Home Health Care Research Articles

A Web-Interface Based Decision Support System for Optimizing Home Healthcare Waste Collection Vehicle Routing

Background: The significant increase in home healthcare (HHC) driven by technological advancements, an ageing population, and heightened disease outbreaks—especially evident during the COVID-19 pandemic—has created an urgent need for improved medical waste management. Methods: This paper presents the development of a decision support system with a web-based interface designed for efficient medical waste collection in the HHC sector. Results: The system utilises Flask for backend operations, with HTML and CSS for the user interface, and manages data using JSON files. Its flexible design supports real-time adjustments for various vehicle types and changing waste production locations. It incorporates dynamic routing by employing two sophisticated metaheuristic algorithms: the Strength Pareto Evolutionary Algorithm (SPEA-2) and the Non-Dominated Sorting Genetic Algorithm (NSGA-II). This setup supports different dataset sizes and vehicle fleets, including Internal Combustion Engine (ICE) vehicles and Electric Vehicles (EVs). Conclusions: The automation reduces uncertainties in waste collection by minimising human intervention. The system is built to be easily adaptable for other sectors with minor modifications and can be expanded to test various scenarios with new selectable parameters.

A reinforcement learning approach for the online dynamic home health care scheduling problem.

Over recent years, home health care has gained significant attention as an efficient solution to the increasing demand for healthcare services. Home health care scheduling is a challenging problem involving multiple complicated assignments and routing decisions subject to various constraints. The problem becomes even more challenging when considered on a rolling horizon with stochastic patient requests. This paper discusses the Online Dynamic Home Health Care Scheduling Problem (ODHHCSP), in which a home health care agency has to decide whether to accept or reject a patient request and determine the visit schedule and routes in case of acceptance. The objective of the problem is to maximize the number of patients served, given the limited resources. When the agency receives a patient's request, a decision must be made on the spot, which poses many challenges, such as stochastic future requests or a limited time budget for decision-making. In this paper, we model the problem as a Markov decision process and propose a reinforcement learning (RL) approach. The experimental results show that the proposed approach outperforms other algorithms in the literature in terms of solution quality. In addition, a constant runtime of less than 0.001 seconds for each decision makes the approach especially suitable for an online setting like our problem.

Regional disparities in home health care utilization for older adults and their associated factors at the secondary medical area level: A Nationwide study in Japan.

As aging populations shift health care from hospitals to communities, Japan has implemented policies to promote home health care. This study explored regional differences in home health care recipients among older adults and related factors. We used nationwide data from 2020 to describe the proportion of older adults receiving regular home visits and the medical institutions utilized across secondary medical areas: urban, middle and depopulated areas. We examined factors associated with the proportion of patients receiving regular home visits. Exposures included each secondary medical area's medical and long-term-care (LTC) resources, adjusted for the older adult population; proportion of single-person households; and regional factors. We performed a multivariate negative binomial distribution analysis. A total of 333 secondary medical areas were included. Urban areas had more patients receiving regular home visits, primarily from enhanced home care support clinics/hospitals (HCSCs). Fewer patients received regular home visits in depopulated areas, and conventional HCSCs were more common. Multivariate analysis revealed that the number of conventional HCSCs (coefficient, 0.17 [95% confidence intervals (CI), 0.08 to 0.26]), enhanced HCSCs (coefficient, 0.21 [95% CI, 0.14 to 0.29]) and population density (coefficient, 0.10 [95% CI, 0.02 to 0.19]) were positively associated with higher home-visit rates. Beds in LTC welfare facilities (coefficient, -0.10 [95% CI, -0.19 to -0.01]) and beds in LTC health facilities (coefficient, -0.09 [95% CI, -0.17 to 0.00]) were negatively associated. Policies to promote home health care have led to high home-visit rates in urban areas. Medical and LTC resources and regional factors influence disparities. As Japan's population ages, it is crucial to recognize these disparities and develop medical and LTC systems tailored to each region's characteristics. Geriatr Gerontol Int 2024; ••: ••-••.

A qualitative study on the current status and problems of pharmacists in home healthcare from the viewpoint of care managers in medically underpopulated areas in Japan

BackgroundUnlike in urban areas, community healthcare in medically underpopulated areas in Japan is constantly challenged because of the uncertainty in effectively using the limited resources. However, no study has focused on human resources or identified the actual state of pharmacists’ support in the community. Therefore, our study identified the actual status and problems of pharmacists involved in home medical care in medically underpopulated areas and discussed the roles required of pharmacists and specific methods of support.MethodsThe content of semi-structured interviews with care managers involved in home healthcare in Misugi town, Tsu City, between November 10, 2023 and March 13, 2024, was analyzed qualitatively using the grounded theory approach.ResultsFive care managers participated in the study. Semi-structured interviews on the actual situation and challenges faced by pharmacists indicated that the following roles were required for pharmacists: as in other regions, it was observed that elderly people with dementia and those living alone managed their medicines, adjusted leftover medicines, collaborated with other professions, bridged with physicians, checked medication status through frequent visits, and adhered to internal medication regimens. Issues related to the characteristics of depopulated areas were identified including human resources, limitations of healthcare resources, economic burden, limits on the number of visits by pharmacists. As a characteristic of communities with no pharmacies and only in-hospital prescribing, pharmacists were expected by care managers to manage the problems caused by in-hospital prescribing.ConclusionsOur findings suggest that pharmacists should ensure the number of visits and collaborate with attending physicians, visiting nurses, and care managers to conduct drug management for patients with dementia and older adults living alone. Community healthcare specialists and those involved in the healthcare planning system can also utilize these findings while planning home healthcare to those who live in medically underpopulated areas in Japan.

Developing a clinical decision support framework for integrating predictive models into routine nursing practices in home health care for patients with heart failure.

The healthcare industry increasingly values high-quality and personalized care. Patients with heart failure (HF) receiving home health care (HHC) often experience hospitalizations due to worsening symptoms and comorbidities. Therefore, close symptom monitoring and timely intervention based on risk prediction could help HHC clinicians prevent emergency department (ED) visits and hospitalizations. This study aims to (1) describe important variables associated with a higher risk of ED visits and hospitalizations in HF patients receiving HHC; (2) map data requirements of a clinical decision support (CDS) tool to the exchangeable data standard for integrating a CDS tool into the care of patients with HF; (3) outline a pipeline for developing a real-time artificial intelligence (AI)-based CDS tool. We used patient data from a large HHC organization in the Northeastern US to determine the factors that can predict ED visits and hospitalizations among patients with HF in HHC (9362 patients in 12,223 care episodes). We examined vital signs, HHC visit details (e.g., the purpose of the visit), and clinical note-derived variables. The study identified critical factors that can predict ED visits and hospitalizations and used these findings to suggest a practical CDS tool for nurses. The tool's proposed design includes a system that can analyze data quickly to offer timely advice to healthcare clinicians. Our research showed that the length of time since a patient was admitted to HHC and how recently they have shown symptoms of HF were significant factors predicting an adverse event. Additionally, we found this information from the last few HHC visits before the occurrence of an ED visit or hospitalization were particularly important in the prediction. One hundred percent of clinical demographic profiles from the Outcome and Assessment Information Set variables were mapped to the exchangeable data standard, while natural language processing-driven variables couldn't be mapped due to their nature, as they are generated from unstructured data. The suggested CDS tool alerts nurses about newly emerging or rising risks, helping them make informed decisions. This study discusses the creation of a time-series risk prediction model and its potential CDS applications within HHC, aiming to enhance patient outcomes, streamline resource utilization, and improve the quality of care for individuals with HF. This study provides a detailed plan for a CDS tool that uses the latest AI technology designed to aid nurses in their day-to-day HHC service. Our proposed CDS tool includes an alert system that serves as a guard rail to prevent ED visits and hospitalizations. This tool can potentially improve how nurses make decisions and improve patient outcomes by providing early warnings about ED visits and hospitalizations.

A Intervenção do Serviço de Atenção Domiciliar junto ao usuário e cuidador na rede de atenção à saúde

**Introduction**: Population aging drives the development of home care practices, expanding the role of healthcare teams. The Home Care Service (SAD) is characterized by comprehensive actions in health promotion, prevention, treatment, and rehabilitation performed at home, ensuring continuity of care and effective integration with healthcare networks and the user. **Objective**: To highlight the relationship between the Home Care Service (SAD) and healthcare networks. **Methodology**: This is a descriptive study in the form of a narrative literature review, which sought to highlight the relationship between the Home Care Service (SAD) and healthcare networks. The research was conducted through online access to the PubMed, Medline, and Scielo databases, using the descriptors "home care services," "SUS," and "healthcare networks." Inclusion criteria were: articles available in full text, in Portuguese and English, addressing the topic, and published between 2019 and 2023. **Results**: The results highlight the importance of home care services in assessing, identifying, and training caregivers, promoting self-care and user autonomy. The lack of professional guidance for caregivers presents an opportunity for improvement in care practices. Furthermore, SAD stands out as an innovative strategy in healthcare, surpassing primary care and emergency services, adopting a humanized approach aligned with SUS. By replacing or complementing hospital stays, it seeks equity in resource distribution for efficient access to home care, with active intervention in caregiver training, playing a crucial role in preventing complications, and consolidating itself as a key agent for a patient-centered approach within the SUS framework. **Conclusion**: The intervention of SAD with the user and caregiver is of utmost importance in training caregivers to assist users, avoiding unnecessary complications and ensuring continuity of care within SUS. Thus, the service complements the care provided in primary care and emergency services and substitutes or complements hospital stays.

Home Healthcare Staffing, Routing, and Scheduling Problem With Multiple Shifts and Emergency Considerations

ABSTRACTEffective planning of human resources is critical in designing an efficient home healthcare system. In this study, we present a novel home healthcare staffing, routing, and scheduling problem inspired by a real‐world application. The proposed problem addresses a set of patients, with varying daily visit requirements, being served by a set of caregivers with different qualification levels over a multi‐day multi‐shift planning horizon. The problem aims to minimize the number of extra shifts for caregivers, maximize the allocation of caregivers to emergencies, and minimize the sum of route durations over the planning horizon. These objectives are optimized hierarchically while considering a set of restrictions, including time windows, skill matching, synchronization, care continuity, and labor regulations. To tackle the problem, we introduce a mixed‐integer linear programming model. The model is then extended and two sets of valid inequalities are incorporated to enhance its tightness. Computational experiments are conducted on a set of 20 instances. The results highlight the efficiency of the proposed extension in increasing both the number of instances that can be solved to optimality and the number of instances for which a feasible solution is found.

AUTOMATED INDOOR ACTIVITY MONITORING FOR ELDERLY AND VISUALLY IMPAIRED PEOPLE USING QUANTUM SALP SWARM ALGORITHM WITH MACHINE LEARNING

Elderly and vision-impaired indoor activity monitoring uses sensor technology to monitor interaction and movement in the living area. This system can identify deviations from regular patterns, provide alerts, and ensure safety in case of emergencies or potential risks. These solutions enhance quality of life by promoting independent living while offering peace of mind to loved ones and caregivers. Visual impairments have become the chief part of these problems over the past few years. Usually, visually impaired people seek help from others to keep doing their daily tasks. An automated human activity recognition (HAR) technique could enhance a vision-impaired person’s transaction activity and safe movement. HAR using deep learning (DL) includes training neural networks to automatically detect and classify various activities carried out by humans based on sensor information. By leveraging DL approaches, the HAR system could accurately identify and classify activities, including sitting, standing, walking, or running, from the information captured by sensors or wearable devices. This system is integral to smart home automation, healthcare, and sports analytics. This study develops an Automated Fractal Quantum Salp Swarm Algorithm with Machine Learning based HAR (QSSA-MLHAR) for assisting elderly and visually impaired people. The QSSA-MLHAR technique uses sensory input data to identify human activities in diverse classes. In the QSSA-MLHAR technique, the min–max scalar is primarily used to scale the input data. Besides, the QSSA-MLHAR technique applies a mixed extreme learning machine (M-ELM) model to classify various human actions. The QSSA-based hyperparameter tuning process is used to improve the detection results of the M-ELM system. A wide range of simulations was performed to ensure the better performance of the QSSA-MLHAR method. The comprehensive outcomes assured that the QSSA-MLHAR technique performs well compared to other models.

Recovery environments in places of daily living: a scoping review and conceptual analysis

BackgroundOwing to advances in medical technology and the promotion of at-home medical care, patients are more frequently being treated in their places of daily living after discharge from acute care hospitals. As medical care and lifestyle are closely linked, the quality of life of the patient and their families therefore depends on the adequate preparation of the recovery environment. Hence, modifying this environment to ensure that the patient’s lifestyle and medical care are complementary is often vital. This study aimed to clarify the concept of recovery environments in places of daily living.MethodsThe literature search and selection of articles were based on a scoping review conducted in Scopus and PubMed, while data extraction and analysis were based on conceptual analysis. Thirty-two articles met the inclusion criteria.ResultsOur analysis of these articles allowed us to classify four types of recovery environments in places of daily living: physical environments appropriate to the health status of the recovering patient, collaborative environments in which intra-family roles are empowered, community environments in which recovering patients are accepted, and service environments in which the required services can be accessed. We also noted the main roles of medical professionals for building relationships with patients: providing decision-making support in places of daily living, creating an environment that empowers patients and their families, and modifying the service environment.ConclusionsFor patients, the main aims of recovery environments in places of daily living are to make them physically comfortable, maintain their identity, and improve their quality of life. Although this study is only a first step towards conceptualizing recovery environments in places of daily living and the final results are tentative, we are nonetheless confident that it will be important for advancing the field of home healthcare research.

Home Health Care and Place of Death in Medicare Beneficiaries With and Without Dementia.

Home health care supports patient goals for aging in place. Our objective was to determine if home health care use in the last 3 years of life reduces the risk of inpatient death without hospice. We analyzed the characteristics of 2,065,300 Medicare beneficiaries who died in 2019 and conducted multinomial logistic regression analyses to evaluate the association between the use and timing of home health care, dementia diagnosis, and place of death. Receiving any home health care in the last 3 years of life was associated with a lower probability of inpatient death without hospice (Pr 23.3% vs 31.5%, p < .001), and this effect was stronger when home health care began prior to versus during the last year of life (Pr 22.5% vs 24.3%, p < .001). Among all decedents, the probability of death at home with hospice compared to inpatient death with hospice was greater when any home health care was used (Pr 46.0% vs 36.5%, p < .001), and this association was strongest among beneficiaries with dementia who started home health care at least 1 year prior to death (Pr 55.6%, p < .001). Use of home health care during the last 3 years of life was associated with reduced rates of inpatient death without hospice, and increased rates of home death with hospice. Increasing affordable access to home health care can positively affect end-of-life care outcomes for older Americans and their family caregivers, especially those with dementia.

Out of the Hospital, Out of the Box: Utilizing the CNS Role in Home Healthcare Settings.

The United States has poorer population health outcomes compared to similar developed nations despite higher healthcare spending. Multiple factors contribute to this problem, including high healthcare costs, insurance coverage limitations, and a lack of focus on preventive care and wellness. Clinical Nurse Specialists (CNSs), primarily known for their impact in acute care settings, increasingly demonstrate their value in outpatient settings like home healthcare. CNSs possess graduate-level training, equipping them with the skills and expertise to develop and implement strategies that improve population health outcomes in home health settings. CNSs provide clinical leadership and support to staff while remaining at the forefront of ensuring the organization delivers high-quality patient care. Understanding the specific skills and competencies of the CNS to support the patient, family, staff, and organization is necessary to improve outcomes for patients in outpatient settings. The CNS delivers care through direct patient care, supporting nurses and nursing practice, and improving organizational systems. This unique skill set allows CNSs to influence home healthcare outcomes across various levels of care positively. This article sheds light on how CNSs enhance patient outcomes in outpatient settings like home healthcare.

Effectiveness of a Training Program for the Prevention of Pressure Ulcers on Caregivers of Elderly Patients.

The aim of this study is to evaluate the impact of face-to-face education on pressure ulcer prevention and care provided to caregivers of patients with pressure ulcers in home healthcare services, specifically on the progression of the ulcers and their effects on the patients. This prospective, analytical intervention study assessed the training program implemented using the presentation teaching strategy for caregivers of patients with pressure ulcers, from the perspective of the patient and caregiver. The participants were 91 patients with pressure ulcers in the Home Health Care Unit and 91 caregivers. The data collection tool, consisted of questions regarding sociodemographic data prepared by researchers and questioning the knowledge of caregivers' knowledge about pressure ulcer. The Barthel Index, Pressure Ulcer Scale for Healing, Braden Risk Assessment Scale, and Care Assessment Inventory provided by family members were used to assess the level of dependence in patients' daily living activities. The patients' average age was 77.21±13.26 years and 58.2% of them were women. The caregivers' average age was 53.32±11.45 years and 83.5% of them were women. A statistically significant increase was observed between knowledge scores before and after training (p<0.001). Indicating that the training positively affects the caregivers' level of knowledge. Factors such as a private room, caregiver support, caregiver competence, and caregiving difficulties were significantly related to changes in knowledge scores. Training programs for caregivers on pressure ulcer handling in home health care patients are effective and should be planned from a broader perspective to include caregivers within the family.

Evaluating the Knowledge of Home Caregivers on Pressure Ulcer Signs and Prevention in Elderly Patients in Al Ahsa.

Background Pressure ulcers are significant health issues affecting elderly patients, leading to severe complications, prolonged hospital stays, and high healthcare costs. Preventive care by home caregivers plays a crucial role in mitigating the development of pressure ulcers. Objective This study aims to assess home caregivers' knowledge of pressure ulcer prevention and investigate the factors associated with knowledge levels in elderly patients in Al Ahsa, Saudi Arabia. Methods A cross-sectional study was conducted involving 231 home caregivers of elderly patients registered in Home Health Care, Al-Ahsa Health Cluster. Data were collected using an online questionnaire assessing demographic information and knowledge of pressure ulcer prevention, adapted from the Pressure Ulcer Knowledge Assessment Tool (PUKAT) 2.0. Data analysis was performed using SPSS version 29.0 (IBM Corp., Armonk, USA), with a Chi-square test used for bivariate analysis of categorical outcomes. Results The majority of caregivers were female (64.5%), aged between 35 and 50 years (47.6%), and primarily family members (83.5%). Most caregivers had been providing care for 5 years or less (79.7%), with 67.5% never having received training in pressure ulcer prevention. Knowledge levels were generally sufficient, with 87.0% of caregivers showing adequate knowledge of pressure ulcer prevention. Significant associations were found between knowledge levels and caregiving duration (p=0.006) as well as training in pressure ulcer prevention (p=0.001). However, other demographic factors, such as age and gender, were not significantly associated with knowledge levels. Conclusion The study found that most home caregivers possess sufficient knowledge of pressure ulcer prevention, although training and caregiving duration significantly influence knowledge levels. These findings underscore the need for comprehensive training programs to improve caregivers' knowledge and practice, thereby enhancing the quality of care for elderly patients and reducing the incidence of pressure ulcers.

Adaptation of the Taiwan Version of the Supportive and Palliative Care Indicators Tool (SPICT-TW) and Its Association with Six-Month Mortality: A Multi-Center Validation Study in Older People.

Background: The Supportive and Palliative Care Indicators Tool (SPICT) was developed for identifying, in a timely manner, patients who may benefit from supportive and palliative care for better treatment review, care-plan discussion, and end-of-life care. Although the SPICT has been validated in different languages and for patients living in different settings, it has not been validated for patients receiving home-based medical care (HBMC), or in the context of using traditional Chinese characters. Objectives: The present study aimed to validate the Taiwanese version of the SPICT (SPICT-TW) and to measure its ability to predict six-month mortality in patients who received HBMC in Taiwan. Methods: Seven HBMC agents (five clinics and two hospitals) participated in this validation study. We recruited 129 patients aged ≥ 50 years who had been consistently receiving HBMC for >two months. Results: The results revealed that the SPICT-TW demonstrated similar reliability and validity compared to other language versions of the SPICT. It may be an appropriate tool for healthcare professionals to detect, in a timely manner, the needs for palliative care in older people who receive home healthcare. Furthermore, we found that a combination of four general indicators and one clinical indicator in the SPCIT-TW has the best prediction ability at predicting six-month mortality in these HBMC recipients. This multi-center study validated the SPICT-TW among HBMC recipients in Taiwan. Conclusions: The SPICT-TW demonstrated high reliability and validity through the Kuder-Richardson 20, an intraclass correlation coefficient, Cohen's kappa, and receiver operating characteristic analysis, supporting its potential as a practical tool for identifying older adults at risk of dying within six months who have not yet received palliative care but may benefit from it.

Reducing Violence Risk: Home Healthcare Nurses and Early Identification of Informal Caregiver Burden.

An expanding body of literature suggests that informal caregiver burden is a growing issue that negatively impacts care recipients, informal caregivers, and formal care providers. Costs associated with informal caregiver burden include risk to the informal caregiver's physical, emotional, and psychological well-being and increased potential to perpetrate violence. By identifying interventions to support informal caregivers, home healthcare nurses can help decrease the risk of negative outcomes and reduce the burden on informal caregivers. This paper examines home healthcare nurses' role in helping reduce the impact of informal caregiver burden, thereby reducing the risk for violence. By prioritizing caregiver burden as a critical area of focus in reducing violence risk, home healthcare organizations and the nurses who work for them can help address gaps in care while also recognizing the informal caregivers' critical role in caring for their loved ones.

Impact of clinical pharmacist on home health care patients in hail region

The primary aim of this research is to assess how the involvement of clinical pharmacists can influence home health care patient’s outcomes, including medication management, adherence to prescribed therapies, and overall patient satisfaction. To achieve this, the study adopted a descriptive and quantitative approach. Data gathered through an electronic questionnaire specifically targeted at home health care patients, totaling 112 individuals, aiming to capture their experiences and perceptions regarding the contributions of clinical pharmacists to their health care. This questionnaire included questions that focus on the effectiveness, accessibility, and patient-centered care provided by clinical pharmacists. The collected data then systematically analyzed using the Statistical Package for the Social Sciences (SPSS) application, allowing for the identification of trends, correlations, and potential areas for improvement in clinical pharmacy services. The study finally concluded that.

Distance-Based Fluorescent Immunosensor for Point-of-Care Test of Illegal Additives through the Gas-Producing Nanozyme.

The colorimetric point-of-care test (POCT) offers a rapid and efficient method for detecting specific targets in real samples. However, traditional colorimetric methods often rely on complex signal amplification techniques or electronic devices to enhance detection sensitivity, which can inadvertently increase both cost and time, thus contradicting the fundamental goals of visual detection methods. Here, we presented a distance-based fluorescent immunosensor that utilized a gas-producing nanozyme for continuous gas production reaction as a signal. Specifically, the SOM-ZIF-8@Pt nanozyme catalyzed the production of O2 from H2O2 to cause an obvious increase in the pressure within a sealed chamber, thus driving the production of H2S to quench the fluorescence of CsPbBr3 on the walls of the capillaries. Based on the competitive immunoassay, the fluorescence quenching lengths were relative with the concentration of aminopyrine in the range from 0.2 to 20 ng/L; thus, the fluorescent POCT-based homemade device was realized through the amplification of distance-based signals facilitated by the continuous gas production reaction. This strategy provides an effective way to realize POCT assays in resource-limited areas by transforming pressure variations into directly observable signals. Furthermore, distinguished by its high sensitivity, ease of operation, and portability, it also represents a significant advancement in biomedical diagnostics, particularly within home healthcare and clinical POCT.

Telemonitoring activities of daily living in home healthcare services to support aging in place

Abstract Context Assessing older adults’ abilities to carry out their activities of daily living (ADLs) is a key determinant in the provision of homecare services for aging in place. Amidst a growing aging population and lack of human resources, continuous remote monitoring technology appears promising to support health and social care professionals (HSCPs) in identifying service needs. However, implementation studies conducted in real-life settings are lacking. This study is part of an on-going action design research project aimed at developing an ambient telemonitoring system monitoring ADLs to support clinical decision making. It focused on the initial step of implementation and aimed to understand 1) which HSCPs would want to use the system, 2) for which care recipient they requested it, and 3) for which reasons. Methods A multiple embedded case study utilizing mixed methods was conducted across 3 healthcare establishments in Quebec, Canada. Descriptive statistics from surveys and medical records was conducted to describe the profile of HSCPs and their care recipients. An inductive qualitative analysis was carried out through interviews with 23 HSCPs, in charge of 31 care recipients, to deepen our understanding of the reasons why they requested the system. Results HSCPs were primarily women (89%) occupational therapists (43%). Home care recipients were also primarily women (74%), with documented refusal of homecare services (65%), diagnosed with cognitive decline (94%), and living in a single-family home or apartment (68%). Overall, interviews revealed HSCPs challenges in getting the necessary information to assess their care recipients needs, despite the presence of in-home services and other strategies in place (e.g. informal carer support). Moreover, the telemonitoring system was perceived as promising for risk management. Conclusions There is an interest for the use of ADL telemonitoring technology in the delivery of home healthcare services for aging in place. Key messages • To facilitate its integration in practice, we explored the need for, and value of, ADLs telemonitoring technology by health and social care professionals (HSCPs) in real-life contexts. • By studying the integration of innovative technologies in home healthcare practices, such as ADLs telemonitoring, we aim to support HSCPs practice in fulfilling older adults desire to age in place.

Research Status of Self-care Ability, Quality of Life, and Community Home Healthcare Needs of the Elderly with Type 2 Diabetes Mellitus

This paper reviews the self-care ability, quality of life, and needs of elderly patients with type 2 diabetes in community-based home care. The study shows that the elderly's self-care ability is closely related to their quality of life, and good self-care ability can significantly reduce the incidence of complications and improve quality of life. Although community-based home care services are crucial for meeting the medical needs of the elderly, there are problems such as insufficient supply, poor information communication, and lack of economic support. By analyzing domestic and foreign studies, this paper proposes suggestions for optimizing community-based home medical services to better support the improvement of elderly diabetes patients' self-care ability and quality of life.

Impacts of chronic diseases and multimorbidity on health-related quality of life among community-dwelling elderly individuals in economically developed China: evidence from cross-sectional survey across three urban centers

ObjectiveAs the ageing process in China further accelerates and the average life expectancy increases, chronic disease prevalence and multimorbidity rates are constantly rising, especially among elderly individuals. However, few previous studies have explored the impacts of chronic diseases and multimorbidity on health-related quality of life (HRQoL). This study aimed to investigate this association among community-dwelling elderly individuals in China.MethodsA cross-sectional study was conducted in communities in three cities (Suzhou, Qingdao, and Guangzhou). The basic characteristics, chronic diseases and HRQoL of participants were collected, and HRQoL was measured by the EuroQol 5-Dimensions 3-Level version (EQ-5D-3L). Logistic regression, Tobit regression and generalized linear models were used to assess the impacts of chronic diseases and multimorbidity on HRQoL.ResultsApproximately 83.2 percent of the 1,218 respondents had chronic conditions, with 30 percent having multimorbidity. After controlling for sociodemographic and health behaviour factors, patients with stroke were more likely to report problems in all five dimensions of the EQ-5D and had a lower EQ-5D utility index (UI) (b = -0.342) than patients with other chronic conditions. Patients with chronic pulmonary obstruction had a lower EuroQol Visual Analog Scale (EQ-VAS) (b = -11.169) than patients with other chronic conditions. Furthermore, patients with multimorbidity had worse HRQoL (P < 0.001).ConclusionsBoth chronic condition probability and multimorbidity rates were high among Chinese community-dwelling elderly individuals. Different disease types had varying degrees of impact on HRQoL, and patients with multimorbidity had worse HRQoL. This study proposes that the government enhance the quality of life of community-dwelling elderly individuals with multimorbidity by establishing long-term care insurance and expanding comprehensive community-based home health care services.