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Forecasts about the aging trend of the world population agree on identifying increased life expectancy as a serious risk factor for the financial sustainability of social healthcare systems if not properly supported by innovative care management policies. Such policies should include the integration within traditional healthcare services of assistive technologies as tools for prolonging healthy and independent living at home, but also for introducing innovations in clinical practice such as long-term and remote health monitoring. For their part, solutions for active and assisted living have now reached a high degree of technological maturity, thanks to the considerable amount of research work carried out in recent years to develop highly reliable and energy-efficient wearable sensors capable of enabling the development of systems to monitor activity and physiological parameters over time, and in a minimally invasive manner. This work reviews the role of wearable sensors in the design and development of assisted living solutions, focusing on human activity recognition by joint use of onboard electromyography sensors and inertial measurement units and on the acquisition of parameters related to overall physical and psychological conditions, such as heart activity and skin conductance. [ABSTRACT FROM AUTHOR]

Human posture recognition has a wide range of applicability in the detective and preventive healthcare industry. Recognizing posture through frequency-modulated continuous wave (FMCW) radar poses a significant challenge as the human subject is static. Unlike existing radar-based studies, this study proposes a novel framework to extract the postures of two humans in close proximity using FMCW radar point cloud. With radar extracted range, velocity, and angle information, point clouds in the Cartesian domain are retrieved. Afterwards, unsupervised clustering is implemented to segregate the two humans, and finally a deep learning model named DenseNet is applied to classify the postures of both human subjects. Using four base postures (namely, standing, sitting on chair, sitting on floor, and lying down), ten posture combinations for two human scenarios are classified with an average accuracy of 96%. Additionally, using the centroid information of human clusters, an approach to detect and classify overlapping human participants is also introduced. Experiments with five posture combinations of two overlapping humans yielded an accuracy of above 96%. The proposed framework has the potential to offer a privacy-preserving preventive healthcare sensing platform for an elderly couple living alone. [ABSTRACT FROM AUTHOR]

Background and Objectives When older adults face increasing care needs or limited support, remaining safely and comfortably at home becomes challenging. Extant research has primarily concentrated on characteristics of the older adult or their primary caregiver on nursing home admission. This study examines the risk of older adults transitioning to residential care (e.g. assisted living, nursing home), focusing on the influence of their care network or involvement of multiple helpers. Research Design and Methods Using the National Health and Aging Trends Study, we conducted competing risk regression models that account for mortality, following 7,085 initially community-dwelling older adults across Rounds 1–9 (2011–2019). We assessed network composition, size, shared tasks, and the number of in-network specialists or generalists while controlling for individual sociodemographic and health factors. Results Individuals with care networks that shared medical tasks had the highest risk of moving to a residential care setting, followed by those sharing household tasks. Conversely, shared mobility or self-care and transportation responsibilities were associated with lower risks. Having more generalists, but not specialists, increased the risk. Larger networks were associated with heightened risk, although having close family members like a spouse was protective. Discussion and Implications The findings underscore that care network characteristics are critical to older adults' ability to age in place. Specifically, older adults with larger networks, lacking a spouse or child, and providing complex care are at greater risk for relocating. Understanding care networks can guide interventions related to care network coordination and resource allocation to help avoid or postpone a residential care move. [ABSTRACT FROM AUTHOR]

This pilot study examines Ohio's licensed nursing home administrators and state tested nursing assistant's perspectives about job satisfaction, future career and employment plans, potential beneficial changes to their organizations, and their thoughts on reducing turnover rates in their field. Ohio Board of Executives of Long-Term Services and Supports provided their contact list of all 1,969 licensed nursing home administrators in Ohio in the fall of 2023. Two surveys were created for licensed nursing home administrators and state tested nursing assistants. Results were analyzed for themes within the open-ended responses; 28 surveys were received from licensed nursing home administrators and 17 surveys were received from state tested nursing assistants. Residents and their families are among the top reasons for job satisfaction, many employees face symptoms of burnout, and wages are a concern among both state tested nursing assistants and licensed nursing home administrators. Future career plans differed between the two professions and had distinct driving factors. A discussion of licensed nursing home administrators' opinions on improving retention and turnover rates should include more accountability, personal responsibility, and adding opportunities for professional growth and development. [ABSTRACT FROM AUTHOR]

Abstract Background Ageing populations and care workforce shortages across Europe are causing challenges for care services for older people. Therefore, it is paramount that limited care resources are allocated optimally, based on the clients’ care needs. Multiple functioning-related factors have been identified that determine the amount of care time clients receive, while organizational and other factors remain largely unexplored. The aim was to examine how various individual and organizational factors are associated with clients’ received care time in different care settings. Methods Cross-sectional observational study design with data from time and motion study, registers, and surveys was used. In total, 1477 home care clients and 1538 residents from assisted living facilities with 24/7 service participated, from 61 Finnish care units. Linear mixed-effect modeling was used to examine the association between individual and organizational-level variables and received care time. Results Physical functioning was the strongest predictor of received care time in both care settings. In home care, greater pain, more unstable health, and higher team autonomy were associated with increased care time. In assisted living, depressive mood and higher staffing level of the organization were associated with care time. Clients who received informal care also received significantly more care time from nurses in both care settings. Conclusions Physical functioning was the main driver of received care time. Interventions that maintain or improve physical functioning can help restrain the growing need of care resources, although it is important to ensure that each client receives care according to their holistic care needs.

Abstract Background Assisted living (AL) is an increasingly common residential setting for persons with dementia; yet concerns exist about sub-optimal care of this population in AL given its lower levels of staffing and services. Our objectives were to (i) examine associations between AL setting (dementia care vs. other), COVID-19 pandemic waves, and prevalent antipsychotic, antidepressant, anti-dementia, benzodiazepine, and anticonvulsant drug use among residents with dementia/cognitive impairment, and (ii) explore associations between resident and home characteristics and prevalent medication use. Methods We conducted a population-based, repeated cross-sectional study using linked clinical and health administrative databases for all publicly funded AL homes in Alberta, Canada, examined between January 2018 - December 2021. The quarterly proportion of residents dispensed a study medication was examined for each setting and period (pandemic vs. comparable historical [2018/2019 combined]) focusing on four pandemic waves (March-May 2020, September 2020-February 2021, March-May 2021, September-December 2021). Log-binomial GEE models estimated prevalence ratios (PR) for period (pandemic vs. historical periods), setting (dementia care vs. other) and period-setting interactions, adjusting for resident (age, sex) and home (COVID-19 cases, health region, ownership) characteristics. Results On March 1, 2020, there were 2,779 dementia care and 3,013 other AL residents (mean age 83, 69% female) with dementia/cognitive impairment. Antipsychotic use increased during waves 2–4 in both settings, but this was more pronounced in dementia care than other AL during waves 3 and 4 (e.g., adjusted [adj]PR 1.20, 95% CI 1.14–1.27 vs. adjPR 1.09, 95% CI 1.02–1.17, interaction p = 0.023, wave 3). Both settings showed a statistically significant but modest increase in antidepressant use and decrease in benzodiazepine use. For dementia care AL residents only, there was a statistically significant increase in gabapentinoid use during several waves (e.g., adjPR 1.32, 95% CI 1.10–1.59, wave 3). Other than a modest decrease in prevalent anti-dementia drug use for both settings in wave 2, no other significant pandemic effects were observed. Conclusions The persistence of the pandemic-associated increase in antipsychotic and antidepressant use in AL residents coupled with a greater increase in antipsychotic and gabapentinoid use for dementia care settings raises concerns about the attendant risks for residents with cognitive impairment.

Background: Ageing populations and care workforce shortages across Europe are causing challenges for care services for older people. Therefore, it is paramount that limited care resources are allocated optimally, based on the clients' care needs. Multiple functioning-related factors have been identified that determine the amount of care time clients receive, while organizational and other factors remain largely unexplored. The aim was to examine how various individual and organizational factors are associated with clients' received care time in different care settings. Methods: Cross-sectional observational study design with data from time and motion study, registers, and surveys was used. In total, 1477 home care clients and 1538 residents from assisted living facilities with 24/7 service participated, from 61 Finnish care units. Linear mixed-effect modeling was used to examine the association between individual and organizational-level variables and received care time. Results: Physical functioning was the strongest predictor of received care time in both care settings. In home care, greater pain, more unstable health, and higher team autonomy were associated with increased care time. In assisted living, depressive mood and higher staffing level of the organization were associated with care time. Clients who received informal care also received significantly more care time from nurses in both care settings. Conclusions: Physical functioning was the main driver of received care time. Interventions that maintain or improve physical functioning can help restrain the growing need of care resources, although it is important to ensure that each client receives care according to their holistic care needs. [ABSTRACT FROM AUTHOR]

Group activities and connection with nature are associated with improved well-being for older adults. This quasi-experiment tests the effectiveness of RASCALs, an innovative program of group activities using nature-focused livestream broadcasts. Assisted living residents in the experimental group (n = 16) lived in buildings that received RASCALs programming twice a week for 3 months. Compared to residents in the comparison group (n = 17) who received regular group activity programming, they experienced significant positive change in the Positive Relations with Others domain of well-being (β =.873, p =.008). Combining nature-focused livestream broadcasts with groups activities for older adults in assisted living communities may be an innovative and effective way to overcome barriers to accessing nature and improve residents' well-being. [ABSTRACT FROM AUTHOR]

Background: Assisted living (AL) is an increasingly common residential setting for persons with dementia; yet concerns exist about sub-optimal care of this population in AL given its lower levels of staffing and services. Our objectives were to (i) examine associations between AL setting (dementia care vs. other), COVID-19 pandemic waves, and prevalent antipsychotic, antidepressant, anti-dementia, benzodiazepine, and anticonvulsant drug use among residents with dementia/cognitive impairment, and (ii) explore associations between resident and home characteristics and prevalent medication use. Methods: We conducted a population-based, repeated cross-sectional study using linked clinical and health administrative databases for all publicly funded AL homes in Alberta, Canada, examined between January 2018 - December 2021. The quarterly proportion of residents dispensed a study medication was examined for each setting and period (pandemic vs. comparable historical [2018/2019 combined]) focusing on four pandemic waves (March-May 2020, September 2020-February 2021, March-May 2021, September-December 2021). Log-binomial GEE models estimated prevalence ratios (PR) for period (pandemic vs. historical periods), setting (dementia care vs. other) and period-setting interactions, adjusting for resident (age, sex) and home (COVID-19 cases, health region, ownership) characteristics. Results: On March 1, 2020, there were 2,779 dementia care and 3,013 other AL residents (mean age 83, 69% female) with dementia/cognitive impairment. Antipsychotic use increased during waves 2–4 in both settings, but this was more pronounced in dementia care than other AL during waves 3 and 4 (e.g., adjusted [adj]PR 1.20, 95% CI 1.14–1.27 vs. adjPR 1.09, 95% CI 1.02–1.17, interaction p = 0.023, wave 3). Both settings showed a statistically significant but modest increase in antidepressant use and decrease in benzodiazepine use. For dementia care AL residents only, there was a statistically significant increase in gabapentinoid use during several waves (e.g., adjPR 1.32, 95% CI 1.10–1.59, wave 3). Other than a modest decrease in prevalent anti-dementia drug use for both settings in wave 2, no other significant pandemic effects were observed. Conclusions: The persistence of the pandemic-associated increase in antipsychotic and antidepressant use in AL residents coupled with a greater increase in antipsychotic and gabapentinoid use for dementia care settings raises concerns about the attendant risks for residents with cognitive impairment. [ABSTRACT FROM AUTHOR]

This study examined the feasibility of implementing an adaptive biking program to concurrently address health and well-being in assisted living memory care residents and staff. Using an intervention protocol designed around the Flourishing Through Leisure Model, resident and staff participants were matched into biking pairs to engage in eight 20-to 30-minute bike rides over four consecutive weeks. The research team assessed (a)recruitment capability and sample characteristics, (b) data collection procedures and outcome measures, (c) acceptability and suitability of the intervention and study procedures (d) resources and ability to manage and implement the study and intervention, and (e) preliminary participant responses to the intervention. Results in each area support the feasibility of implementation on a larger scale and provide insights for program improvements and research opportunities. Given the lack of structured intervention protocols that emphasize multiple domains of health for two populations concurrently, the study also documented a replicable RT adaptive biking protocol designed to meet the needs of both staff and residents. Implications for RT practice include increased awareness of the value of RT services among other health care providers, and new opportunities for interprofessional collaboration. [ABSTRACT FROM AUTHOR]

Long-term care settings are at the center of strongly debated approaches to policies that shape the delivery of care and operational practices. There is advocacy for transformational change within these settings to support a person-centered approach to care delivery, but it is difficult and multifaceted involving everything from changing the level of staffing and care models to developing appropriate metrics to assess an individual's quality of life. The physical environment is a key component for accomplishing the organizational and operational goals related to person-centered care, but providers and their design teams need the appropriate tools to guide evidence-based decision-making. The Environmental Audit Scoring Evaluation (EASE) is a tool that helps lend structure to the process of developing the environment for our senior population—especially those living with dementia. This perspective article will discuss how EASE aims to align the design process to more fully support the myriad environmental elements that have a demonstrable impact on the individual, and the associated quality of life they experience. The article will also explore how EASE differs from previous planning strategies that did not prioritize residents' psychological wellbeing in conforming to current person-centered philosophies.

Introduction. Currently, there is a fairly high demand from society for changing approaches to the life of people with disabilities, improving the level and quality of their lives. There is an increase in the number of people with disabilities who need to be assisted when receiving services for assisted living, assisted work and social employment of disabled people in the Russian Federation. The article considers the main methodological approaches to assessing the quality and effectiveness of support measures in the provision of services for assisted living, assisted work and social employment of persons with disabilities.Aim. The study of indicators of the quality and effectiveness of support measures for the formation of unified approaches in various departments of the support system of the Russian Federation aimed at improving the level of assistance and support to the population.Materials and methods. Normative legal and methodological documentation, special literature, information systems of federal executive authorities of the subjects of the Russian Federation. Applied general scientific methods (content analysis, analytical, system-structured, comparative) and methodological methods of systematization, comparison, generalization, interpretation, as well as special methods — formal legal, comparative legal.Results. The main approaches to assessing the quality and effectiveness of support measures may include: availability of receiving support events; compliance with goals and objectives; the economic component (the necessary costs for conducting support activities); competence and professionalism of specialists; satisfaction of recipients (improving the quality of life of recipients). To assess the quality and effectiveness of support measures, the following criteria are highlighted: improving the quality of life of assisted persons, including their physical, psychological and social well-being, improving social adaptation and inclusion of escorted persons in society; the communicative effectiveness of the work of the specialists of the support system, both in a group and individually with each assisted one; сost-effectiveness of support activities, optimization of resource use and reduction of costs for the provision of the support process; аssessment of the satisfaction of the assisted ones and their families with the assistance and support provided; the effectiveness of interdepartmental interaction, co-operation and co-ordination of work between various services and organizations in the support system; assessment of the achievement of targets and tasks in the support system. The score is determined for each criterion separately based on the amount of points received. If the amount is below 55% of the maximum possible, the rating is "unsatisfactory", if from 56 to 85% – "good", above 85% – "excellent". Thus, the introduction of methods for evaluating the effectiveness and quality of support measures will make them more accessible and useful for all categories of the population in need of the Russian Federation.Discussion. One of the key indicators of the quality and effectiveness of the support system's activities is the availability of support activities for all those in need. It is necessary to ensure equal access to quality support in obtaining social services for all categories of people in need, regardless of their place of residence, family income and other factors. Another important indicator is the effectiveness of the work of the specialists providing support. Training and advanced training of specialists, as well as modern methods of working with assisted ones and their families, will help to increase the effectiveness of assisting activities when receiving social services and improve the results of assistance, in general. Effective implementation of methods and technologies for assessing the quality, accessibility and effectiveness of the support system requires a systematic approach and co-ordination of efforts at various levels, interdepartmental interaction, regulation of legal relations in the support system in the Russian Federation.Conclusion. The main indicators of the quality and effectiveness of support contribute to providing feedback from both the assisted ones and those in need of support activities, as well as from the specialists of the support system and management structures. This will allow considering the opinions and needs of all participants in the support process, which contributes to the development of a sustainable and adaptive system.

Gait speed and timed-up-and-go (TUG) predict cognitive decline, falls, and mortality. Dual-tasks may be useful in cognitive screening among people living with dementia (PWD), but more evidence is needed. This cross-sectional study aimed to compare single- and dual-task performance and determine the influence of dementia severity on dual-task performance and interference. Thirty PWD in two residential care facilities (Age: 81.3 ± 7.1 years; Montreal Cognitive Assessment: 10.4 ± 6.0 points) completed two trials of single- (feet apart) and dual-task posture (feet apart while counting backward), single- (walk 4 m) and dual-task gait (walk 4m while naming words), and single- (timed-up-and-go (TUG)), and dual-task functional mobility (TUG while completing a category task) with APDM inertial sensors. Dual-tasks resulted in greater sway frequency, jerk, and sway area; slower gait speed; greater double limb support; shorter stride length; reduced mid-swing elevation; longer TUG duration; reduced turn angle; and slower turn velocity than single-tasks (ps < 0.05). Dual-task performance was impacted (reduced double limb support, greater mid-swing elevation), and dual-task interference (greater jerk, faster gait speed) was related to moderate-to-severe compared to mild PWD. Moderate-to-severe PWD had poorer dynamic stability and a reduced ability to appropriately select a cautious gait during dual-tasks than those with mild PWD, indicating the usefulness of dual-tasks for cognitive screening. [ABSTRACT FROM AUTHOR]

Continuous and unobtrusive monitoring of daily human activities in homes can potentially improve the quality of life and prolong independent living for the elderly and people with chronic diseases by recognizing normal daily activities and detecting gradual changes in their conditions. However, existing human activity recognition (HAR) solutions employ wearable and video-based sensors, which either require dedicated devices to be carried by the user or raise privacy concerns. Radar sensors enable non-intrusive long-term monitoring, while they can exploit existing communication systems, e.g., Wi-Fi, as illuminators of opportunity. This survey provides an overview of passive radar system architectures, signal processing techniques, feature extraction, and machine learning's role in HAR applications. Moreover, it points out challenges in wireless human activity sensing research like robustness, privacy, and multiple user activity sensing and suggests possible future directions, including the coexistence of sensing and communications and the construction of open datasets.

Forecasts about the aging trend of the world population agree on identifying increased life expectancy as a serious risk factor for the financial sustainability of social healthcare systems if not properly supported by innovative care management policies. Such policies should include the integration within traditional healthcare services of assistive technologies as tools for prolonging healthy and independent living at home, but also for introducing innovations in clinical practice such as long-term and remote health monitoring. For their part, solutions for active and assisted living have now reached a high degree of technological maturity, thanks to the considerable amount of research work carried out in recent years to develop highly reliable and energy-efficient wearable sensors capable of enabling the development of systems to monitor activity and physiological parameters over time, and in a minimally invasive manner. This work reviews the role of wearable sensors in the design and development of assisted living solutions, focusing on human activity recognition by joint use of onboard electromyography sensors and inertial measurement units and on the acquisition of parameters related to overall physical and psychological conditions, such as heart activity and skin conductance.

Human posture recognition has a wide range of applicability in the detective and preventive healthcare industry. Recognizing posture through frequency-modulated continuous wave (FMCW) radar poses a significant challenge as the human subject is static. Unlike existing radar-based studies, this study proposes a novel framework to extract the postures of two humans in close proximity using FMCW radar point cloud. With radar extracted range, velocity, and angle information, point clouds in the Cartesian domain are retrieved. Afterwards, unsupervised clustering is implemented to segregate the two humans, and finally a deep learning model named DenseNet is applied to classify the postures of both human subjects. Using four base postures (namely, standing, sitting on chair, sitting on floor, and lying down), ten posture combinations for two human scenarios are classified with an average accuracy of 96%. Additionally, using the centroid information of human clusters, an approach to detect and classify overlapping human participants is also introduced. Experiments with five posture combinations of two overlapping humans yielded an accuracy of above 96%. The proposed framework has the potential to offer a privacy-preserving preventive healthcare sensing platform for an elderly couple living alone.

Background: Assistive Robotic Arms are designed to assist physically disabled people with daily activities. Existing joysticks and head controls are not applicable for severely disabled people such as people with Locked-in Syndrome. Therefore, eye tracking control is part of ongoing research. The related literature spans many disciplines, creating a heterogeneous field that makes it difficult to gain an overview. Objectives: This work focuses on ARAs that are controlled by gaze and eye movements. By answering the research questions, this paper provides details on the design of the systems, a comparison of input modalities, methods for measuring the performance of these controls, and an outlook on research areas that gained interest in recent years. Methods: This review was conducted as outlined in the PRISMA2020 Statement. After identifying a wide range of approaches in use the authors decided to use the PRISMA-ScR extension for a scoping review to present the results. The identification process was carried out by screening three databases. After the screening process, a snowball search was conducted. Results: 39 articles and 6 reviews were included in this article. Characteristics related to the system and study design were extracted and presented divided into three groups based on the use of eye tracking. Conclusion: This paper aims to provide an overview for researchers new to the field by offering insight into eye tracking based robot controllers. We have identified open questions that need to be answered in order to provide people with severe motor function loss with systems that are highly useable and accessible. [ABSTRACT FROM AUTHOR]

Introduction: Promoting individuals' health across different life spans has always been key to a holistic nursing practice. Seniors are a diverse population who go through many physical and mental changes as they age. During the last decade, assisted living facilities (ALFs) have dramatically increased in numbers to provide care and living services in a home‐like environment. Aim: The aim of this descriptive exploratory study was to explore the quality of life as perceived by seniors who reside in assisted living facilities (ALFs). Design: This study utilized a descriptive exploratory design to investigate the quality of life of seniors living in ALFs. Methods: Seventeen residents from two ALFs were interviewed to gather their perspectives on the quality of their lives while living in an ALF. The interviews were conducted by the researcher and were audio‐recorded and transcribed verbatim. The data were analysed using thematic analysis. Results: Three major themes surfaced from residents' descriptions: 'physical environment', 'social environment' and 'home‐like atmosphere'. The quality of life in ALFs was found to be predominantly an outcome of the exchange between the personal capability of residents to adapt to changes and the capacity of the facility to meet residents' diverse needs. Patient or Public Contribution: Participants who discussed their quality of life in ALFs provided profound insights into this aspect of their lives. The findings from this study can potentially enlighten ALF stakeholders and enhance the quality of life for seniors residing in these facilities. [ABSTRACT FROM AUTHOR]

Purpose: Assisted Living (AL) residents are embedded in "care convoys" comprised of a dynamic network of formal and informal care partners. Using the convoys of care model—a multi-level framework connecting care convoy properties to resident outcomes—we examined healthcare management and communication between convoy members. We recommend strategies to engage primary care in supporting collaboration, communication, and consensus-building for older adults and their convoys. Methods: Data were collected from the longitudinal study, Convoys of Care: Developing Collaborative Care Partnerships in AL. Fifty residents and their care convoy members (N = 169) were followed in eight AL homes in Georgia over 2 years. Original data were analyzed using Grounded Theory Methods of qualitative data, including formal and informal interviewing, participant observation, and record review. Results: The convoys of care model provide an innovative perspective that will assist providers in supporting AL residents and their care partners to achieve better care outcomes. Findings demonstrate the utility of understanding the structure and function of social resources and implications for improving healthcare outcomes. Conclusion: This research informs the work of physicians and mid-level providers with patients in AL by providing strategies to uncover specific social determinants of health. Recommendations for use in patient encounters are enumerated. [ABSTRACT FROM AUTHOR]

Abstract Background According to Swedish law, older adults in Sweden should be able to live a good, safe, and independent life with social and healthcare provided, based on their individual needs. In assisted living in Swedish eldercare the environment affects the older adults’ ability to participate in decision-making and strengthens their ability to feel meaningfulness. The ability of staff working in social and healthcare to invite older adults to participate varies. It is important to examine how older adults perceive their situation, as caregivers in eldercare tend to focus on routine work and experience difficulties in meeting the individual needs of older adults. The aim of this study was to explore how older adults in assisted living experienced participation in daily activities. Methods A qualitative interview study was conducted in two municipalities in the western part of Sweden. An exploratory and inductive design was used. Individual interviews were conducted with 11 older adults living in two different assisted living facilities. The data were analysed using thematic analysis. Results The interviews resulted in three themes: Being involved, Sense of well-being, and Influenced by the context. The older adults’ experiences of participation were interpreted as feelings of being involved in daily life activities, and how they felt involved in their own care and nursing. Participation created prerequisites for well-being. Sense of well-being could be related to feelings of security and social community. The organisation and work environment of the healthcare staff had a great impact on their ability to increase the participation of the older adults. The older adults were aware of the everyday work situation of the providers of social and healthcare and were Influenced by the context. Discussion/conclusion Important conditions for a good quality of life and participation for the older adults are to be treated with respect, receive information, and be able to choose. The older adults expressed several good ideas for improvements and a willingness to be involved in the development of the organisation at different levels. It is essential to invite older adults in assisted living to participate in the design of care and nursing.

Although development and growth of assisted living (AL) services for the severely mentally ill (SMI) has lasted for decades, and is still ongoing, research on AL services is scarce. Furthermore, the broad variation in AL service models, lack of global taxonomy for AL services and inconsistent reporting of AL service habitants makes the evaluation and comparison of AL services challenging. The purpose of the current study was, for the first time in Finland, to evaluate the applicability of the international Simple Taxonomy for Supported Accommodation (STAX-SA) for recategorization of current national AL service categories for the mentally ill. Data for the study is obtained from the Porvoo ASPA-project. Our main finding was that the correspondence to STAX-SA categorization was good, as 64.7% of the AL service levels could directly be classified to certain STAX-SA types. The strength of STAX-SA categorization was the ability to describe the majority of the 24-hour and part-time service units. STAX-SA ability to describe AL services weakened as the level of AL service decreased but remained reasonable. STAX-SA as a methodological tool has potential in enabling comparative studies on AL services based on the level they provide. STAX-SA has strengths in describing AL units and the services provided in them, especially by differentiating custodial care units from rehabilitation units in AL.

Abstract The aim of this work is to assess the performance of various inkjet printing techniques. These techniques are aimed at optimizing the volume of conductive ink used in the fabrication of inkjet printed Radio Frequency Identification tags. It is also possible that they can be used in fabricating other electronic and electromagnetic devices and structures. Three ink optimization approaches were examined viz. gridded (meshed) designs, conductive area trimming and selective ink deposition. The volume of conductive ink utilized in tag fabrication and the measured on‐body (forearm) read range of the tag were used to develop a figure of merit which determined the best printing approach. Although the longest read range was obtained from the tag with 48% conductive area trimming (Trim 1), the best figure of merit, that is, the tag with the best balance between measured read range and utilized conductive ink, was obtained from the tag that had its surface area trimmed by 65% (Trim 2). It is however suggested that optimum use of conductive ink would be achieved with a combination of 65% surface area trimming and selective ink deposition technique.

ObjectiveThe current cross-sectional study examined cognition and performance-based functional abilities in a continuing care senior housing community (CCSHC) that is comparable to other CCSHCs in the US with respect to residents' demographic characteristics.MethodParticipants were 110 older adult residents of the independent living unit. We assessed sociodemographics, mental health, neurocognitive functioning, and functional capacity.ResultsCompared to normative samples, participants performed at or above expectations in terms of premorbid functioning, attention span and working memory, processing speed, timed set-shifting, inhibitory control, and confrontation naming. They performed below expectation in verbal fluency and verbal and visual learning and memory, with impairment rates [31.4% (>1 SD below the mean) and 18.49% (>1.5 SD below the mean)] well above the general population (16% and 7%, respectively). Within the cognitive test battery, two tests of delayed memory were most predictive of a global deficit score. Most cognitive test scores correlated with performance-based functional capacity.ConclusionsOverall, results suggest that a subset of older adults in the independent living sector of CCSHCs are cognitively and functionally impaired and are at risk for future dementia. Results also argue for the inclusion of memory tests in abbreviated screening batteries in this population. We suggest that CCSHCs implement regular cognitive screening procedures to identify and triage those older adults who could benefit from interventions and, potentially, a transition to a higher level of care.

Abstract Aim The aim of the study was to identify interventions to promote mobility that has an impact on the quality of life of people living in nursing homes and assisted living facilities. Design The design of the study was a systematic review. Methods The search was performed in September 2021 in the databases PubMed, Epistemonikos and the Cochrane Library for studies published between 2010 and 2021 in the German or English language. Results Four studies identified improvements in mobility and quality of life. Nine of the ten included studies showed impacts of the interventions on different mobility variables. Heterogeneous variables and instruments were used to assess quality of life and, in particular, mobility, which made it difficult to compare the results of the studies. Approximately 50% of the identified studies had small sample sizes.

Abstract Introduction Promoting individuals' health across different life spans has always been key to a holistic nursing practice. Seniors are a diverse population who go through many physical and mental changes as they age. During the last decade, assisted living facilities (ALFs) have dramatically increased in numbers to provide care and living services in a home‐like environment. Aim The aim of this descriptive exploratory study was to explore the quality of life as perceived by seniors who reside in assisted living facilities (ALFs). Design This study utilized a descriptive exploratory design to investigate the quality of life of seniors living in ALFs. Methods Seventeen residents from two ALFs were interviewed to gather their perspectives on the quality of their lives while living in an ALF. The interviews were conducted by the researcher and were audio‐recorded and transcribed verbatim. The data were analysed using thematic analysis. Results Three major themes surfaced from residents' descriptions: ‘physical environment’, ‘social environment’ and ‘home‐like atmosphere’. The quality of life in ALFs was found to be predominantly an outcome of the exchange between the personal capability of residents to adapt to changes and the capacity of the facility to meet residents' diverse needs. Patient or Public Contribution Participants who discussed their quality of life in ALFs provided profound insights into this aspect of their lives. The findings from this study can potentially enlighten ALF stakeholders and enhance the quality of life for seniors residing in these facilities.

Background: Assistive Robotic Arms are designed to assist physically disabled people with daily activities. Existing joysticks and head controls are not applicable for severely disabled people such as people with Locked-in Syndrome. Therefore, eye tracking control is part of ongoing research. The related literature spans many disciplines, creating a heterogeneous field that makes it difficult to gain an overview.Objectives: This work focuses on ARAs that are controlled by gaze and eye movements. By answering the research questions, this paper provides details on the design of the systems, a comparison of input modalities, methods for measuring the performance of these controls, and an outlook on research areas that gained interest in recent years.Methods: This review was conducted as outlined in the PRISMA 2020 Statement. After identifying a wide range of approaches in use the authors decided to use the PRISMA-ScR extension for a scoping review to present the results. The identification process was carried out by screening three databases. After the screening process, a snowball search was conducted.Results: 39 articles and 6 reviews were included in this article. Characteristics related to the system and study design were extracted and presented divided into three groups based on the use of eye tracking.Conclusion: This paper aims to provide an overview for researchers new to the field by offering insight into eye tracking based robot controllers. We have identified open questions that need to be answered in order to provide people with severe motor function loss with systems that are highly useable and accessible.

Introduction: Sleep disturbance is a hallmark of Alzheimer's disease and related dementias, and caregiver stress caused by patients' nighttime wandering, injuries, and agitation are frequently at the root of decisions to move them to assisted living facilities, where typically dim institutional lighting can further exacerbate their sleep problems. This study explored the effects of a circadian-effective lighting intervention on actigraphic sleep measures and subjective assessments of sleep disturbance, depression, and sleep-disturbed behaviors. Methods: Fourteen older adult (=60 years) participants (11 females, mean age = 84.1 [SD 8.9]), all diagnosed with moderate to severe dementia and sleep disturbance, were recruited from 3 assisted living and memory care facilities. Following a crossover, placebo-controlled design, 3 different lighting modes were used to deliver high levels of circadian stimulus to the participants' eyes for two 8-week intervention periods in a counter balanced order with a 4-week washout between the study's 2 conditions (dim light control vs. active intervention). Actigraphy and questionnaire data were collected over 7-day assessment periods that preceded (baseline weeks 1 and 9) and concluded (post-intervention week 9 and 22) the intervention periods. Actigraphic outcomes included sleep duration, sleep time, sleep efficiency, sleep start time, and sleep end time. Subjective assessments included the Cornell Scale for Depression in Dementia (CSDD), Pittsburgh Sleep Quality Index (PSQI), and Sleep Disorders Inventory (SDI) instruments. Results: Under the active condition, sleep duration significantly (p = 0.018) increased and sleep start time significantly (p = 0.012) advanced after the intervention compared to baseline. Also under the active condition, PSQI (p = 0.012), CSDD (p = 0.007), Sleep Disorders Inventory frequency (p = 0.015), and SDI severity (p = 0.015) scores were significantly lower after the intervention compared to baseline. Discussion: This study demonstrates that a circadian-effective lighting intervention delivering bright days and dark nights improves measures of sleep and mood in dementia patients living in controlled environments. [ABSTRACT FROM AUTHOR]

Background: According to Swedish law, older adults in Sweden should be able to live a good, safe, and independent life with social and healthcare provided, based on their individual needs. In assisted living in Swedish eldercare the environment affects the older adults' ability to participate in decision-making and strengthens their ability to feel meaningfulness. The ability of staff working in social and healthcare to invite older adults to participate varies. It is important to examine how older adults perceive their situation, as caregivers in eldercare tend to focus on routine work and experience difficulties in meeting the individual needs of older adults. The aim of this study was to explore how older adults in assisted living experienced participation in daily activities. Methods: A qualitative interview study was conducted in two municipalities in the western part of Sweden. An exploratory and inductive design was used. Individual interviews were conducted with 11 older adults living in two different assisted living facilities. The data were analysed using thematic analysis. Results: The interviews resulted in three themes: Being involved, Sense of well-being, and Influenced by the context. The older adults' experiences of participation were interpreted as feelings of being involved in daily life activities, and how they felt involved in their own care and nursing. Participation created prerequisites for well-being. Sense of well-being could be related to feelings of security and social community. The organisation and work environment of the healthcare staff had a great impact on their ability to increase the participation of the older adults. The older adults were aware of the everyday work situation of the providers of social and healthcare and were Influenced by the context. Discussion/conclusion: Important conditions for a good quality of life and participation for the older adults are to be treated with respect, receive information, and be able to choose. The older adults expressed several good ideas for improvements and a willingness to be involved in the development of the organisation at different levels. It is essential to invite older adults in assisted living to participate in the design of care and nursing. [ABSTRACT FROM AUTHOR]

ObjectiveThe current cross-sectional study examined cognition and performance-based functional abilities in a continuing care senior housing community (CCSHC) that is comparable to other CCSHCs in the US with respect to residents' demographic characteristics.MethodParticipants were 110 older adult residents of the independent living unit. We assessed sociodemographics, mental health, neurocognitive functioning, and functional capacity.ResultsCompared to normative samples, participants performed at or above expectations in terms of premorbid functioning, attention span and working memory, processing speed, timed set-shifting, inhibitory control, and confrontation naming. They performed below expectation in verbal fluency and verbal and visual learning and memory, with impairment rates [31.4% (>1 SD below the mean) and 18.49% (>1.5 SD below the mean)] well above the general population (16% and 7%, respectively). Within the cognitive test battery, two tests of delayed memory were most predictive of a global deficit score. Most cognitive test scores correlated with performance-based functional capacity.ConclusionsOverall, results suggest that a subset of older adults in the independent living sector of CCSHCs are cognitively and functionally impaired and are at risk for future dementia. Results also argue for the inclusion of memory tests in abbreviated screening batteries in this population. We suggest that CCSHCs implement regular cognitive screening procedures to identify and triage those older adults who could benefit from interventions and, potentially, a transition to a higher level of care.

Introduction: Sleep disturbance is a hallmark of Alzheimer’s disease and related dementias, and caregiver stress caused by patients’ nighttime wandering, injuries, and agitation are frequently at the root of decisions to move them to assisted living facilities, where typically dim institutional lighting can further exacerbate their sleep problems. This study explored the effects of a circadian-effective lighting intervention on actigraphic sleep measures and subjective assessments of sleep disturbance, depression, and sleep-disturbed behaviors.Methods: Fourteen older adult (≥60 years) participants (11 females, mean age = 84.1 [SD 8.9]), all diagnosed with moderate to severe dementia and sleep disturbance, were recruited from 3 assisted living and memory care facilities. Following a crossover, placebo-controlled design, 3 different lighting modes were used to deliver high levels of circadian stimulus to the participants’ eyes for two 8-week intervention periods in a counter balanced order with a 4-week washout between the study’s 2 conditions (dim light control vs. active intervention). Actigraphy and questionnaire data were collected over 7-day assessment periods that preceded (baseline weeks 1 and 9) and concluded (post-intervention week 9 and 22) the intervention periods. Actigraphic outcomes included sleep duration, sleep time, sleep efficiency, sleep start time, and sleep end time. Subjective assessments included the Cornell Scale for Depression in Dementia (CSDD), Pittsburgh Sleep Quality Index (PSQI), and Sleep Disorders Inventory (SDI) instruments.Results: Under the active condition, sleep duration significantly (p = 0.018) increased and sleep start time significantly (p = 0.012) advanced after the intervention compared to baseline. Also under the active condition, PSQI (p = 0.012), CSDD (p = 0.007), Sleep Disorders Inventory frequency (p = 0.015), and SDI severity (p = 0.015) scores were significantly lower after the intervention compared to baseline.Discussion: This study demonstrates that a circadian-effective lighting intervention delivering bright days and dark nights improves measures of sleep and mood in dementia patients living in controlled environments.

Introduction: Various diseases cause pigmentation of the oral mucosa. Among them, however, Laugier-Hunziker syndrome is not well known to dentists. Laugier-Hunziker syndrome is a benign pigmentary disorder characterized by the unique expression of pigmentation of the mucosa, nails and skin. In this report, we present a rare case of Laugier-Hunziker syndrome that occurred in an elderly person. Case Presentation: The patient was an 84-year-old female resident of an elderly care facility. The institutional dental hygienist reported that she was concerned about the discoloration of the oral mucosa. On examination, she had pigmentation of her oral mucosa and nails. She had no history of any disease or medication that would cause pigmentation. Although this condition was initially unknown to us, a diagnosis of Laugier-Hunziker syndrome was made. Conclusion: We report a case of Laugier-Hunziker syndrome in an elderly woman, which is not a well-known condition among dental professionals. More knowledge about diseases that cause pigmentation of the oral mucosa would be helpful in dental practice, especially at external facilities. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to identify interventions to promote mobility that has an impact on the quality of life of people living in nursing homes and assisted living facilities. Design: The design of the study was a systematic review. Methods: The search was performed in September 2021 in the databases PubMed, Epistemonikos and the Cochrane Library for studies published between 2010 and 2021 in the German or English language. Results: Four studies identified improvements in mobility and quality of life. Nine of the ten included studies showed impacts of the interventions on different mobility variables. Heterogeneous variables and instruments were used to assess quality of life and, in particular, mobility, which made it difficult to compare the results of the studies. Approximately 50% of the identified studies had small sample sizes. [ABSTRACT FROM AUTHOR]

Physical, emotional, and cognitive changes are well documented in aging populations. We administered a comprehensive battery of mental and physical health measures and the Montreal Cognitive Assessment (MoCA; a cognitive screening tool) to 93 independently living older adults (OAs) residing in a Continuing Care Senior Housing Community. Performance on the Timed Up-and-Go (TUG) test (a measure of functional mobility) correlated more strongly with the MoCA total score than did measures of aging, psychiatric symptoms, sleep, and both self-report and objective physical health. Furthermore, it was associated with MoCA Attention, Language, Memory, and Visuospatial/Executive subscales. The MoCA-TUG relationship remained significant after controlling for demographic and physical/mental health measures. Given that the TUG explained significantly more variance in broad cognitive performance than a comprehensive battery of additional physical and mental health tests, it may function as a multimodal measure of health in OAs, capturing physical changes and correlating with cognitive measures.

This work presents a novel method for motion sensor placement within smart homes. Using recordings from 3D depth cameras within six real homes, clusters are created with the resident’s tracked location. The resulting clusters identify the possible position of a sensor and its field of view. By using a sequence of clusters as input to a Recurrent Neural Network, we evaluate our method on the task of activity recognition and prediction. These results are compared to using sensor events as input sequence, from motion sensors that were installed empirically in the same homes. Different clustering methods are investigated and all outperform the installed motion sensors, achieving a significant increase of prediction accuracy and F1-score.

Dehospitalization for people with severe mental illness (SMI) has continued for decades and led to the development of assisted living (AL) services. However, there is little knowledge on how the increasing use of AL services relates to the time trends of different psychiatric services. This study utilizes a 23-year time series data from Finland to evaluate the use of AL services in relation to the use of psychiatric inpatient and specialized psychiatric outpatient care. This population-based data from 1996 to 2018 was extracted from the Sotkanet Statistics and Indicator Bank, administered by the Finnish Institute for Health and Welfare (THL). The analyses of the time trends in different levels of psychiatric AL services, classified according to support given to AL habitants, was possible to perform from the year 2006 onwards. The Joinpoint Regression analysis was applied to estimate time trends of the indicators selected for our study. In the whole 23-year study period, an increased rate of habitants in psychiatric AL services was correlated with an increased number of specialized psychiatric outpatient visits (r = 0.766, p

One of the most difficult components of stroke therapy is regaining hand mobility. This research describes a preliminary approach to robot-assisted hand motion therapy. Our objectives were twofold: First, we used machine learning approaches to determine and describe hand motion patterns in healthy people. Surface electrodes were used to collect electromyographic (EMG) data from the forearm's flexion and extension muscles. The time and frequency characteristics were used as parameters in machine learning algorithms to recognize seven hand gestures and track rehabilitation progress. Eight EMG sensors were used to capture each contraction of the arm muscles during one of the seven actions. Feature selection was performed using the Pareto front. Our system was able to reconstruct the kinematics of hand/finger movement and simulate the behaviour of every motion pattern. Analysis has revealed that gesture categories substantially overlap in the feature space. The correlation of the computed joint trajectories based on EMG and the monitored hand movement was 0.96 on average. Moreover, statistical research conducted on various machine learning setups revealed a 92% accuracy in measuring the precision of finger motion patterns. [ABSTRACT FROM AUTHOR]

Abstract Background Family and friend caregivers play significant roles in advocating for and ensuring quality health and social care of residents in Assisted Living (AL) homes. However, little is known about how the COVID-19 pandemic and related visitor restrictions affected their health and mental well-being. We examined the prevalence and correlates of anxiety and depressive symptoms among caregivers of AL residents during the initial wave of COVID-19 in two Canadian provinces. Methods A cross-sectional web-based survey was conducted among family/friend caregivers of AL residents in Alberta and British Columbia (Oct 28, 2020—Mar 31, 2021) to collect data on their sociodemographic, health and caregiving characteristics, as well as concerns about residents’ health and social care before and during the first wave of the pandemic. A clinically significant anxiety disorder and depressive symptoms were assessed with the GAD-7 and CES-D10 instruments, respectively. Separate multivariable (modified) Poisson regression models identified caregiver correlates of each mental health condition. Results Among the 673 caregivers completing the survey (81% for Alberta residents), most were women (77%), white (90%) and aged ≥ 55 years (81%). Clinically significant anxiety and depression were present in 28.6% and 38.8% of caregivers respectively. Both personal stressors (comorbidity level, income reduction, low social support) and caregiving stressors exacerbated by the pandemic were independently associated with caregiver anxiety and depression. The latter included increased concern about the care recipients’ depression (adjusted risk ratio [adjRR] = 1.84, 95% confidence interval [CI] 1.19–2.85 for caregiver anxiety and adjRR = 1.75, 95% CI 1.26–2.44 for caregiver depressive symptoms) and reported intention to withdraw the resident from AL because of COVID-19 (adjRR = 1.24, 95%CI 0.95–1.63 for caregiver anxiety and adjRR = 1.37, 95%CI 1.13–1.67 for caregiver depressive symptoms). Conclusions Caregivers of residents in AL homes reported significant personal and caregiving-related stressors during the initial wave of COVID-19 that were independently associated with an increased likelihood of experiencing clinically significant anxiety and depressive symptoms. Healthcare providers and AL staff should be aware of the prevalence and varied correlates of caregivers’ mental health during public health crises so that appropriate screening and support may identified and implemented.

Purpose: Clasp-penetrating oral injury caused by removable partial dentures is basically a minor injury but can also cause complications such as continuous bleeding. No systematic investigations of clasp injury have been undertaken. The aims of this study were to reveal the characteristics of clasp injury and estimate variables associated with clasp injury of the oral mucosa. Methods: This retrospective study used clasp injury as the outcome variable, with primary predictor variables of demographic characteristics, medical history, local characteristics, and denture design, including the site of the affected clasp. Denture type was examined according to the classification of Kennedy. Collected data were statistically analyzed using the χ2 test or Fisher's exact test and the level of significance adopted was 5%. Results: This report consists of 73 cases (36 men and 37 women), of which 31 cases had precise denture information. Among them, clasp injuries were more common with Class I (51.6%) and Class II (32.3%) dentures (p <.001). Premolar (64.5%) and canine clasps (32.3%) were significantly more frequently involved (p <.001). Conclusion: Clasp injury of the oral mucosa was significantly more common on the tongue, and mandibular free-end saddle dentures with premolar or canine clasps were the most notable risk factor for clasp-penetrating injury of the oral mucosa. [ABSTRACT FROM AUTHOR]

Background: Assisted-living (AL) settings are an important residential care option for old and disabled Americans, but there are no national data characterizing medication use in AL. Objective: To investigate medication costs and use of older adults living in the AL settings compared to those in the community, independent living, and nursing home settings. Design: 2015 National Health and Aging Trends Study; nationally representative cross-sectional study. Paticipants: Respondents ≥ 65 years with Medicare Part D prescription drug coverage (n = 5980, representing 32.34 million older adults). Measures: Total Part D medication costs; number of 30-day prescription fills; binary indicators for overall polypharmacy (≥ 5 and ≥ 10 concurrent medications), prescription fills of opioid and psychotropic medications including antipsychotics, benzodiazepines, gabapentinoids, antidepressants, and central nervous system-active (CNS-active) polypharmacy. Results: Adjusting for demographics, the annual medication costs among AL residents, at $3890, were twice as high as those of their community-dwelling counterparts ($1932; p <.01). All medication outcomes except opioids were higher for older adults in AL compared to community settings. While the adjusted number of 30-day prescription fills among AL residents was slightly lower than that of nursing home residents (89.5 vs. 106.2; p <.05), AL residents experienced equivalent rates of overall polypharmacy ≥ 10 medications (30.2% vs. 23.5%), antipsychotics (30.8% vs. 27.8%), benzodiazepines (30.7% vs. 32.6%), gabapentinoids (21.2% vs. 16.1%), and CNS-active polypharmacy (26.0% vs. 36.9%; p >.05 for all). Patterns of use across settings were consistent when limited to older adults with dementia. Conclusions: Older Americans in AL experience a prescription medication burden similar to those in nursing homes. AL settings have an important opportunity to ensure their medication-related clinical services and supports match the needs of their residents. [ABSTRACT FROM AUTHOR]

Engineering invention must be in tandem with public demands. Often it is difficult to identify the priorities of consumers where technological advancement is needed. In line with the global challenge of increasing fall prevalence among older adults, providing prevention solutions is the key. This study aims at developing an improved fall detection device using an approach called Quality Function Deployment (QFD). The goal is to investigate features to incorporate in existing device from consumer's perspectives. A three-phases design process is constructed; (1) Questionnaire, (2) Ishikawa Method, and (3) QFD. The proposed method begins with identifying customer needs as the requirement analysis, followed by a method to convert them to design specifications to be added in a fall detection device using QFD tool. As the top feature is monitoring balance, the new improved fall detection devices incorporating balance features will help older adults to monitor their level of risk of falling. [ABSTRACT FROM AUTHOR]

Background: Health-monitoring smart homes are becoming popular, with experts arguing that 9-to-5 health care services might soon become a thing of the past. However, no review has explored the landscape of smart home technologies that aim to promote physical activity and independent living among a wide range of age groups. Objective: This review aims to map published studies on smart home technologies aimed at promoting physical activity among the general and aging populations to unveil the state of the art, its potential, and the research gaps and opportunities. Methods: Articles were retrieved from 6 databases (PubMed, CINAHL, Scopus, IEEE Xplore, ACM Library, and Web of Science). The criteria for inclusion were that the articles must be user studies that dealt with smart home or Active Assisted Living technologies and physical activity, were written in English, and were published in peer-reviewed journals. In total, 3 researchers independently and collaboratively assessed the eligibility of the retrieved articles and elicited the relevant data and findings using tables and charts. Results: This review synthesized 20 articles that met the inclusion criteria, 70% (14/20) of which were conducted between 2018 and 2020. Three-quarters of the studies (15/20, 75%) were conducted in Western countries, with the United States accounting for 25% (5/20). Activities of daily living were the most studied (9/20, 45%), followed by physical activity (6/20, 30%), therapeutic exercise (4/20, 20%), and bodyweight exercise (1/20, 5%). K-nearest neighbor and naïve Bayes classifier were the most used machine learning algorithms for activity recognition, with at least 10% (2/20) of the studies using either algorithm. Ambient and wearable technologies were equally studied (8/20, 40% each), followed by robots (3/20, 15%). Activity recognition was the most common goal of the evaluated smart home technologies, with 55% (11/20) of the studies reporting it, followed by activity monitoring (7/20, 35%). Most studies (8/20, 40%) were conducted in a laboratory setting. Moreover, 25% (5/20) and 10% (2/20) were conducted in a home and hospital setting, respectively. Finally, 75% (15/20) had a positive outcome, 15% (3/20) had a mixed outcome, and 10% (2/20) had an indeterminate outcome. Conclusions: Our results suggest that smart home technologies, especially digital personal assistants, coaches, and robots, are effective in promoting physical activity among the young population. Although only few studies were identified among the older population, smart home technologies hold bright prospects in assisting and aiding older people to age in place and function independently, especially in Western countries, where there are shortages of long-term care workers. Hence, there is a need to do more work (eg, cross-cultural studies and randomized controlled trials) among the growing aging population on the effectiveness and acceptance of smart home technologies that aim to promote physical activity. [ABSTRACT FROM AUTHOR]

The Resident VIEW is a measure of person-centered care (PCC) from residents' perspectives and was previously studied in nursing homes. The current study presents descriptive data for the Resident VIEW in community-based care settings including assisted living, residential care (AL/RC), and adult foster homes (AFH). Using a two-stage sampling design, we recruited 31 AL/RC and 119 AFH in Oregon and completed face-to-face structured interviews with 227 and 195 residents, respectively. Residents provided ratings for both the importance of and their experience with 66 items that tapped into PCC practices in eight domains. Results are provided for each item, many of which are significantly associated with greater quality of life, better resident satisfaction, and fewer depressive symptoms, especially in the domains of personalized care and being treated like a person. Incongruence between importance and experience ratings indicate many residents experience unmet needs across multiple domains. The Resident VIEW performed well in different types of settings, providing an important tool for researchers and providers who wish to learn about the PCC experience from residents' points of view. [ABSTRACT FROM AUTHOR]

The growing share of the population over the age of 65 is putting pressure on the social health insurance system, especially on institutions that provide long-term care services for the elderly or to people who suffer from chronic diseases or mental disabilities. This pressure can be reduced through the assisted living of the patients, based on an intelligent system for monitoring vital signs and home automation. In this regard, since 2008, the European Commission has financed the development of medical products and services through the ambient assisted living (AAL) program—Ageing Well in the Digital World. The SmartCare Project, which integrates the proposed Computer Vision solution, follows the European strategy on AAL. This paper presents an indoor human activity recognition (HAR) system based on scene understanding. The system consists of a ZED 2 stereo camera and a NVIDIA Jetson AGX processing unit. The recognition of human activity is carried out in two stages: all humans and objects in the frame are detected using a neural network, then the results are fed to a second network for the detection of interactions between humans and objects. The activity score is determined based on the human–object interaction (HOI) detections. [ABSTRACT FROM AUTHOR]

Long-term care settings are at the center of strongly debated approaches to policies that shape the delivery of care and operational practices. There is advocacy for transformational change within these settings to support a person-centered approach to care delivery, but it is difficult and multifaceted involving everything from changing the level of staffing and care models to developing appropriate metrics to assess an individual's quality of life. The physical environment is a key component for accomplishing the organizational and operational goals related to person-centered care, but providers and their design teams need the appropriate tools to guide evidence-based decision-making. The Environmental Audit Scoring Evaluation (EASE) is a tool that helps lend structure to the process of developing the environment for our senior population-especially those living with dementia. This perspective article will discuss how EASE aims to align the design process to more fully support the myriad environmental elements that have a demonstrable impact on the individual, and the associated quality of life they experience. The article will also explore how EASE differs from previous planning strategies that did not prioritize residents' psychological wellbeing in conforming to current person-centered philosophies., Competing Interests: RW was employed by RAW Consultants. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wrublowsky, Kaup and Calkins.)

Background: Older adults living in assisted living facilities (ALFs) are at risk for physical and mental health decline that precipitates nursing home placement. There is a need for an exercise program that improves the quality of life (QOL) for older adults living in the ALFs. This study’s primary purpose was to investigate the feasibility of an Enriched tai chi (ETC) intervention program on improving the QOL of older adults living in an ALF. Method: A convenience sample of six older adults living in the same ALF attended the ETC program for 16 consecutive sessions two times per week for 8 weeks. A pre-test and post-test one-group design was used. The 36-Item Short Form Survey and the Beck depression inventory were used to measure QOL and mood at baseline, the 4th week, and the 8th week of the study. Results: Wilcoxon sign rank test on pre and postintervention SF-36 scores were significant (p < .05). Pre-test and post-test intervention changes in mood were significantly improved (BDI; p < .05). Conclusion: These findings suggest the ETC program may be a feasible intervention to improve the QOL of older adults in ALFs, warranting the need for further research.

Objectives: To reveal whether an accessible open floorplan Multisensory Stimulation Environment (MSSE) room design has a positive impact as a nonpharmacologic intervention for episodes of Behavioral and Psychological Symptoms of Dementia (BPSD) in older adults living in a Memory Care Assisted Living (MCAL) facility as well as reducing the need for direct care supervision. Methods: Retrospective pre/post cohort design of 24 residents living in a Midwest MCAL facility in the United States with a diagnosis of dementia and over 65 years of age, analyzed by secondary medical chart review for 12 months to assess impact of an accessible open floorplan MSSE room design. The pre/post design analyzed secondary data over two periods of time; 6 months prior to the MSSE installation and 6 months following the MSSE installation. Results: Following the installation of an open floorplan MSSE, the number of observed BPSD episodes changed from 367 (17%) pre-test to 298 (10%) post-test over a 12-month time period. The Comparison of Proportions test determined that the difference in the proportion of BPSD episodes documented was statistically significant with clinical implications. Conclusions: The accessible open floorplan MSSE room design, located within a single-site MCAL facility, utilized as a nonpharmacological intervention for BPSD, was found in this explorative study to be effective and potentially clinically meaningful in improving behavioral episodes for older adults diagnosed with dementia in MCAL settings.

Prevalence of cirrhosis and hepatic encephalopathy (HE) in older patients receiving care in long-term care settings is unknown. This systematic review aimed to identify potential factors associated with HE and cognitive impairment in older patients with cirrhosis. A PubMed search of English-language articles published between January 1, 2000, and November 3, 2021, was conducted to identify studies in adults with cirrhosis relevant to cognitive impairment and/or HE (e.g., fall, frailty, and sarcopenia). Of 2,879 English-language publications, 24 were included. In patients with cirrhosis, falls were increased in the presence of HE and were associated with increased injury risk. Frailty was associated with HE development and cognitive impairment in patients with cirrhosis. Further, cognitive impairment and frailty were predictive of HE-related hospitalizations. Sarcopenia increased the risk of developing HE. Furthermore, specific medications increased the risk of developing HE. Risk reduction and management of patients with HE are critical to prevent negative outcomes. [ABSTRACT FROM AUTHOR]

Background: Family and friend caregivers play significant roles in advocating for and ensuring quality health and social care of residents in Assisted Living (AL) homes. However, little is known about how the COVID-19 pandemic and related visitor restrictions affected their health and mental well-being. We examined the prevalence and correlates of anxiety and depressive symptoms among caregivers of AL residents during the initial wave of COVID-19 in two Canadian provinces.Methods: A cross-sectional web-based survey was conducted among family/friend caregivers of AL residents in Alberta and British Columbia (Oct 28, 2020-Mar 31, 2021) to collect data on their sociodemographic, health and caregiving characteristics, as well as concerns about residents' health and social care before and during the first wave of the pandemic. A clinically significant anxiety disorder and depressive symptoms were assessed with the GAD-7 and CES-D10 instruments, respectively. Separate multivariable (modified) Poisson regression models identified caregiver correlates of each mental health condition.Results: Among the 673 caregivers completing the survey (81% for Alberta residents), most were women (77%), white (90%) and aged ≥ 55 years (81%). Clinically significant anxiety and depression were present in 28.6% and 38.8% of caregivers respectively. Both personal stressors (comorbidity level, income reduction, low social support) and caregiving stressors exacerbated by the pandemic were independently associated with caregiver anxiety and depression. The latter included increased concern about the care recipients' depression (adjusted risk ratio [adjRR] = 1.84, 95% confidence interval [CI] 1.19-2.85 for caregiver anxiety and adjRR = 1.75, 95% CI 1.26-2.44 for caregiver depressive symptoms) and reported intention to withdraw the resident from AL because of COVID-19 (adjRR = 1.24, 95%CI 0.95-1.63 for caregiver anxiety and adjRR = 1.37, 95%CI 1.13-1.67 for caregiver depressive symptoms).Conclusions: Caregivers of residents in AL homes reported significant personal and caregiving-related stressors during the initial wave of COVID-19 that were independently associated with an increased likelihood of experiencing clinically significant anxiety and depressive symptoms. Healthcare providers and AL staff should be aware of the prevalence and varied correlates of caregivers' mental health during public health crises so that appropriate screening and support may identified and implemented. [ABSTRACT FROM AUTHOR]

Falls, highly common in the constantly increasing global aging population, can have a variety of negative effects on their health, well-being, and quality of life, including restricting their capabilities to conduct activities of daily living (ADLs), which are crucial for one's sustenance. Timely assistance during falls is highly necessary, which involves tracking the indoor location of the elderly during their diverse navigational patterns associated with different activities to detect the precise location of a fall. With the decreasing caregiver population on a global scale, it is important that the future of intelligent living environments can detect falls during ADLs while being able to track the indoor location of the elderly in the real world. Prior works in these fields have several limitations, such as the lack of functionalities to detect falls and indoor locations in a simultaneous manner, high cost of implementation, complicated design, the requirement of multiple hardware components for deployment, and the necessity to develop new hardware for implementation, which make the wide-scale deployment of such technologies challenging. To address these challenges, this work proposes a cost-effective and simplistic design paradigm for an ambient assisted living system that can capture multimodal components of user behaviors during ADLs that are necessary for performing fall detection and indoor localization in a simultaneous manner in the real-world. Proof-of-concept results from real-world experiments are presented to uphold the effective working of the system. The findings from two comparative studies with prior works in this field are also presented to uphold the novelty of this work. The first comparative study shows how the proposed system outperforms prior works in the areas of indoor localization and fall detection in terms of the effectiveness of its software design and hardware design. The second comparative study shows that the cost of the development of this system is the lowest as compared to prior works in these fields, which involved real-world development of the underlining systems, thereby upholding its cost-effective nature. [ABSTRACT FROM AUTHOR]