Elderly Care Research Articles

Evaluating Anatomy Education in Kastamonu Çatalzeytin Vocational Higher Schools through Student Feedbacks

Aims: The aim of this study is to assess the attitudes of students in Vocational Higher Schools by obtaining their opinions, regarding the Anatomy course. Methods: This study is a survey-based research aimed at evaluating the opinions of 639 students enrolled in different programs (Disability Care and Rehabilitation, Physiotherapy, and Elderly Care Programs) at Kastamonu University Çatalzeytin Vocational Higher School regarding the Anatomy course, which they have taken theoretically. The survey questionnaire consists of 29 questions related to the evaluation of theoretical classes and eight questions related to the evaluation of exams. The survey questions were created online, and the participating students were provided with a link to access the survey questionnaire. Results: When asked about the contribution of the Anatomy course content to their professional development, 60.5% of the students responded positively, while 18.2% responded negatively. In regards to the inclusion of practical classes alongside theoretical classes, 80.9% of the students responded positively, while 7.1% responded negatively. Regarding the evaluation of exams, 63.8% of the students responded positively to the question of including visual-based questions in theoretical exams, while 19.5% responded negatively. When asked about the inclusion of practical exams alongside theoretical exams, 50% responded positively, while 27.6% responded negatively. Conclusions: Based on the findings of this study, which incorporates the opinions of the students, it is emphasized that practical classes should be included alongside theoretical classes in Anatomy education. Furthermore, it is noted that reminder sessions would be beneficial in the following years due to the tendency of forgetting the content of the Anatomy course.

Contingent on paradoxical policies: migrants’ trajectories to permanent residence and skilled care work in Denmark

ABSTRACT Syrian refugees and Ukrainian labour migrants are among the increasing number of migrants in Denmark who have enrolled in training programmes to become skilled care workers in response to the Danish state’s initiatives to increase labour supply for public-sector elderly care. However, stricter immigration legislation together with regulations concerning state-financed education complicate training, employment and residence for these migrants. This article explores how the Danish welfare state’s conflicting interests in and attempts at pursuing both a strict immigration policy and securing enough trained care workers in eldercare affect trajectories to skilled care work among foreign nationals residing in Denmark. Based on data from long-term ethnographic fieldwork, we demonstrate how in various ways Syrian and Ukrainian care work trainees with temporary residence face a double-sided uncertainty, as their lives in Denmark are contingent on events and decisions out of their control, such as amendments to immigration and educational policies and legislation. On the one hand, these events and decisions jeopardize the migrant trainees’ and their families’ future in Denmark. On the other hand, they offer opportunities to make new connections and acquire new knowledge and skills, which in the longer run may contribute to improving their lives in Denmark.

Research on How the Digital Economy Contributes to Achieving A High-Level and Balanced Development of the Elderly Care Service Industry

Abstract China’s aging population has gained significant attention. Population aging implies that the demand for elderly care services will be on the rise. However, China’s aging exhibits a notable characteristic of getting old prior to achieving affluence, which directly constrains the enhancement of the level of elderly care services. The Communist Party of China and the government attach considerable importance to the issue of population aging and pensions. The Third Plenary Session of the 20th CPC Central Committee adopted the Decision of the CPC Central Committee on Further Comprehensively Deepening Reform and Promoting Chinese-Style Modernization, emphasizing that “we should actively respond to population aging and improve the development of elderly care and elderly care industry policy mechanisms.” Regarding the supply of pension services, due to the professional and long-term nature of pension services, the supply cost remains high. The contradiction between the low level of demand and the high cost of supply might lead to the “low-level equilibrium trap” of the elderly service industry. The digital economy has achieved remarkable effects in promoting the elderly care service industry. It has played a vital role in optimizing the allocation of elderly care resources, reducing the cost of elderly care services, and creating a superior elderly care ecosystem. In this context, it holds considerable academic value and practical significance to study the impact of the digital economy on the development of pension service industry, to analyze the digital divide and bridge the path for the development of the pension service industry, and to explore the countermeasures and ideas of the digital economy to facilitate the high-level, balanced, and high-quality development of the pension service industry.

Artificial Intelligence in public health: A case study

Artificial Intelligence technology has become an innovative tool in global healthcare that helps to manage various problems of scale and complexity. Its use in public health is multifaceted and multivariate extending across early outbreak detection, risk modeling and prediction, efficient vaccine logistics and administration, reducing health disparities, aiding assist in diagnosis, everyday monitoring of chronic diseases, telemedicine and virtual chatbots especially for elderly care, mental health and oncology patients, and community engagement. Despite these huge generational advantages, multiple challenges exist in data quality, security and misuse, individual privacy, contextual application, accountability and oversight and remain primary concerns for universal adoption of artificial intelligence. There is a need for safeguards and a global regulatory framework to responsibly harvest the benefits of artificial intelligence for the advancement of public and community health.

An interrogation of family-based care for the elderly in Kaloleni sub-location, Kisumu, Kenya

The aim of this study was to interrogate family based care services for the elderly within Kaloleni Sub-Location, Kisumu, Kenya. The population of the elderly (age 60 and above) is projected to outnumber children (0-9 years) by the year 2030, and by 2050, to exceed the population of adolescents and youth aged between 10 to 14 years. The Kenya government is exploring the development of a community care strategy and the roll-out of an Integrated Care of Older Persons (ICOPE) package. While family-based care has been the policy and cultural preference for offering long term elderly care, the state recognized growing demand for responsive changes to current realities. This research set the following three objectives: First, to establish the state of family based care in Kaloleni sub-location; second, to examine alternatives to family based care that exist in the sub-location, and, lastly, to interrogate policy options as suggested by respondents in the study. Using Krejcie and Morgan sample size determination table, a total of 120 elderly persons aged 70 and above were traced and 92 of them randomly sampled. The methodology deployed was mixed methods involving narrative interviewing and cross sectional survey. Descriptive data analysis and thematic analysis were deployed for quantitative and qualitative results respectively. Narrative interviewing/In depth interviews method was used in collecting data from Kaloleni sub-location. While findings from this research may not be generalizable due to study limitations and scope, the study strongly demonstrated the desperate state of gerontological care in informal settlements in urban centers in Kisumu, where over 90% of respondents sought improvement on care service provision for the elderly. The elderly persons mostly rely on care givers from the family but these care givers also tend to be dependent on the elderly respondents for general upkeep. Results support the literature that contends that older people are vulnerable to poverty. It was recommended that policy must shift to address factors that promote healthy aging and diminish suffering in old age as population aging continues. Further studies of a longitudinal nature are required to lend greater insight and inform policy.

Exploring the Causes and Policy Explanations for the Imbalance between Supply and Demand of Professional Healthcare Personnel in Grassroots Elderly Care Institutions in Qingdao

Current pension agency for with the deepening of aging degree and “combining medical and nursing care” policy response has many problems, widespread phenomenon is professional staff pension agency imbalance between supply and demand. In this study, the causes of this problem and its policy explanation are analyzed by using the in-depth interview method of qualitative research. Through the interviews with nurses, medical staff and management personnel in the local pension institutions in Qingdao, it is found that the causes of the imbalance between the supply and demand of professional medical staff mainly include insufficient number of medical staff, inconsistency between workload and income, tension between doctors and patients, and operation difficulties of pension institutions. The key to solving the problem is to promote cooperation between enterprises and schools, set up unified posts, improve the recruitment system, increase government subsidies and support, and formulate and implement targeted policies and measures to form a reasonable and efficient medical and nursing combination system.

A Comparative Study of Sensor Quantity and Data Granularity in AAL Systems for Activity Recognition

Abstract As populations age, the demand for non-intrusive elderly care solutions increases, highlighting the need for efficient AAL systems. Current research predominantly focuses on wearable sensors at high data frequencies. There is a critical gap in research in understanding the effectiveness of model performance using ambient sensors operating at varied granularities and with varied numbers of sensors. This study addresses this gap by investigating how sensor quantity and data frequency affect an artificial intelligence model’s ability to detect various activities of daily living. The methodology employs a quantitative, experimental design to systematically assess the performance of artificial intelligence models across sensor quantity and data frequencies. This assessment will be conducted through a multi-study approach involving different populations to ensure robust and generalizable findings. Each model’s efficacy will be evaluated using 5-fold cross-validation and GridSearchCV for rigorous hyperparameter tuning, employing diverse data aggregation and imputations techniques to maintain comprehensive analysis integrity. The primary goal of this research is to determine the optimal data granularity and number of sensors that maximize AI models’ ability to detect daily living activities while minimizing resource demands, thereby enhancing the sustainability and scalability of AAL systems. This work aims to advance the field of ambient sensing in elderly care, offering significant implications for designing and implementing future AAL technologies and potentially improving the quality of life for the elderly population. Key messages • The study explores the optimal configuration of data granularity and sensor quantity to maximize AI model efficiency in detecting activities of daily living among older adults. • The study investigates the impact of data frequency and sensor count on AI model performance in detecting daily activities, aiming to optimize Ambient Assisted Living systems for the elderly.

The impact of a cardio-geriatric integrated care on mortality and readmissions in older patients with Heart Failure. Results of a quasi-experimental study

Abstract Background Despite advancements in heart failure (HF) management, older adults still experience adverse outcomes. Post-discharge care for frail elders is often complicated by non-cardiac events and Hospital-Acquired Deconditioning Syndrome. While an integrated multidisciplinary approach combining cardiological and geriatric expertise appears highly beneficial, it remains underutilized. Purpose To evaluate the effectiveness of an integrated Cardio-Geriatric approach in improving one-year mortality, reducing HF readmissions and increasing days-alive-out-of-hospital (DAOH) among older patients discharged from acute care hospitals. Methods The study utilized a before-and-after design. The study enrolled two groups of patients: the first consisted of individuals aged ≥ 65 years hospitalized for acute HF between January 2018 and December 2019, receiving usual care (UC) post-discharge follow-up (referral to a cardiologist and general practitioner); the second group evaluated outpatients in the Cardio-Geriatric ambulatory clinic (CG) within three weeks after discharge for acute HF between January 2020 and December 2022. Primary outcomes included one-year all-cause mortality, HF readmissions and DOAH. Cox Regression analysis adjusted for age, sex, frailty status, and main comorbidities assessed CG effectiveness. Results Among 606 patients (mean age 86 years, 56% females), 477 received US, the remaining 175 were referred to the CG. At 1-year follow-up we observed a significant reduction in re-hospitalizations between CG and UC (36.5% vs. 53.6%; respectively, p < 0.001) and mortality (20% vs. 44.8%; respectively, p < 0.001). CG patients had more than double DAOH (300 ± 100 vs 156 ± 145 days, p <0.001). Cox regression analysis confirmed CG integrated approach as a protective factor for mortality or re-hospitalization even after adjustment for confounders [aHR 0.50; 95% CI (0.28-0.89)]. Respiratory diseases, neurological conditions, and infections were common causes of readmission, emphasizing the need for comprehensive post-discharge care. Conclusion The Cardio-Geriatric integrated approach significantly improved outcomes, highlighting the potential of integrated care in addressing the multifaceted needs of older adults with heart failure

Suggestion on the elderly care model specific to Türkiye

The world population is aging as a result of increasing life expectancy and decreasing birth rates. Since Turkey is among the fastest aging countries in the world, social aging is expected to emerge as a significant problem in the coming years. This research is a qualitative study conducted to determine suggestions for creating an elderly care model specific to Turkey. In this context, in-depth interviews were conducted face to face or online with eight participants providing elderly care services and seven participants receiving the service. Participants were determined by snowball sampling method. Semi-structured questionnaires were used as data collection tools and the obtained data were analyzed using the MAXQDA computer program. The expressions used by the participants in the interviews were coded 306 times under 86 headings and collected under four themes. "Health services provided to the elderly" was the theme with the most codes (33.01%). “Care services for the elderly” was coded 92 times (30.07%), “Social services and social assistance for the elderly” was coded 76 (24.84%) and “Financing, social security system and legal regulations” was coded 37 (12.09%) times. . As a result of the research, suggestions were made for the elderly care model specific to Turkey to improve the health system offered to the elderly, strengthen the social security system, improve care services for the elderly and strengthen social services and social assistance for the elderly. (Extended English summary is at the end of this document) Özet Yaşam süresinin uzaması ve doğum oranlarının düşmesi sonucunda dünya nüfusu yaşlanmaktadır. Türkiye, dünyada en hızlı yaşlanan ülkeler arasında yer aldığı için gelecek yıllarda toplumsal yaşlanmanın önemli bir problem olarak ortaya çıkması beklenmektedir. Bu araştırma, Türkiye’ye özgü yaşlı bakım modeli oluşturulmasına yönelik öneriler belirlemek amacıyla yapılan niteliksel bir çalışmadır. Bu kapsamda yaşlı bakım hizmeti sunan sekiz ve hizmeti alan yedi katılımcı yüz yüze ya da online olarak derinlemesine görüşme gerçekleştirilmiştir. Katılımcılar kartopu örnekleme yöntemi ile belirlenmiştir. Veri toplama aracı olarak yarı yapılandırılmış soru formları kullanılmış ve elde edilen veriler, MAXQDA bilgisayar programı kullanılarak analiz edilmiştir. Görüşmelerde katılımcıların kullandıkları ifadeler 86 başlık altında 306 kez kodlanmış ve dört tema altında toplanmıştır. “Yaşlılara sunulan sağlık hizmetleri” en çok kod içeren tema olmuştur (%33,01). “Yaşlılara yönelik bakım hizmetleri” 92 (%30,07), “Yaşlılara yönelik sosyal hizmetler ve sosyal yardımlar” 76 (%24,84) ve “Finansman, sosyal güvenlik sistemi ve hukuki düzenlemeler” 37 (%12,09) kez kodlanmıştır. Araştırma sonucunda, Türkiye’ye özgü yaşlı bakım modeli için yaşlılara sunulan sağlık sistemini iyileştirilmesi, sosyal güvenlik sistemini güçlendirilmesi, yaşlılara yönelik bakım hizmetlerinin iyileştirmesi ve yaşlılara yönelik sosyal hizmetler ve sosyal yardımları güçlendirmesine yönelik önerilerde bulunulmuştur.

Optimizing elderly care: a data-driven AI model for predicting polypharmacy risk using SHARE data

Abstract Background Polypharmacy (PP), which rises with age, is a growing public health challenge, affecting health outcomes and escalating healthcare expenditure. Leveraging the comprehensive European coverage and longitudinality of the Survey of Health, Ageing, and Retirement in Europe (SHARE) study, we aim to assess PP prevalence patterns and identify the most effective machine learning (ML) model for predicting long-term PP risk, as a foundation for a scalable predictive tool. Methods We used data from participants aged above 50 who were present in wave 6 and at least one of the subsequent three waves of the SHARE study, aiming to predict PP risk at 2, 4, and 6-year intervals. PP was defined as the concurrent use of five or more medications. We analyzed PP prevalence trends and selected the predictor variables from wave 6 using LASSO regression analysis. We evaluated eight ML models, namely, ANN, SVM, DT, RF, GB, XGBoost, LightGBM, and CatBoost, using a rigorous cross-validation strategy to ensure robustness and reliability. Results Our analysis reveals an upward trend in PP prevalence across the surveyed countries, with aggregate figures rising from 34.03% (95% CI 33.1-34.9) in wave 7 to 36.75% (95% CI 35.6-37.9) in wave 8, reaching 39.91 (95% CI 38.9-40.9) in wave 9. Additionally, using the Categorical Boosting ML model to predict PP resulted in overall accuracies of 75.08%, 73.7%, and 71.65% and recall rates of 72.83%, 70.48%, and 67.96% for the 2, 4, and 6-year intervals, respectively. Conclusions This study reveals a rising trend of PP across European countries and demonstrates the potential of using longitudinal data and ML to enhance PP prediction. The tool developed represents a step forward in risk stratification, which would be particularly beneficial in practical settings where family physicians or pharmacists could employ the tool to monitor elderly patients, predict and thus prevent PP, and reduce the negative health and economic impact associated with it. Key messages • The integration of machine learning with longitudinal data presents a significant advance in polypharmacy risk prediction. • The tool we developed highlights the potential translational impact of our findings.

Landscape Design Strategies for Healthy Aging-in-Place in Communities: Case Studies from Suzhou, China

As the global population ages, the World Health Organization promotes “Healthy Aging” to enhance the quality of life for the elderly. In China, with its substantial aging population, the “9073” elderly care mode, which prioritizes community-based care, was implemented in 2011. However, the specific needs of elderly residents in different climatic and cultural contexts are often overlooked. This study addresses this gap by examining how community green space design can support healthy aging, using Suzhou as a case study due to its significant elderly population. This research examines the relationship between community environments, elderly needs, and behaviors. Our findings reveal that elderly residents have complex needs, seeking safety, comfort, health, social interaction, and spiritual richness simultaneously. A mismatch was observed between their stated preferences for features like seating and shade and their actual usage patterns, suggesting that existing green spaces may not fully meet their needs. This study underscores the importance of incorporating both expressed preferences and proactive design strategies to enhance the healthy benefit of community green spaces. These insights support the “Healthy China 2030” strategy and promote the well-being of elders, contributing to sustainable urban regeneration.

Functioning in Older Adults: Prevalence and Implications for Policy and Digital Services

Abstract Background Actions maintaining and promoting functioning, and proactively preparing for the surge in demand for services in near future, are needed as the population is aging. Policy actions need to base on up-to-date picture of the situation. We examined the prevalence of limitations in different dimensions of functioning in the older population. Methods Data consisted of participants aged 75 years or older (n = 9,686) in the nationally representative Healthy Finland Survey in 2022. The questionnaire included questions on various aspects of functioning (physical, cognitive, psychosocial, need and use of help), quality of life, internet use and digital competence. Weighted prevalence of functional limitations by age (75-79, 80-84, 85-89, ≥90 years) was analyzed for men and women using logistic regression, sampling design and non-response acknowledged. Results Difficulties in most aspects of functioning increased rapidly with age. In ≥ 90-year-olds, one third experienced major difficulties in activities of daily living (vs. 4% in 75-79-year-olds), and 30% of men and 45% women aged 90 or over experienced major difficulties in getting out of their home (vs. 4% in 75-79-year-olds). The prevalence of loneliness doubled by age, from 9% in the youngest to 21% in oldest age group. The corresponding increase in psychological distress was from 9% to 15%. Need for help increased dramatically with age, but the unmet need among those needing help did not, being around 20% in all age groups. In ≥ 90-year-olds, 83% of men 92% of women reported little or no internet skills (vs. 40% in 75-79-year-olds), and 55% of men and 75% women did not use digital services at all, i.e. neither independently nor with help from others (vs. 25-28% in 75-79-year-olds). Conclusions Difficulties in functioning and need of help were common among the oldest age groups which underlines the urgency to ensure sufficient resources for elderly care. Key messages • While developing health and social care services, equal access to services must be ensured even for those not able to use digital services. • Functioning must be supported not only by measures aimed at the individual, but also by improving the environment so that people with a lower level of functioning can cope with their everyday lives.

Epidemiological analysis of 2106 geriatric trauma patients in a level I trauma center in Lanzhou City, Gansu Province, China.

As the global population ages, geriatric trauma gains attention. Limited studies on geriatric trauma in developing countries necessitate comprehensive investigation. This study aims to delineate the epidemiological characteristics of geriatric trauma, providing insights for prevention and enhanced elderly trauma care. Clinical data of 2106 geriatric trauma patients (age ≥ 60) treated from November 1, 2020, to October 31, 2023, at the trauma center of the First Hospital of Lanzhou University were retrospectively analyzed. Descriptive statistics covered temporal and monthly distribution, trauma sites, causes, and length of stay. Inclusive were 2106 geriatric patients (941 males, 1165 females; male-to-female ratio 1:1.24). Trauma incidence was higher in summer and autumn (May-October) than winter (November-December). Peak incidents occurred between 14:00-16:00, with concentrations at 12:00-16:00 and 20:00-22:00. Falls (59.35%), road traffic accidents (16.62%), other traumas (14.10%), cutting/stabbing (4.56%), violence (3.42%), mechanical injuries (1.61%), winter sports injuries (0.14%), burns (0.14%), and animal bites (0.06%) were major causes. Extremity and skin injuries prevailed, with significant site distribution differences (P < .001). Average length of stay at the trauma center was 78.35 ± 48.32 minutes. The gender distribution, timing, causes, and sites of trauma in the elderly differ significantly from other age groups. Unlike the higher occurrence of trauma in young men compared to women, among the elderly, it is more prevalent in women than men, mainly attributed to falls. It is crucial to implement specific measures to prevent trauma in the elderly, and the advancement of information technology in the trauma care system could additionally improve the quality of care.

Transformation of informal elder care practices and mobilities during the pandemic

ABSTRACT The COVID-19 pandemic revealed that when formal care services closed down, informal care burden was unequally transferred to women. Women across the world became part of “caregiver pools”. Using textual archive material collected by the Finnish Literature Society, we analyse the transformation of informal elder care practices in Finland. We adopt a care mobility and care process perspective to analyse how informal elder care was transformed due to social distancing measures that restricted ageing individuals and their family members’ local and translocal mobilities. We find that over 70-year-olds had to adapt their daily mobilities according to risk assessment. Caregiving provided by mostly female family members was replaced by digital care at a distance, which reinforced existing inequalities in care. We argue that the pandemic simultaneously brought about both a time–space compression and what we call a time–space expansion that affected the everyday practices and mobilities of care.

An Analysis of the Impact of Population Ageing on Inflation in China

Abstract: The relationship between demographic change and economic development is one of the most recent and important research topics. Researchers have found that aging will have a certain impact on inflation, but there is still a research gap and controversy on China's inflation problem. Therefore, this paper collects data on the aging process of China's population and inflation rate between 2004 and 2023 and applies graphical analysis and literature analysis to study the data to try to find a cleaner relationship. Through the research, it can be concluded that China's changing population structure has a relatively inhibitory effect on inflation and a negative effect on economic development. The reason may be that the decline in the labor force caused by population aging has a greater impact on aggregate demand than on aggregate supply. Overall, to reduce the impact of the deepening process of population aging, postponing the retirement age and developing the elderly care industry can be an effective way to boost aggregate supply growth to control the increased inflation rate.

Smart Home Technologies for Enhancing Independence of Living and Reducing Care Dependence in Older Adults: A Systematic Review.

To systematically review the potential of smart home technology to enhance the independence of older adults and reduce their dependence on care. Additionally, it sought to examine the positive impacts of such technology on their golden years. A systematic review based on Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The search was conducted on 8 April 2024. Peer-reviewed studies in PubMed, Embase, Web of Science, IEEE Xplore, Scopus, The Cochrane Library, CINAHL, CNKI, WANFANG DATA and VIP from 1 January 2000 to 8 April 2024 were searched. The methodological quality assessment used the Mixed Methods Appraisal Tool (MMAT). Positive findings relevant to this study were extracted from the literature and analysed using thematic synthesis. After meticulously examining 3404 studies, we identified 21 relevant sources for in-depth analysis, including qualitative studies (n = 10), experimental studies (n = 9) and mixed method studies (n = 2). These sources were grouped into five core themes based on the pivotal role of smart home technologies in enabling ageing in place: daily monitoring, assisted living activities, life reminders, functional improvement and emotional companionship. The study found that smart home technology offers numerous benefits to the lives of older adults, including increased independence, psychological support, improved cognitive functioning, enhanced self-management, increased mobility, support for caregivers, promoted social engagement and enhanced quality of life. Smart home technology can enhance the independence of older adults' lives, reduce their dependence on care, alleviate the burden on caregivers and promote home-based elderly care. This systematic review contributes to understanding the capability of smart home technology to promote elderly care at home and help better utilise smart home technology to benefit older adults. Older adults and their caregivers should be encouraged to adopt this technology to improve older adults' quality of life. No patient or public contribution.

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.

Is patriarchy undermined in urbanization? Rural families and housing properties in relocated villages in the urbanizing northwestern China

China’s urbanization has relocated many rural families, but it remains unclear if such changes undermine patriarchy. This study draws on survey and interview data in northwestern China to examine what prevailing principles families draw on in dividing the newly acquired family wealth (1) between parents and children, (2) between elder and younger children, and (3) between sons and daughters. These family decisions are not triggered by life course changes but are induced by a sudden increase in family wealth, which may differ from what usually happens in rural families. Quantitative comparison and qualitative case analysis suggest the accelerated downstream transfers from parents and the mixed desires to prioritize sons’ housing needs, care for each child’s entitlement, compensate less privileged children, and secure parents’ elderly care. The persisting values and rising desires, as reflected by multiple principles of altruism, exchange, entitlement, son preference, and need, contributed to the persisting gender effect and the ambiguous generation and parity effects—parents and elder children did not have apparent advantages in family property structures when rural families were relocated or enclosed into urban areas.

OLG Model Analysis of Delayed Retirement and Social Pension Effects on Family-Based Elderly Care in China

Driven by the traditional concept of “Raising Children to Ensure Old-age Security”, China’s elderly care system has long relied on a family-centered approach, with intergenerational financial transfers (IFTs) serving as a major source of income for the elderly. However, as China’s population ages, the government’s plan to implement delayed retirement from 2025, along with pension reforms, is expected to reshape family-based eldercare and intergenerational financial dynamics. This paper employs an Overlapping Generation (OLG) model, grounded in unified growth theory, which incorporates a delayed retirement policy under the constraint of pension fund balance to examine the impact of adjusting the pension contribution rates (PCRs) and raising retirement age (RA) on IFT rates. The research findings indicate a negative correlation between RA, PCR, and IFT. Both policies have the potential to alleviate the burden on family-based eldercare. The integrated implementation of these two policies not only creates room for a phased reduction in pension contribution rates but also enables the effective utilization of senior workers’ expertise and experience.

Randomized controlled trial parallel-group on optimizing community pharmacist's care for the elderly: The influence of WhatsApp-Email delivered clinical case scenarios.

Drug-related problems (DRPs) significantly threaten the safety of the elderly. In order to improve pharmacists' ability to minimize these events, novel educational interventions that consider the current challenges in clinical practice are crucial. The primary objective is to assess the impact of two unique educational interventions on pharmacists' ability to identify DRPs. A total of 127 community pharmacies in the United Arab Emirates (UAE) were recruited and randomly allocated to one of three arms using a 1:1:1 allocation ratio. While a series of clinical case scenarios (N = 24) related to elderly care were established and validated and sent to pharmacists in Active Group A over a 3-month period, lengthy research articles focused on medication safety in elderly were emailed to pharmacists in Active Group B. The control group pharmacist received no intervention. Then, pharmacists self-reported the number, categories, and severity of DRPs and pharmacist recommendations. The incidence of DRPs identified by pharmacists was 10.8% in Active Group A, 2.0% in the Control Group (p = 0.011), and 3.8% in Active Group B (p = 0.014). A significant difference was observed in the proportion of DRP types between Active Group A and the Control Group. The most common DRPs in Active Group A were avoidable medication (14.7%) and untreated disease (9.2%). Pharmacists in Active Group A (37.2%) and Active Group B (32.3%) most commonly intervened by recommending the cessation of medication, while the most common intervention in the Control Group was recommending a decrease in dose (29.8%). The mean cost reduction per patient was highest in Active Group A (31.3 ±11.8 $), followed by Active Group B (20.8 ±8.6 $) and the Control Group (19.6 ±9.5 $). The mean time needed to resolve a DRP was shortest in Active Group A (7.3 ±3.5 minutes), followed by Active Group B (9.8 ±4.2 minutes) and the Control Group (9.8 ±5.7 minutes). Using WhatsApp to deliver clinical scenarios was effective in improving pharmacists' ability to identify and address DRPs in elderly patients, resulting in faster resolution and higher cost savings.