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Long-Term Care for Older Adults

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 36270

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Special Issue Editors

Prof. Dr. Tetsuya Tanioka

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Guest Editor

Department of Nursing Outcome Management, The University of Tokushima, Tokushima 770-8509, Japan
Interests: nursing outcome management; research design; nursing theory; caring; advanced technologies; psychiatric mental health nursing; rehabilitation; healthcare robots

Dr. Michael Joseph Dino

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Co-Guest Editor

1. Research Development & Innovation Center, Our Lady of Fatima University, Valenzuela City 1440, Philippines
2. Phi Gamma Chapter, Sigma Theta Tau Honor Society in Nursing, Valenzuela City 1440, Philippines
Interests: educational gerontology; gerotechnology; research ethics; telehealth; mobile health; telerehabilitation; healthcare robots

Special Issue Information

Dear Colleagues,

Significant improvement in healthcare delivery has brought about increased life expectancy, equating to a larger percentage of older adults with multiple chronic disease conditions and functional impairments. This population experiences challenges in mobility, poor performance of activities of daily living, and eventually, decreased quality of life. Therefore, the utilization of advanced technologies for the care and rehabilitation of older persons is increasingly being recognized as the most promising solution to foster independence, social engagement, and a safe environment for growing cohorts of older adults.

With the aim of advancing research, scholarship, caring science, and academic discourse in the field, this Special Issue of Healthcare seeks original commentaries, research, short reports, and literature reviews related to trends, issues, and challenges in long-term care for older adults, focusing on healthcare innovations and technologies catered to helping this population. Your submission may include topics related to one or more of the following keywords:

Long-term care
Older adults
Quality of life
Evidence-based nursing care
Caring
Rehabilitation
Advanced technologies
Community nursing
Quality of life
Public health

Creating a better world for this population is possible through our collaborative efforts and sustainable commitment to building a community of healthy, energetic, optimistic, driven, and empowered older adults. Your scholarly contribution will help further evidence-based practice, foster a culture and system of quality care, and produce data-informed policies concerning gerotechnology.

We invite you to take part in this noble endeavor.

Prof. Dr. Tetsuya Tanioka
Dr. Michael Joseph Dino
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

long-term care
older adults
quality of life
evidence-based nursing care
caring
rehabilitation
advanced technologies
community nursing
quality of life
public health

Published Papers (13 papers)

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Research

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17 pages, 810 KiB

Open AccessArticle

Family Involvement Training for Staff and Family Caregivers: Case Report on Program Design and Mixed Methods Evaluation

by Cecilia Marion, Shazmin Manji, Linda Podlosky, Heather MacGillivray, Tanya L’Heureux, Sharon Anderson and Jasneet Parmar

Healthcare 2024, 12(5), 523; https://doi.org/10.3390/healthcare12050523 - 22 Feb 2024

Viewed by 818

Abstract

The COVID-19 pandemic underscored the imperative for meaningful family involvement in long-term care, aligning with policy and safety standards while enhancing outcomes for caregivers, residents, and staff. The objectives of this article are as follows: (1) a case study report on implementing a family involvement intervention designed to facilitate the formal and safe engagement of family caregivers in resident care and (2) the pilot evaluation of the intervention. We used Knapp’s six-step implementation science model to guide and describe intervention development to provide insight for others planning family involvement projects. We employed sequential mixed methods, including surveys with quantitative and qualitative questions before and after program implementation for providers, and surveys and interviews with family caregivers a year after. We used the Mann–Whitney U test (p < 0.05) to assess differences in health providers’ perceptions pre- and post-education. Families and staff perceived that the Family Involvement Program was important for improving the quality of care, residents’ quality of life and family/staff relationships. Providers’ perceptions of the program’s positive impact on residents’ quality of life (p = 0.020) and quality of care (p = 0.010), along with their satisfaction with working relationships with families (p = 0.039), improved significantly after the program. Qualitative data confirmed improvements in family–staff relationships. In conclusion, we documented the design of this family involvement initiative to encourage family caregivers and staff to work together in residents’ care. Youville’s Family Involvement Program gives families and family caregivers an explicit role as partners in long-term care. The mixed methods pilot evaluation documented improvements in staff and family relationships. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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11 pages, 274 KiB

Open AccessArticle

Examining Factors Associated with Dynapenia/Sarcopenia in Patients with Schizophrenia: A Pilot Case-Control Study

by Ryuichi Tanioka, Kyoko Osaka, Hirokazu Ito, Yueren Zhao, Masahito Tomotake, Kensaku Takase and Tetsuya Tanioka

Healthcare 2023, 11(5), 684; https://doi.org/10.3390/healthcare11050684 - 25 Feb 2023

Viewed by 1500

Abstract

Sedentary behavior in patients with schizophrenia causes muscle weakness, is associated with a higher risk of metabolic syndrome, and contributes to mortality risk. This pilot case-control study aims to examine the associated factors for dynapenia/sarcopenia in patients with schizophrenia. The participants were 30 healthy individuals (healthy group) and 30 patients with schizophrenia (patient group), who were matched for age and sex. Descriptive statistics, Welch’s t-test, cross-tabulations, adjusted residuals, Fisher’s exact probability test (extended), and/or odds ratios (ORs) were calculated. In this study, dynapenia was significantly more prevalent in patients with schizophrenia than in healthy individuals. Regarding body water, Pearson’s chi-square value was 4.41 (p = 0.04), and significantly more patients with dynapenia were below the normal range. In particular, body water and dynapenia showed a significant association, with an OR = 3.42 and 95% confidence interval [1.06, 11.09]. Notably, compared with participants of the healthy group, patients with schizophrenia were overweight, had less body water, and were at a higher risk for dynapenia. The impedance method and the digital grip dynamometer used in this study were simple and useful tools for evaluating muscle quality. To improve health conditions for patients with schizophrenia, additional attention should be paid to muscle weakness, nutritional status, and physical rehabilitation. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

17 pages, 899 KiB

Open AccessArticle

Developing a Theory of Community Caring for Public Health Nursing

by Saori Iwamoto

Healthcare 2023, 11(3), 349; https://doi.org/10.3390/healthcare11030349 - 25 Jan 2023

Cited by 1 | Viewed by 5206

Abstract

Nursing theories focus on individual and community care and human relationships in unique contexts. One of these contexts is the community in which a theory-based systematic nursing practice process is warranted. This article describes a theory of Community Caring for Public Health Nursing (CCPHN), which is grounded in four nursing metaparadigms by Fawcett: persons, environment, health, and nursing. This theory has three assumptions: (1) community caring fosters care demonstrations in nursing, (2) caring communities comprise members with community attachments united by their common values rather than rigid customs, and (3) community caring is expressed competently in mutual-care practices. From these assumptions, a nursing perspective supporting the community caring process is exhibited as the expression of caring by public health nurses toward supportive and promotive nursing processes that enhance a caring community. Nurses play critical roles in leading the establishment of caring communities. In future research, it is critical to verify whether building a caring community by public health nursing practices based on this theory of CCPHN contributes to the health and well-being of the people in the community. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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15 pages, 1751 KiB

Open AccessArticle

Event History Analysis of Factors Affecting Survival of Older Adults in Taiwan

by Yuan-Chen Lo, Wei-Chung Hsu, Shao-Jen Weng, Yao-Te Tsai, Shih-Chia Liu and Cheng-Hsiang Lin

Healthcare 2022, 10(12), 2439; https://doi.org/10.3390/healthcare10122439 - 2 Dec 2022

Viewed by 1162

Abstract

(1) Background: Due to rapidly increasing average age of Taiwan’s population, it is very important to analyze the factors affecting the survival of older adults. (2) Methods: In this study, the 1989 Taiwan Longitudinal Study on Aging, which lasted 22 years and consisted of seven surveys, was used. Furthermore, Cox and Aalen’s time-dependent frailty models were used to analyze factors that affect the survival of older adults. (3) Results: Based on past literature, we selected 15 important factors that were closely associated with the survival of older adults and constructed six models based on these factors. The study results showed that, in addition to background characteristics, physical and mental conditions, activities of daily living (ADL), physical performance, and self-rated health had a huge association with the survival of older adults. (4) Conclusions: We selected ten variables (age, gender, population, education level, ADL status, physical performance, self-rated health, smoking, chewing betel nut, and the presence of a spouse), and their combinations were used to generate reduced models, which could be considered as important markers that affect and predict the survival of older adults. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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11 pages, 1311 KiB

Open AccessArticle

Comparison of Subjective Facial Emotion Recognition and “Facial Emotion Recognition Based on Multi-Task Cascaded Convolutional Network Face Detection” between Patients with Schizophrenia and Healthy Participants

by Toshiya Akiyama, Kazuyuki Matsumoto, Kyoko Osaka, Ryuichi Tanioka, Feni Betriana, Yueren Zhao, Yoshihiro Kai, Misao Miyagawa, Yuko Yasuhara, Hirokazu Ito, Gil Soriano and Tetsuya Tanioka

Healthcare 2022, 10(12), 2363; https://doi.org/10.3390/healthcare10122363 - 24 Nov 2022

Cited by 1 | Viewed by 1589

Abstract

Patients with schizophrenia may exhibit a flat affect and poor facial expressions. This study aimed to compare subjective facial emotion recognition (FER) and FER based on multi-task cascaded convolutional network (MTCNN) face detection in 31 patients with schizophrenia (patient group) and 40 healthy participants (healthy participant group). A Pepper Robot was used to converse with the 71 aforementioned participants; these conversations were recorded on video. Subjective FER (assigned by medical experts based on video recordings) and FER based on MTCNN face detection was used to understand facial expressions during conversations. This study confirmed the discriminant accuracy of the FER based on MTCNN face detection. The analysis of the smiles of healthy participants revealed that the kappa coefficients of subjective FER (by six examiners) and FER based on MTCNN face detection concurred (κ = 0.63). The perfect agreement rate between the subjective FER (by three medical experts) and FER based on MTCNN face detection in the patient, and healthy participant groups were analyzed using Fisher’s exact probability test where no significant difference was observed (p = 0.72). The validity and reliability were assessed by comparing the subjective FER and FER based on MTCNN face detection. The reliability coefficient of FER based on MTCNN face detection was low for both the patient and healthy participant groups. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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11 pages, 269 KiB

Open AccessArticle

Robots and Robotics in Nursing

by Gil P. Soriano, Yuko Yasuhara, Hirokazu Ito, Kazuyuki Matsumoto, Kyoko Osaka, Yoshihiro Kai, Rozzano Locsin, Savina Schoenhofer and Tetsuya Tanioka

Healthcare 2022, 10(8), 1571; https://doi.org/10.3390/healthcare10081571 - 18 Aug 2022

Cited by 16 | Viewed by 7901

Abstract

Technological advancements have led to the use of robots as prospective partners to complement understaffing and deliver effective care to patients. This article discusses relevant concepts on robots from the perspective of nursing theories and robotics in nursing and examines the distinctions between human beings and healthcare robots as partners and robot development examples and challenges. Robotics in nursing is an interdisciplinary discipline that studies methodologies, technologies, and ethics for developing robots that support and collaborate with physicians, nurses, and other healthcare workers in practice. Robotics in nursing is geared toward learning the knowledge of robots for better nursing care, and for this purpose, it is also to propose the necessary robots and develop them in collaboration with engineers. Two points were highlighted regarding the use of robots in health care practice: issues of replacing humans because of human resource understaffing and concerns about robot capabilities to engage in nursing practice grounded in caring science. This article stresses that technology and artificial intelligence are useful and practical for patients. However, further research is required that considers what robotics in nursing means and the use of robotics in nursing. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

12 pages, 278 KiB

Open AccessArticle

Elderly Caregivers’ Awareness of Caregiving Health Risks

by Shimon Amar, Aya Biderman, Sara Carmel and Yaacov G. Bachner

Healthcare 2022, 10(6), 1034; https://doi.org/10.3390/healthcare10061034 - 2 Jun 2022

Cited by 3 | Viewed by 1659

Abstract

The aim of this study was to assess the level of awareness of elderly primary caregivers of being at physical and mental health risk due to their caregiving role, as well as to examine the impact of sociodemographic characteristics, patient care characteristics, and situational variables on caregivers’ awareness. Data were collected by interview of a sample of primary caregivers aged 60+. A total of 202 primary caregivers responded positively, representing a response rate of 65% (202/311). We found a low–moderate level of awareness. The final multivariate regression analysis (F (12, 179) = 21.26, p < 0.000) revealed six variables, out of nearly 30, that are associated with a high percentage (59%) of the variability of caregivers’ awareness, namely caregiving burden, caregivers’ self-rated health, patient’s disease severity, caregiver gender, number of children, and familial relation to the patient. Action may be taken to raise caregivers’ awareness. Such interventions would possibly contribute to the quality of life and health of caregivers, enable the optimal treatment of the patient, and reduce the costs imposed on the health system and society in general. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

13 pages, 1352 KiB

Open AccessArticle

Investigation of Methods to Create Future Multimodal Emotional Data for Robot Interactions in Patients with Schizophrenia: A Case Study

by Kyoko Osaka, Kazuyuki Matsumoto, Toshiya Akiyama, Ryuichi Tanioka, Feni Betriana, Yueren Zhao, Yoshihiro Kai, Misao Miyagawa, Tetsuya Tanioka and Rozzano C. Locsin

Healthcare 2022, 10(5), 848; https://doi.org/10.3390/healthcare10050848 - 5 May 2022

Cited by 1 | Viewed by 2213

Abstract

Rapid progress in humanoid robot investigations offers possibilities for improving the competencies of people with social disorders, although this improvement of humanoid robots remains unexplored for schizophrenic people. Methods for creating future multimodal emotional data for robot interactions were studied in this case study of a 40-year-old male patient with disorganized schizophrenia without comorbidities. The qualitative data included heart rate variability (HRV), video-audio recordings, and field notes. HRV, Haar cascade classifier (HCC), and Empath API^© were evaluated during conversations between the patient and robot. Two expert nurses and one psychiatrist evaluated facial expressions. The research hypothesis questioned whether HRV, HCC, and Empath API^© are useful for creating future multimodal emotional data about robot–patient interactions. The HRV analysis showed persistent sympathetic dominance, matching the human–robot conversational situation. The result of HCC was in agreement with that of human observation, in the case of rough consensus. In the case of observed results disagreed upon by experts, the HCC result was also different. However, emotional assessments by experts using Empath API^© were also found to be inconsistent. We believe that with further investigation, a clearer identification of methods for multimodal emotional data for robot interactions can be achieved for patients with schizophrenia. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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12 pages, 1877 KiB

Open AccessArticle

Remote-Controlled Drone System through Eye Movements of Patients Who Need Long-Term Care: An Intermediary’s Role

by Feni Betriana, Ryuichi Tanioka, Atsunori Kogawa, Riku Suzuki, Yuki Seki, Kyoko Osaka, Yueren Zhao, Yoshihiro Kai, Tetsuya Tanioka and Rozzano Locsin

Healthcare 2022, 10(5), 827; https://doi.org/10.3390/healthcare10050827 - 30 Apr 2022

Cited by 2 | Viewed by 1930

Abstract

The use of a remote-controlled drone system (RDS) by eye movements was studied to assist patients in psychiatric long-term care (PLTC) to allow them to view the environment outside the hospital, hoping that this will bring them some enjoyment. However, successfully applying this system requires human intermediaries in facilitating the interactions between patients and RDS operators. The aim of the study was to describe the role of nurses as intermediaries in the application of an RDS through eye movements of patients PLTC. This study employed the Intentional Observational Clinical Research Design. Data collection was performed in November 2021 at a psychiatric hospital with selected patients in PLTC. Seventeen patients took part in the indoor experiment, whereas 23 patients took part in the outdoor experiment. Fifteen of the 23 patients in the outdoor experiment were the same patients who took part in the indoor experiment. Most of the patients in the indoor and outdoor test arenas could successfully, delightfully, and safely fly the drone. This study demonstrated that RDS using just eye movements could increase the quality of life in older patients with psychiatric problems in PLTC. For the successful use of this drone system, nurse intermediaries assumed critically significant roles. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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15 pages, 8095 KiB

Open AccessArticle

Support and Empowerment for Older Adult Spousal Caregiving of People with Mild and Moderate Dementia: A Participatory Action Research

by Chia-Jung Hsieh, Pei-Fang Yin, Chi-Yi Chiu, Yu-Ping Hsiao and Yu-Ling Hsiao

Healthcare 2022, 10(3), 569; https://doi.org/10.3390/healthcare10030569 - 18 Mar 2022

Cited by 3 | Viewed by 2261

Abstract

Background: Little attention has been given to the older adult caregivers of spouses with mild and moderate dementia in the caring dynamics process. The aim of this action research was to develop a program for providing support and empowerment to older adult caregivers of spouses with mild and moderate dementia in the community. Methods: The researchers acted as facilitators, with a view to empowering participants. We recruited participants from a day-care center and two community service stations. Data were collected with semi-structured, in-depth interviews with 19 dementia care dyads and from the notes, reflections, and feedback of collaborative researchers. Relevant themes for content analysis were extracted. Results: Three action cycles were completed over 18 months. The results revealed goals of three cycles: to connect the home situation and effective dialogue as a bridge to the researcher, to confirm the daily needs or expectations of the caregiver and the patient, and to enhance the interactions and quality of life of family members with resources and network. This process was cyclical and repetitive, and it also generated partnerships that built relationships among the interdisciplinary team, families, and researchers. At the same time, team workers formed a cooperative and coordinated family service mechanism to reflect the professional values and practice capabilities. Conclusions: The intervention program was based on the promotion of factors for the caregiver, linking to environmental protective factors, and the stabilization of mental and neurological symptoms of dementia patients, thereby enhancing the response capabilities of home caregivers while meeting the patient’s care needs in life. It is a tool that can effectively be used for support and empowerment in this population. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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15 pages, 862 KiB

Open AccessArticle

Implementation of an Advance Care Planning Inventory and Its Possible Effect on Quality of Dying: A Nationwide Cross-Sectional Study in Group Homes for Persons with Dementia in Japan

by Seira Takada, Yasuko Ogata, Yoshie Yumoto and Masaomi Ikeda

Healthcare 2022, 10(1), 62; https://doi.org/10.3390/healthcare10010062 - 29 Dec 2021

Cited by 2 | Viewed by 2116

Abstract

This study aimed to develop an inventory for advance care planning implementation for persons with dementia in group homes and to examine the association between inventory implementation and residents’ quality of dying. A nationwide cross-sectional study was conducted via questionnaires mailed from 2000 group homes in Japan, selected through stratified random sampling. Participants were managers and care planners who had provided end-of-life care for recently deceased residents. The newly developed inventory was used to assess advance care planning implementation for persons with dementia, and the Quality of Dying in Long-term Care Scale was used to evaluate quality of dying. The valid response rate was 28.5% (n = 569). The factor structure of the newly developed Advance Care Planning Practice Inventory and the association between its implementation and quality of dying were verified using factor analysis and internal consistency, and logistic regression, respectively. The composite score and the factor score of the newly developed inventory were significantly associated with quality of dying (p < 0.05). The implementation of advance care planning improves the quality of dying. These findings can be used in development of educational programs, as well as research on advance care planning for care providers. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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Review

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10 pages, 604 KiB

Open AccessReview

Snacktivity^TM, Giant Games and Immersive Virtual Reality Exercises: A Rapid Narrative Review of These New Physical Activity Practices among Older People Living in Nursing Homes and Long-Term Care Facilities

by Nounagnon Frutueux Agbangla, Marie-Philippine Séba and Frédérique Bunlon

Healthcare 2022, 10(10), 1897; https://doi.org/10.3390/healthcare10101897 - 28 Sep 2022

Cited by 1 | Viewed by 1772

Abstract

In developed countries, the increasing number of older adults raises many public health challenges. Physical activity can enable healthy aging, as it is beneficial for both mental and physical health. Despite this, not all older adults engage in physical activity or have access to it. To counteract this, new physical practices such as Snacktivity^TM, giant games and immersive virtual reality exercises are being developed. The main objective of this rapid narrative review is to summarize the effects of Snacktivity^TM, giant games and immersive Virtual Reality (VR) exercise among older adults living in nursing homes and long-term care facilities. A scientific review was performed using the search engines PubMed, PsycInfo and Web of Science on 7 July 2022. Fifty-nine items are identified in total, and five items are included in the literature review. Synthesis of the studies shows that immersive virtual reality and giant games improve the motivation and enjoyment of older adults and are beneficial for their functional abilities. Furthermore, no interventional studies have tested the effect of Snacktivity^TM in older adults. This review suggests that future studies should be conducted to further explore the effects of these new physical activity practices in older adults living in nursing homes or long-term care facilities. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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29 pages, 694 KiB

Open AccessEditor’s ChoiceReview

Wishes and Needs of Nursing Home Residents: A Scoping Review

by Roxana Schweighart, Julie Lorraine O’Sullivan, Malte Klemmt, Andrea Teti and Silke Neuderth

Healthcare 2022, 10(5), 854; https://doi.org/10.3390/healthcare10050854 - 6 May 2022

Cited by 12 | Viewed by 3474

Abstract

Falling birth rates and rising life expectancy are leading to global aging. The proportional increase in older people can be observed in almost all countries and regions worldwide. As a result, more people spend their later years in nursing homes. In homes where person-centered care is implemented, residents report greater satisfaction and quality of life. This approach is based on the wishes and needs of the residents. Therefore, the purpose of this scoping review is to explore the wishes and needs of nursing home residents. A scoping review of the literature was conducted in which 12 databases were systematically searched for relevant articles according to PRISMA-ScR guidelines. Both quantitative and qualitative study designs were considered. A total of 51 articles met the inclusion criteria. Included articles were subjected to thematic analysis and synthesis to categorize findings into themes. The analysis identified 12 themes to which the wishes and needs were assigned: (1) Activities, leisure, and daily routine; (2) Autonomy, independence, choice, and control; (3) Death, dying, and end-of-life; (4) Economics; (5) Environment, structural conditions, meals, and food; (6) Health condition; (7) Medication, care, treatment, and hygiene; (8) Peer relationship, company, and social contact; (9) Privacy; (10) Psychological and emotional aspects, security, and safety; (11) Religion, spirituality; and (12) Sexuality. Nursing home residents are not a homogeneous group. Accordingly, a wide range of needs and wishes are reported in the literature, assigned to various topics. This underscores the need for tailored and person-centered approaches to ensure long-term well-being and quality of life in the nursing home care setting. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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