Search Results (404)

A process evaluation was embedded in the multinational Music Interventions for Dementia and Depression in ELderly care (MIDDEL) trial to better understand barriers and facilitators for implementing music-based interventions (MBIs). Stakeholders from 66 care home units across 5 countries completed a survey at baseline (n = 229) and after a six-month intervention period (n = 101), comparing expectations and experiences between countries, intervention groups, and stakeholders. MBIs were evaluated and found to be relevant and feasible. Barriers include a lack of support, turnover among employees, and a lack of motivation. Facilitators include individual stakeholders who proactively facilitate and stimulate implementation, as well as the presence of stable, well-functioning teams, clear communication, and adhering to project plans. Fewer barriers than expected related to care staff workload and the time needed for implementing new MBIs in care homes. MBIs can be beneficial for people with dementia, yet implementation in care homes can be challenging due to contextual factors. Involving stakeholders in key positions is essential: care home managers are pivotal for policy-making and the sustainable adoption of MBIs, whereas the commitment and the involvement of care staff are needed for day-to-day implementation. Insight into these barriers to and facilitators of implementation can contribute to the interpretation of trial results. Full article

Background: Older adults living in aged care are at risk of poor health outcomes due to influenza, pneumococcal disease, and herpes zoster infections. Despite these conditions being vaccine-preventable, little is known about vaccine uptake rates in the residential elderly care setting in Australia. Methods: This was a retrospective cohort study examining the medical records of residents of 31 aged care homes in Australia (n = 1108). Data were extracted from medical records for the period March 2023 to September 2023. The proportion of residents vaccinated against influenza, pneumococcal disease, and herpes zoster was calculated. Univariate and multivariate logistic regressions were used to identify possible demographic and other characteristics associated with the vaccination uptake. Results: This study included 1108 residents. Two-thirds (68%) were female, and the median age was 87 years. All residents had one or more comorbidities. Most (92.6%) had received an influenza vaccine within the prior two years, but only 38.3% had received a pneumococcal vaccine, and 16.8% had received herpes zoster vaccination. In all models, receipt of the other vaccines was a significant predictor for vaccine administration. The other factor associated with influenza vaccination was non-consumption of alcohol and younger age for herpes zoster vaccination. Conclusions: While there is a high uptake of influenza vaccines, there is a low uptake of both pneumococcal and herpes zoster vaccines in residents of aged care facilities. Further research into the barriers and enablers of vaccine uptake should be undertaken, with the goal of increasing the vaccination uptake in this vulnerable population. Full article

Smart home technology enhances the quality of life, particularly with respect to in-home care and health monitoring. While video-based methods provide accurate behavior analysis, privacy concerns drive interest in non-visual alternatives. This study proposes a Bluetooth Low Energy (BLE)-enabled indoor positioning and behavior recognition system, integrating machine learning techniques to support sustainable and privacy-preserving health monitoring. Key optimizations include: (1) a vertically mounted Data Collection Unit (DCU) for improved height positioning, (2) synchronized data collection to reduce discrepancies, (3) Kalman filtering to smooth RSSI signals, and (4) AI-based RSSI analysis for enhanced behavior recognition. Experiments in a real home environment used a smart wristband to assess BLE signal variations across different activities (standing, sitting, lying down). The results show that the proposed system reliably tracks user locations and identifies behavior patterns. This research supports elderly care, remote health monitoring, and non-invasive behavior analysis, providing a privacy-preserving solution for smart healthcare applications. Full article

The quality of living environments for older adults represents a critical component of social sustainability in an ageing society. Among various housing options, nursing homes are the most institutionalised form of elderly care and demand special attention regarding architectural design. This paper explores the impact of architectural and open space features on social sustainability in living environments for older adults. A comparative analysis of three Slovenian nursing homes is presented. The first two, built in the post-war period, were based on elevated architectural criteria inspired by Swedish human-centred housing design. The third was completed in 2021 in the post-COVID-19 era, which revealed the vulnerability of such housing typologies. An integrated methodological framework was developed by applying two complementary assessment tools: the Safe and Connected, developed by the authors to evaluate the spatial, health, and social resilience of nursing home environments, and the Well-being and Integration, addressing the role of open space with a particular emphasis on the identification of older adults with their environment and the facilitation of social resilience. Both tools evaluate indicators linked to the social dimension of quality of life for older adults. The results show a gradual improvement in architectural quality from the 1960s to the 1980s, followed by a partial decline in the contemporary case. The Swedish example scored highest across both tools. In contrast, the newest Slovenian facility scored surprisingly low in social integration, highlighting critical gaps in current nursing home design. This study demonstrates the value of applying interdisciplinary, tool-based evaluations in identifying design strategies that foster resilient and inclusive LTC environments, and the proposed framework may serve as a decision-making aid for architects, planners, and policymakers. This research highlights the importance of reintroducing human-oriented design principles to support socially sustainable nursing home environments. Full article

Background: After an older person moves into a nursing home, the next of kin often continues to participate in the care provided there. This participation in care may contribute valuable knowledge of the preferences and wishes of the older person, thereby helping nursing staff deliver personalised care. Objectives: The aim of this study was to explore how next of kin experience their participation in the care of older persons residing in nursing homes after educating nursing staff about participation in palliative care. Methods: This follow-up study used a qualitative design based on semi-structured interviews with 37 next of kin. A thematic analysis was applied. Results: Participation of the next of kin involved active communication and collaboration with nursing staff, expressed in three themes: striving to achieve co-created care, navigating involvement through presence, and building commitment through communication and information. The dual role of being an emotionally close next of kin and a participant in the relative’s care was challenging and became increasingly burdensome and often overwhelming when the older person’s health deteriorated. Conclusions: This study reveals the need to develop and implement a policy for the participation of next of kin in the care of older people living in nursing homes. In addition, support groups can increase well-being through dialogue with other next of kin, thereby alleviating emotional strain. Increased implementation of life stories and the use of digital communication would keep the next of kin informed about the older person’s condition, especially when they cannot be present in person. Life story is a valuable tool for person-centred care and strengthens the relationships between the next of kin, the older person, and the nursing staff. Full article

This study presents the findings of an academic extension project focused on promoting oral health and diagnosing oral lesions in institutionalized elderly individuals. The project involved visits by students and faculty to two nursing homes in southern Brazil. Data collection included extraoral and intraoral clinical examinations and educational activities such as lectures and the distribution of printed materials on oral and denture hygiene. According to caregiving staff, oral hygiene, including denture cleaning, was generally performed once daily during morning showers. A total of 118 older adults (68 males and 50 females; mean age 76.1 ± 8.6 years) were examined. Forty-nine used dentures, of whom only 24 (49%) reported satisfaction with their prostheses. In total, 42 oral lesions were identified, mainly angular cheilitis (8), inflammatory fibrous hyperplasia (7), irritation fibroma (7), frictional hyperkeratosis (7), prosthetic stomatitis (5), actinic cheilitis (3), traumatic ulcers (3), and leukoplakia (2). Educational sessions also targeted caregivers, offering practical guidance for improving hygiene practices. The results underscore the need for better oral care and improved access to dental services for institutionalized elderly populations. Academic extension activities play a valuable role in health promotion and in training future professionals in elderly care. Full article

Background: China’s rapidly aging population has increased the need for effective community-based eldercare services. However, the lack of standardized, culturally relevant evaluation frameworks hinders consistent service quality assessment and improvement. Objective: This systematic review aims to identify, synthesize, and critically evaluate the existing quality indicators (QIs) currently utilized for home-based community elderly care HCEC in China. It also aims to highlight gaps to inform the development of a more comprehensive and context-appropriate quality framework. Methods: Following PRISMA guidelines, systematic searches were conducted across Web of Science, PubMed, Wiley, and CNKI databases for studies published in English and Chinese from 2008 onward. Extracted QIs from eligible studies were categorized using Donabedian’s structure–process–outcome (SPO) model. Results: Fifteen studies met the inclusion criteria, with QI sets ranging from 5 to 64 indicators. Most studies emphasized structural and procedural aspects, while outcome measures were limited. Key gaps include inconsistent terminology, insufficient medical care integration, narrow stakeholder engagement, and limited cultural adaptation of Western theoretical frameworks. Furthermore, subjective weighting methods predominated, impacting indicator reliability. Conclusions: Currently, there is no formal quality framework to guide service providers in HCEC, and therefore, quality indicators can be described as fragmented and lack cultural specificity, medical integration, and methodological robustness. Future research should prioritize developing culturally anchored and medically comprehensive QI frameworks, standardize indicator terminology, actively involve diverse stakeholders through participatory methods, and adopt hybrid methodological approaches combining subjective expert insights and objective, data-driven techniques. Alignment with established international standards, such as the OECD long-term care quality indicators, is essential to enhance eldercare quality and support evidence-based policymaking. Full article

The challenges and increasing number of elderly individuals requiring remote monitoring at home highlight the need for technological innovations. This study devised an eHealth mobile application designed to detect abnormal movement behavior and alert caregivers when a lack of movement is detected for an abnormal period. By utilizing the built-in accelerometer of a conventional mobile phone, an application was developed to accurately record movement patterns and identify active and idle states. Fuzzy logic, an artificial intelligence (AI)-inspired paradigm particularly effective for real-time reasoning under uncertainty, was integrated to analyze activity data and generate timely alerts, ensuring rapid response in emergencies. The approach reduced development costs while leveraging the widespread familiarity with mobile phones, facilitating easy adoption. The approach involved collecting real-time accelerometry data, analyzing movement patterns using fuzzy logic-based inferencing, and implementing a rule-based decision system to classify user activity and detect inactivity. This pilot study primarily validated the devised fuzzy logic method and the functional prototype of the mobile application, demonstrating its potential to leverage universal smartphone accelerometers for accessible remote monitoring. Using fuzzy logic, temporal and behavioral symmetry in movement patterns were adapted to detect asymmetric anomalies, e.g., abnormal inactivity or falls. The study is particularly relevant considering lonely individuals found deceased in their homes long after dying. By providing real-time monitoring and proactive alerts, this eHealth solution offers a scalable, cost-effective approach to improving elderly care, enhancing safety, and reducing the risk of unnoticed deaths through fuzzy logic. Full article

Background: The aging population is increasing, leading to a greater need for home care for older adults, often provided by informal caregivers (ICs). These caregivers face numerous challenges, requiring adequate training and support. Objectives: This study aimed to map the main interventions performed by the Rehabilitation Nursing Specialist in empowering ICs of older adults at home. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology. The search included seven articles published between 2019 and 2024, in Portuguese, English, and Spanish, available in the PubMed e CINHAL Ultimate databases. The descriptors used were (Rehabilitation Nursing) AND (Informal Caregivers OR Caregivers) AND (Elderly OR Aged) AND (mentoring OR Training. Results: The RNS interventions focused on training caregivers in technical skills (e.g., positioning, transfers, hygiene care, feeding, medication administration), preventing caregiver burden, managing behavioral and psychological symptoms of dementia, promoting self-care, and emotional support. Educational programs and the use of technologies (telehealth) were identified as effective strategies. Conclusions: RNS interventions are crucial for enhancing the skills and well-being of ICs, improving the quality of care provided to older adults at home, and reducing caregiver burden. Person-centered care, continuous support, and recognizing the caregiver’s role are fundamental aspects of these interventions. Full article

Social robots in Ambient Assisted Living (AAL) environments offer a promising alternative for enhancing senior care by providing companionship and functional support. These robots can serve as intuitive interfaces to complex smart home systems, allowing seniors and caregivers to easily control their environment and access various assistance services through natural interactions. By combining the emotional engagement capabilities of social robots with the comprehensive monitoring and support features of AAL, this integrated approach can potentially improve the quality of life and independence of elderly individuals while alleviating the burden on human caregivers. This paper explores the integration of social robotics with ambient assisted living (AAL) technologies to enhance elderly care. We propose a novel framework where a social robot is the central orchestrator of an AAL environment, coordinating various smart devices and systems to provide comprehensive support for seniors. Our approach leverages the social robot’s ability to engage in natural interactions while managing the complex network of environmental and wearable sensors and actuators. In this paper, we focus on the technical aspects of our framework. A computational P2P notebook is used to customize the environment and run reactive services. Machine learning models can be included for real-time recognition of gestures, poses, and moods to support non-verbal communication. We describe scenarios to illustrate the utility and functionality of the framework and how the robot is used to orchestrate the AAL environment to contribute to the well-being and independence of elderly individuals. We also address the technical challenges and future directions for this integrated approach to elderly care. Full article

The rapid growth of China’s aging population has made elderly care a pressing social issue. Due to an imperfect pension system, limited uptake of institutional care, and uneven regional economic development, most elderly people in China still rely on home-based care. Elderly people living at home are usually cared for by their family, partners, caregivers, or themselves. However, this often fails to meet their complex health, safety, and emotional needs. Artificial intelligence may provide promising solutions to improve home care experiences and address the multifaceted health and lifestyle challenges faced by homebound elderly people. This review explores the applications of artificial intelligence in home-based care from four main perspectives: home health care, home safety and security, smart life assistants, and psychological care and emotional support. We systematically searched PubMed, IEEE Xplore, CNKI, and Scopus databases, integrated the latest research published between 2015 and 2024, focused on peer-reviewed, practice-oriented research, and reviewed relevant technology development paths and the current status of the field. Unlike previous studies that focused on physiological monitoring, this study is the first to systematically and comprehensively evaluate the role of artificial intelligence in improving the convenience of daily life and mental health support for elderly people at home. By comprehensively reviewing and analyzing the basic principles and application background of artificial intelligence technology in this field, we summarize the current technical and ethical challenges and propose future research directions. This study aims to help readers gain a deeper understanding of the current status and emerging trends of artificial intelligence-enabled home-based elderly care, thereby providing valuable insights for continued innovation and application in this rapidly developing field. Full article

Current research on aged housing prioritizes community planning and environmental enhancement over older adults’ needs, creating a retrofit mismatch amid population aging. To investigate the relationship between indoor environmental quality and residential satisfaction among elderly occupants, this study examines 72 households in aged residential buildings, analyzing four environmental indicators (thermal, lighting, acoustic environments, and air quality). The environmental measurements reveal that 81.9% of thermal environment parameters fall below the ASHRAE-55 comfort range, with winter average temperatures reaching only 13.94 °C. Insufficient illumination exists in kitchen and bedroom areas. Lifestyle patterns including infrequent air conditioning use (87%) and window ventilation substituting range hoods (32%) may deteriorate thermal comfort and air quality. An ordered logistic regression analysis demonstrates significant correlations between all four environmental indicators and elderly satisfaction levels. Thermal comfort emerges as the priority focus for aging-adapted retrofitting. Air quality improvement shows particularly significant potential for enhancing residential satisfaction. Although prolonged window opening (73%) exacerbates low-temperature/high-humidity conditions and noise exposure, it still contributes positively to overall satisfaction. This research provides crucial insights for aligning aged residential retrofitting with home-based elderly care requirements, promoting housing development that better accommodates the lifestyle patterns of older populations, thereby improving quality of life for aging-in-place residents. Full article

Background: In Italy, public health investments have not kept pace with the rising demand for cancer care. Hospitalization costs are increasing, and length of stay (LOS) remains a critical metric for hospital efficiency and care quality. Methods: An ecological study analyzed hospital discharge records of patients admitted to “Policlinico Tor Vergata” (Rome, Italy) in 2022. Associations between cancer types and key variables influencing inpatient care were analyzed using logistic regression models (AOR; 95% CI), along with discharge patterns. Results: Among 14,451 ordinary hospitalizations, cancer diagnoses accounted for 16.4%, with blood cancers as the largest subgroup (20.1%). LOS outliers (5%) contributed to 11,342 excess hospitalization days. Blood cancers were associated with prolonged LOS (2.031; 1.499–2.753), while blood (2.368; 1.911–2.933), gastric (2.216; 1.603–3.062), and bladder cancers (2.661; 2.133–3.319) had a higher infection risk. Patients with bladder cancers were more likely to be ≥65 years old (2.661; 2.133–3.319). Secondary diagnoses were more likely to occur in gastric cancer types (1.637; 1.486–1.802). A discharge analysis revealed that 46.8% of cancer patients were discharged home without activation of home care services, and only 0.2% received home care activation. Cancer patients were more likely to be discharged home (2.150; 1.911–2.418) while awaiting completion of diagnostic or therapeutic processes. Conclusions: Our findings highlight the significant variability in hospitalization patterns across cancer types and the inadequacy of current discharge planning processes. The burden of prolonged LOS highlights the unsustainability of current care models. An urgent transition toward integrated, community-based simultaneous care models is needed to reduce healthcare costs, prevent prolonged hospitalizations, and improve outcomes, particularly for vulnerable elderly patients. Full article

In Jordan, where aging at home reflects Islamic cultural values, elderly populations face housing environments that fail to meet their needs, challenging sustainable aging-in-place objectives. This study explores how space personalization enhances autonomy and control among Jordan’s elderly using a mixed-methods approach combining surveys and interviews across multiple governorates. Findings reveal that space personalization strengthens elders’ sense of control over daily activities and household decisions, with private room allocation emerging as particularly significant. While conflicts between generations present barriers to control, cherished objects, such as heirlooms and religious artifacts, play a vital role in maintaining emotional connections and territorial identity. The study highlights the need for culturally sensitive housing modifications that respect cultural traditions while addressing practical needs, recommending community-based care programs and intergenerational dialogue initiatives. These insights contribute to sustainable urban development strategies that support dignified aging while preserving socio-cultural heritage, offering lessons for similar communities facing rapid demographic transitions. Full article

Artificial intelligence (AI) and assistive robotics can transform older-person care by offering new, personalised solutions for an ageing population. This paper outlines recent advances in AI-driven applications and robotic assistance in silver care, emphasising their role in improved healthcare services, quality of life and ageing-in-place and alleviating pressure on healthcare systems. Advances in machine learning, natural language processing and computer vision have enabled more accurate early diagnosis, targeted treatment plans and robust remote monitoring for elderly patients. These innovations support continuous health tracking and timely interventions to improve patient outcomes and extend home-based care. In addition, AI-powered assistive robots with advanced motion control and adaptive response mechanisms are studied to support physical and cognitive health. Among these, companion robots, often enhanced with emotional AI, have shown potential in reducing loneliness and increasing connectedness. The combined goal of these technologies is to offer holistic patient-centred care, which preserves the autonomy and dignity of our seniors. This paper also touches on the technical and ethical challenges of integrating AI/robotics into eldercare, like privacy and accessibility, and alludes to future directions on optimising AI-human interaction, expanding preventive healthcare applications and creating an effective, ethical framework for eldercare in the digital age. Full article