Aged Services Research Articles

Embedded and exterior practices of cross-sector co-production: the impact of fields

Abstract Cross-sector co-production involving voluntary organisations in the production and delivery of social services has been adopted across many welfare states. Economic and demographic changes have led to increased involvement of volunteer initiatives in different welfare policy fields. How different field properties enable, constrain, and shape co-production practices remains, however, under researched. In this article, we address this shortcoming in a comparative case design exploring the practices of co-production within the two fields of elderly services and refugee services. We develop a conceptual framework and demonstrate that differential distribution of resources leads to diverging outcomes and perspectives for co-production. Based on a two-year in-depth study of one large Danish municipality, we find two forms of co-production practices, which reflect different field conditions. In the field of elderly services, co-production takes the form of ‘embedded’ practices, and in the field of refugee services co-production takes the form of ‘exterior’ practices. We demonstrate that each of these co-production forms entail ambiguous outcomes and antagonistic positions for voluntary and public sector actors, depending on the policy field.

Day hospital for psychogeriatric patients: implementation of best practice

AbstractBackgroundPsychogeriatric day hospitals best practices deliver integrated patient and family centered care by multidisciplinary teams, providing a safer transition between acute psychogeriatric units to rehabilitation services and outpatients clinical care. This reduces inpatient length of stay and rehospitalization rates, favoring a successful daily routine care at home. We implemented in 2022 an elderly day hospital service at the Institute of Psychiatry USP Medical School, Brazil. This case report illustrates how day hospitals can contribute to a better clinical outcome.Case report64 year‐old male patient with bipolar disorder (BD), recurrent readmissions in our psychogeriatric unit due to either complications from bipolar disorder or clinical conditions and family burden (2020 for 90 days due to rapid cycling BD and 2021 to treat clinical conditions 4 days). When he was at home his family reported increased burden and difficulty in daily care. They asked for readmissions in this period .The cognitive impairment and functional decline were associated with neuroprogression in BD.The lack of adequate treatment worsened psychiatric, cognitive symptoms and the capacity to maintain his activities of daily living (ADL).In 2022 he was admitted due to behavior symptoms (irritability and aggressivity) in our inpatient unit for 19 days. Transitioned to day hospital, he attended activities for two months, twice a week. The intervention provided cognitive and functional stimulation, caregivers training and psychoeducation. It was performed in groups and individually (patient and family).We observed improvement in cognition, basic daily life activities and social support. Admission and transition to outpatient care were CGI‐04‐04, MMSE 20‐23 and Katz 02‐04. We observed reduction in family burden and management of psychiatric and behavior symptoms.ConclusionPatient and family needs were identified and cared for, and we achieved an improved health outcome by creating a safe transition, reducing length of stay and preventing readmission. This present intervention demonstrates a clinical example of the coordinated approach in order to provide transitional care and enable rehabilitation (cognition, basic daily life and bipolar symptoms).The benefits of the patient‐ family centered care provides consistent recovery and decreased length of hospital stay and risk of readmission.

Relationship of close contact settings with transmission and infection during the SARS-CoV-2 Omicron BA.2 epidemic in Shanghai

IntroductionWe analysed case-contact clusters during the Omicron BA.2 epidemic in Shanghai to assess the risk of infection of contacts in different settings and to evaluate the effect of demographic factors...

Pemberdayaan Dan Peningkatan Mutu Kesehatan Lansia Di Panti Sosial Tresna Wreda Wana Seraya Kota Denpasar

Indonesia is included in the aging society, which is the category of a country that has an elderly population above 7%. Along with the increasing life expectancy of the population in Indonesia, the Province of Bali is included in the fourth category of society with an old structure. This proves that with such a large number of elderly, there should be a contribution of more effective elderly services, because the higher the problem of the elderly can be helped and handled, the better the elderly will be and will extend their life expectancy. To answer the problems of the elderly, several activities were carried out including: health checks for the elderly and other activities that support the improvement of the health quality of the elderly. Furthermore, providing training and guidance to the elderly to be able to do fitness exercises to stay healthy physically and psychologically, as well as socializing PHBS for the elderly. Therefore, this activity needs to work with partners so that it can be useful for the elderly at the Tresna Wreda Wana Seraya Social Institution, Denpasar.

Exploring the differentiated elderly service subsidies considering consumer word-of-mouth preferences

PurposeThe elderly service industry is emerging in China. The Chinese government introduced a series of policies to guide elderly service enterprises to improve their service quality. This study explores novel differentiated subsidy strategies that not only promote the improvement of service quality in elderly service enterprises but also alleviate the financial burden on the government.Design/methodology/approachEvolutionary game and Hotelling models are employed to investigate this issue. First, a Hotelling model that considers consumer word-of-mouth preferences is established. Subsequently, an evolutionary game model between local governments and enterprises is constructed, and the evolutionary stable strategies of both parties are analyzed. Finally, simulation experiments are conducted.FindingsThe findings indicate that local government decisions have a significant influence on the behavior of elderly service enterprises. Increasing the proportion of local governments opting for subsidy strategies helps incentivize elderly service enterprises to improve their service quality. Furthermore, providing differentiated subsidies based on the preferences of the customer base of elderly service enterprises can encourage service quality improvement while reducing government expenditure. The findings offer valuable insights into the design of government subsidy policies.Originality/valueCompared with previous research, this study examines the role of consumer preferences in a differentiated subsidy policy. This enriches the authors’ understanding of the field by incorporating neglected aspects of consumer preferences in the context of the emerging elderly service industry.

The Development of Elderly Services: Stylized Facts and Prospect in China

Population aging has emerged as one of China's major concerns due to the country's ongoing economic development and population increase. In order to predict the future growth of China's aged service industry and to suggest appropriate change-management techniques, this article examines the existing status of China's aging population. First, in this essay, the current situation with China's aging population is examined, including the sharp rise in the proportion of the old and the progression of aging., and the existence of urban-rural aging differences. Secondly, this paper analyzes the causes of population aging and the combined effects of various factors such as aging family knots. Then, the paper discusses how to improve China's elderly service industry and proposes corresponding policy recommendations and changes in wording. Finally, the paper points out that to meet the challenges posed by population aging, and to ensure the senior population's health, longevity, and happiness, a sound aged service system must be established. and aggressively pursue the education and training of elderly service employees to enhance their knowledge, abilities, and employment possibilities for the elderly population's involvement and fulfillment. Aside from that, the government should strengthen cooperation with enterprises and social organizations to improve the elderly service industry.

Social Governance and Sustainable Development in Elderly Services: Innovative Models, Strategies, and Stakeholder Perspectives

Introduction: The global demographic shift towards an aging population has created an urgent need for high-quality elderly care services. This study focuses on “elder services” within the framework of sustainable development, addressing seniors with intensive care needs and independent seniors. Methods—Social Governance: To understand the social governance aspects, we employ a qualitative methodology, analyzing policy documents, novel care methods, and successful case studies. Sustainable Development: Simultaneously, our study investigates sustainable development, examining the methods used to promote sustainability in geriatric care. Research Question: Our research question centers on identifying strategies that foster inclusivity and sustainability in elder services, considering diverse needs, housing, community involvement, and the role of technology. Results: We identified innovative models aimed at improving the well-being of older individuals, including community-driven initiatives, technology-assisted solutions, holistic wellness programs, intergenerational interaction programs, and the integration of traditional and modern care methods. We explored stakeholder perspectives, providing insights into the complexities of implementing effective elderly care solutions. Our study evaluated the efficiency of diversified social governance models in geriatric care, highlighting their benefits compared to traditional models. We presented specific concerns and suggestions from stakeholders regarding sustainable development in geriatric care. Discussion: Our findings underscored the importance of collaboration among various stakeholders to enhance elderly care. Our study summarizes key insights from current policies and anticipated future trajectories in geriatric care, providing a foundation for developing sustainable elderly care facilities.

The Predicament and Countermeasures of Rural Cultural Endowment Development Under the Vision of Rural Revitalization

Manufacturing industry is the pillar industry of the national economy and the foundation of a country's economic and social development. As the region with the fastest economic development and the largest economic aggregate in China, the development of the Yangtze River Delta has attracted extensive attention from all walks of life since it was listed as a national strategy in 2018, and the manufacturing production level is in the leading position in the country. In the context of the rural revitalization strategy, with the continuous promotion of the rural elderly service capacity, many problems have been solved. To put it simply, cultural endowment can be understood as a positive concept of endowment, which not only ADAPTS to people's development and life, but also pays more attention to the spiritual needs of the elderly. At the same time, with the emergence of the "new and old" group, the increasing number of the group also promotes the development of cultural endowment to a certain extent. In this regard, it is necessary to make a comprehensive and detailed analysis of the current difficulties in the development of rural cultural endowment, and formulate targeted strategies, so as to make the rural cultural endowment into a new development mode.

Fidan: a predictive service demand model for assisting nursing home health-care robots

While population aging has sharply increased the demand for nursing staff, it has also increased the workload of nursing staff. Although some nursing homes use robots to perform part of the work, such robots are the type of robots that perform set tasks. The requirements in actual application scenarios often change, so robots that perform set tasks cannot effectively reduce the workload of nursing staff. In order to provide practical help to nursing staff in nursing homes, we innovatively combine the LightGBM algorithm with the machine learning interpretation framework SHAP (Shapley Additive exPlanations) and use comprehensive data analysis methods to propose a service demand prediction model Fidan (Forecast service demand model). This model analyzes and predicts the demand for elderly services in nursing homes based on relevant health management data (including physiological and sleep data), ward round data, and nursing service data collected by IoT devices. We optimise the model parameters based on Grid Search during the training process. The experimental results show that the Fidan model has an accuracy rate of 86.61% in predicting the demand for elderly services.

The elderly health profile and health services access during 2020-2021: results from Passi d’Argento

Abstract Background The COVID-19 pandemic has affected the community in multiple health, economic, social and cultural aspects and the impact was stronger among the over-65s. PASSI d'Argento (PdA) surveillance system monitors the effects on physical activity, partecipation in social life and healthcare renunciation due to fear of Covid contagion or services interruption. Methods Since 2016, PdA has been continuously collecting information on health, behavioural risk factors, quality of life and the care and assistance needs of eldely people. Data is collected through an anonymous and standardised questionnaire. Physical activity is assessed with the Physical Activity Scale for Elderly, an internationally validated instrument that considers all types of activities commonly performed by elderly. High PASE values correspond to high levels of physical activity. Results The percentage of physically active elderly decreased significantly during the pandemic, from 39% (CI95% 38.3-39.8) in 2016-2019 to 35% (CI95% 33.7-36.4) in 2020-2021. The decline is greater among people with economic difficulties (44.4% to 37.5), women (from 36.7% to 33.5%), among those with chronic deseases (from 37% to 31%) or sensory impairment (from 31.3% to 27.5%). Participation in social life declines significantly from 23.1% (95% CI 22.5.1-23.8) in the pre-covid period to 142 (95% CI 13.2-15.1) in 2020-2021. The pandemic develops in a context where inequalities in prevention and care already exist; 32% of elderly declared difficulties in accessing health services in 2016-2019. During pandemic period 28% of the over-65s gave up at least one medical or diagnostic examination with a risk of delayed in diagnosis and treatment. Conclusions PdA shows the importance of monitoring the strong impact of emergency on several aspects of elderly population to riorganize the local health system organization, implement targeted interventions and improve the health services’ offers to reduce inequalities. Key messages • Riorganize the local health system is crucial to improve targeted interventions and reduce inequalities in care and prevention for elderly population. • Early diagnosis and adequate therapy are crucial in old age.

Consumer Attitudes toward Community Elderly Services during Negative Population Growth and Sustainable Development

In 2022, it became apparent that China had officially become a nation witnessing negative population growth. Coinciding with the emergence of an aging society, the occurrence of population sustainable development has emerged as a crucial concern for society. In recent times, community-oriented elderly care has garnered prominence and materialized as a feasible pathway for confronting the matter of familial elderly care in a society with an aging populace. This study was conducted in three provincial capital cities in different regions of China. Based on the ABC theory and Maslow’s hierarchy of needs theory, and with reference to the research of relevant scholars, the study investigated consumers’ attitudes towards community elderly care services from the perspectives of health care services, housekeeping services, entertainment, catering services, etc., and put forward research hypotheses. The questionnaire was dimensionally reduced using factor analysis, and the hypotheses were tested using regression analysis. The findings validate that the delivery of medical provisions, domestic aid, recreational and culinary facilities, camaraderie, and counseling visits, along with bespoke services, substantially enhance consumer receptivity towards community-oriented elderly care provisions. As a result, these conclusions assume the role of valuable points of reference for entities engaged in furnishing such services.

Experiences With and Access to Evidence-Based Health Promotion Programs for Older American Indian, Alaska Native, and Native Hawaiian Peoples.

Evidence-based programs (EBPs) work effectively for participants whose characteristics match those of the EBP research participants. However, EBPs have been almost exclusively developed and evaluated for the general U.S. population with limited American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) community engagement. Thus, an AI/AN/NH Evidence-Based Program Advisory Council sought to identify AI/AN/NH peoples' experiences with and access to EBPs. We held 20 listening sessions with AI/AN/NH Elder services program staff (n = 118) and with AI/AN/NH Elders (n = 82) and conducted a self-administered online survey with Title VI Directors (n = 63). The six themes that emerged from the listening sessions with staff included misunderstanding community engagement, valuing fidelity over flexibility, lack of cultural awareness, assumptions about available infrastructure, unrealistic implementation timelines, and funding restrictions. Listening session themes with Elders included definitions of aging well, participation motivators, preferred activities, participation barriers, and unmet needs. Survey data indicated that programming of greatest interest for Elders as identified by Title VI Directors and staff included and/or addressed cultural activities (81%), socialization (75%), diabetes (73%), caregiving (68%), and nutrition (68%). Seventy-six percent of survey respondents had heard of EBPs and 24% indicated that EBPs were not being implemented in their community. The Advisory Council developed specific action steps with the goal of improving AI/AN/NH communities' access to culturally appropriate and feasible EBPs. The steps require collective action from federal agencies, national partners, EBP program developers and administrators, local organizations, and Elders to ensure EBPs are accessible and culturally appropriate for AI/AN/NH Elders.

Transformasi Pusat Layanan Gizi Masyarakat UNP sebagai Layanan Terpadu Penyakit Sindrom Metabolik

The main objective of the program at the community nutrition service center is to encourage Padang State University clinics to provide holistic community nutrition services. This service center is assisted by nutrition from FMIPA, and FPP Culinary Experts, as well as from FIK, which is intended for the community. The implementation of this activity is managed by a group of lecturers who are scientifically closely related to the program to be made. The proposed community nutrition service center is expected to develop well in providing individual and community services based on clinical nutrition. Community nutrition service centers are oriented towards other health service efforts found in clinics, namely promotive, preventive, curative and rehabilitative. The advantage of this service center compared to other first level health facilities such as the puskesmas is that the services provided are accompanied by assistance in the field when conducting counseling and providing services with integrity. The main targets of community nutrition services are children, adolescents, pregnant women and the elderly. The programs carried out include infant and toddler nutrition service programs, youth nutrition services, pregnant women nutrition services, elderly nutrition services and pre-participation examinations. This clinic is under the Chancellor of UNP which will be developed within the Center for Health Service Development. It is hoped that the UNP clinic will continue to develop according to the capabilities of each faculty in developing health services according to their scientific fields.

Elderly tourism management: A bibliometric approach

Elderly tourism constitutes an important sector within the sustainable development of the tourism industry, attracting an increasing body of research focused on market development. This study aims to outline the progression of elderly tourism research within the past five years (2019–2023) and determine prospective research trajectories and opportunities in the subject. Employing CiteSpace visual analysis technology, this investigation constructs knowledge graphs of authors, institutions, and countries from 332 English-language academic articles from the Web of Science and culminates a keyword co-occurrence knowledge graph. Next, cluster and burst analyses revealed the prevailing trends and focal points in elderly tourism research. The results underscore that while many researchers have been drawn to elderly tourism, the collaborative relationships between these scholars remain tenuous, resulting in the relatively disparate study and the absence of a lead author group. China dominates the field, producing a far greater quantity of studies than other nations. Hence, this study encourages different countries, higher education institutions and disciplines to strengthen cooperation in the management and development of elderly tourism, especially paying attention to the importance of elderly tourism services, quality management and technology integration for the sustainable development of elderly tourism.

Digital Empowerment for Urban Ageing: The Case of Dishui Charity

With the deepening of population ageing and the gradual improvement of people's living standards, the multi-level and diversified service demands of the elderly groups continue to grow, and the elderly care industry is in urgent need of upgrading. Digital empowerment of the elderly service industry is an innovative move to promote the high-quality development of elderly services, establish an Internet channel for medical and nursing care integration, promote the upgrading of elderly products supplies, and promote the further improvement of the quality standard system of the urban elderly industry, digital technology empowerment provides a new impetus for the high-quality development of elderly services.

Aerobic exercise with low-intensity gymnastics against physical fitness and body mass index in the elderly

Decreased physical activity in the elderly is a problem today, lack of physical activity and not understanding physical activity causes a decrease in fitness and body mass index for the elderly. This study aims to improve the physical fitness and body mass index of the elderly with Aerobic exercise with low-intensity gymnastics. This study was a quasi-experiment with a single-group pretest posttest group design. Subjects involved with purposive sampling techniques with sample criteria with the application of inclusion and exclusion criteria with 40 elderly social services in Surakarta city. Instruments to measure physical fitness used the Rock Port test as far as 1609 m and body mass index measurements of weight and height. Data analysis using prerequisite tests and Kolmogorov Smirnov tests with SPPS 25 for Windows programs. The homogeneity test in this study used Test F. The data obtained were processed using IBM SPSS version 25 and paired T-test. The results showed a significant difference between physical fitness before and after aerobic exercise with low-intensity gymnastics, it was from the results of significance 0.056 (<0.05). While the results showed there was a significant difference between body mass index before and after aerobic exercise with low-intensity gymnastics from the results of significance P = 0.028 (<0.05). From these results, aerobic exercise can improve physical fitness and body mass index in the elderly. So that the elderly can take advantage of these activities to maintain their body health.

Strengthening community empowerment for elderly health service in new normal by Pol-Sadar (Integrated Health Service Post for Elderly)

Before the pandemic, older people actively participated in an integrated health service post named POSYANDU. This high participation is due to community health workers who understand their role in realizing basic health services. During the pandemic, POSYANDU must be held with attention to developments in the COVID-19 case. We implemented the online-based service of integrated health posts to provide online health services for older people. This paper explains the participation of elders, family, and community health workers in the revitalization strategies of integrated health service activities for older people during the pandemic. The activities included health assessments via telemedicine (video call), drive-thru services for vital signs assessment and simple lab checks, home visits, and education via WhatsApp as needed. The implementation began in June 2020 and in May 2021 with 184 older people in some places in Central Java, including Semarang City, District of Semarang, and District of Batang. We also worked with teaching volunteers consisting of five community health workers and 19 nursing students in the community. The results of these activities were the findings of health problems experienced by the elderly during the pandemic (depression, hypertension, and joint stiffness), increased knowledge, and physical activity in the elderly group. The 100 older people participated in online exercise activities accompanied by their families and felt a decrease in complaints of joint stiffness, and 84 elders people participated in health education and exercise activities in open areas by implementing strict health protocols. Most participants said they were satisfied with Pol-Sadar activities as a health service strategy for older people during the pandemic. In conclusion, the online program was effective as a strategy of health services for elderly people, especially during the new normal era, and increased the participation of family and community health workers, but it needs adequate devices to participate.

Analysis on the Retirement Model of “Medical Combined with Nursing” for Commercial Insurance Companies to Cope with the Demographic Situation in China

China’s population is characterized by an aging problem and a widespread situation where elderly people live with illnesses, which leads to a constant increase in the demand for medical and nursing resources among the elderly. In 2014 September, National Development and Reform Commission jointly with the Ministry of Civil Affairs, the Ministry of Finance and nine other departments jointly issued the “Notice on Accelerating the Promotion of Health and Elderly Services Project Construction”, formally referred to the “medical combined with nursing” expression for the first time. Since then, various industries have been actively exploring the retirement model of “medical combined with nursing”, the insurance industry has also been actively participating in exploring the layout. The retirement model of “medical combined with nursing” can integrate medical and nursing resources to effectively address the reality of China’s demographic situation. In this context, this paper analyzes the participation of China’s commercial insurance companies in the retirement model of “medical combined with nursing” and puts forward optimization suggestions.

Resource allocation of rural institutional elderly care in China's new era: spatial-temporal differences and adaptation development

ObjectivesIn the new era of China, to ensure that rural residents can get the corresponding institutional elderly services equally, it is necessary to investigate the current situation of resource allocation of rural institutional elderly care and make corresponding adaptation suggestions. Study designThis research discusses the characteristics and evolution pattern of rural aging, the resource allocation of rural elderly care institutions, and the adaptation degree of rural institutional elderly care resource and aging. MethodsThe research methodology consists of the following stages: entropy-based Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS), kernel density estimation, coupling coordination, spatial autocorrelation, and Theil index decomposition. ResultsThe degree of aging in rural areas of China is rising, and the whole population has entered a moderate aging society, showing the spatial characteristics of ‘high in the east and low in the west’. The resource allocation of rural institutional elderly care in China is at a low level, and the absolute differences among provinces tend to reduce over time, and the overall resource allocation level tends to decline. The provinces that were in the mismatched adaptation relationship in the early stage have improved; however, the number of provinces with mismatched adaptability has continued to increase. The local spatial autocorrelation of resource adaptation verifies that the middle and lower reaches of the Yangtze River as the core form a hot spot, and during the observation period, the spatial agglomeration effect of the core is strengthened. The Theil index decomposition of resource adaptation indicates that the within-group differences between the eastern and western regions is significantly higher than that between the northeastern and central regions. ConclusionsFirst, special attention should be paid to preventing the resource allocation of rural institutional elderly care in the eastern and western regions from falling again. Second, to avoid more and more low-adapted provinces falling into the ‘mismatch dilemma’ with the deepening of the aging degree. Third, strengthen cooperation among regions and promote the coordinated development of resource allocation of institutional elderly care in various regions. Fourth, the priority of institutional elderly care balanced development should be given to the eastern region and western region, thus weakening the overall difference.

The Level of Social Engagement in the Success of the Elderly Posyandu Program in Indonesia

The elderly population is an inevitable stage of life that everyone will experience. In Indonesia, the health issues faced by the elderly require the attention and readiness of society, experts, and the government. This research aims to analyze the level of social engagement in the success of the elderly Posyandu program in Indonesia. Qualitative and library research methods are employed. The narrative method is used to analyze the literature, with secondary data collected from databases such as Scientific Direct and Scholar. Results: Initially, 2700 research studies and articles were identified from the databases. After screening for publication year, duplicate titles, and abstracts, 10 research studies were selected. The criteria for the articles or journals focused on social engagement, elderly, and healthcare services. The findings of the research highlight three main points: (1) supporting factors in implementing the elderly Posyandu program, such as community outreach and ensuring adequate facilities, (2) involvement of various services including preventive, curative, rehabilitative, and promotive programs, and (3) the importance of social engagement, which involves active participation of the elderly and receiving emotional and social support from family and the community. Social engagement programs for elderly Posyandu in major cities have shown positive outcomes. Active involvement of the elderly, support from family and the community, improved accessibility, information and education, and emotional support are key factors contributing to the program's success. Based on these successful outcomes, this study recommends the participation of Posyandu in social engagement program activities in other major cities.