an alternative location of care. A person’s location of care can influence health and wellbeing. Healthcare organizations and policy makers are increasingly challenged to better support elders’ dwelling and health care needs. A summary of the evidence that examines home care compared to other care locations can inform decision making. We surveyed and summarized the evidence evaluating the impact of home care versus alternative locations of care on elder health outcomes.MethodsWe conducted an overview of systematic reviews. Data sources included MEDLINE, the Cochrane Library, EMBASE, and CINAHL. Eligible reviews included adults 65+ years, elder home care, alternative care locations, and elder health outcomes. Two independent reviewers screened citations. We extracted data and appraised review quality using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) checklist. Results were synthesized narratively.ResultsThe search yielded 2575 citations, of which 19 systematic reviews were eligible. Three hundred and forty studies with 271,660 participants were synthesized across the systematic reviews. The categories of comparisons included: home with support versus independent living at home (n = 11 reviews), home care versus institutional care (n = 3 reviews), and rehabilitation at home versus conventional rehabilitation services (n = 7 reviews). Two reviews had data relevant to two categories. Most reviews favoured home with support to independent living at home. Findings comparing home care to institutional care were mixed. Most reviews found no differences in health outcomes between rehabilitation at home versus conventional rehabilitation services. Systematic review quality was moderate, with a median AMSTAR score of 6 (range 4 - 10 out of 11).ConclusionsThe evidence on the impact of home care compared to alternative care locations on elder health outcomes is heterogeneous. Our findings support positive health impacts of home support interventions for community dwelling elders compared to independent living at home. There is insufficient evidence to determine the impact of alternative care locations on elders’ health. Additional research targeting housing and care options for the elderly is needed.

Latent classes of caregiver relationships with patients: Workplace violence implications

The bonds and relationships that direct care workers in the home setting (DCWHs) develop with their elderly or disabled home care patients may put them at risk for patient violence. This study used a data-driven approach, latent class analysis, to identify distinct underlying patterns of DCWH–patient relationships and then assessed how DCWH–patient class membership was associated with patient violence. This study analyzed survey data obtained from 964 DCWHs working in two not-for-profit home care agencies. Four classes of DCWH–patient relationships emerged: Non-familial (40% of the sample), Overly Concerned (14%); Boundary-keeping (22%), and Overly Involved (24%). DCWHs in the Overly Involved class were more likely to experience physical violence from their patients relative to those in the Non-familial class (probability = 0.11 vs. 0.04, p = 0.01). Building a positive relationship with boundaries between caregivers and patients may have a potential to reduce patient violence toward the caregivers and ultimately improve the quality of care.