Search results for: home-based care for the aged

Authors: Zijiao Chai, Wangming Li

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Hangzhou is one of the cities with the most serious aging in China. Community home-based care for the aged is an important solution to old-age care in aging society. In this aspect, Europe, the United States and Japan are on the top in the world. As an East Asian country, Japan has similar cultural traditions in pension with China. So, there is much enlightenment China can get from Japan in the mode of community home-based care for the aged. This paper introduces the mode of community home-based care for the aged in Kishiwada, Japan and Hangzhou, China. Then compare the two modes in the aspects of insurance system for the aged, community service and facilities, support system and so on. Thereby the success experience of Kishiwada and weaknesses of Hangzhou are summarized. At last, the improvement strategy of facility plan and service mode of community home-based care for the aged in China are also proposed.

Keywords: community, comparison, elderly-oriented, home-based care for the aged, support system

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Authors: Lukasz Grzegorz Broda, Taiwo Oseni, Andrew Stranieri, Rodrigo Marino, Ronelle Welton, Mark Yates

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The oral health of residents in aged care centres in Australia is poor, contributing to infections, hospital admissions, and increased suffering. Although the use of electric toothbrushes has been deployed in many centres, smartbrushes that record and transmit information about brushing patterns and duration are not routinely deployed. Yet, the use of smartbrushes for aged care residents promises better oral care. Thus, a study aimed at investigating the appropriateness and suitability of a smartbrush for aged care residents is currently underway. Due to the peculiarity of the aged care setting, the incorporation of smartbrushes into residents’ care does require careful planning and design considerations. This paper describes an initial design process undertaken through the use of an actor to understand the important elements to be incorporated whilst installing a smartbrush for use in aged care settings. The design covers the configuration settings of the brush and app, including ergonomic factors related to brush and smartphone placement. A design science approach led to an installation re-design and a revised protocol for the planned study, the ultimate aim being to design installations to enhance perceived usefulness, ease of use, and attitudes towards the incorporation of smartbrushes for improving oral health care for aged care residents.

Keywords: smartbrush, applied computing, life and medical sciences, health informatics

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Authors: Chick Loveline Ayoh Epse Ndi

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Our cultural stance has deep implications for the psychological and physical well-being of the old. Cameroon is still rooted on the traditional belief that stipulates that; the aged are best catered for in the family setting where the children and grandchildren are supposed to give in return for services invested on them by the former. This is why up till date, there are no “Rest Homes” or “Convalescent hospitals” despite the rising challenges faced by the aged in this context. Beside the special measure set aside to cater for the aged, such as “Rest Homes” for the healthy, “Convalescent hospitals” are created set to cater for the health of the aged in the Western context with other facilities such as geriatric units. The health care practitioners are aware of aging diseases and have trained human resources like Gerontologists to cater for the aged and aging diseases. Meanwhile, in Africa and Cameroon in particular, such infrastructural and human resources are still to be considered in the health care system. It can be assumed that the aged and aging diseases are still to be considered in the health care system in this context. This is why we talk of therapeutic nihilism, where the aged are mixed up with other categories of patients with no special attention given to them. This qualitative study carried out in the Yaounde, the capital city of Cameroon, with their best referent hospitals, reveal that; the aged and aging diseases are still a myth in this context. Data collected in both private and public health institutions show that there is only one public institution in Cameroon that has a geriatric unit with no specialists. Patients who aretreated in this unit are considered as aged with terminal diseases that need palliative care and not intensive care. Cameroon is still lacking in terms of health care to the aged and ageing diseases. Like other patients, the aged are treated with a lot of laxity and no value. There is an emergency to create special health care units for geriatrics and and train gerontologist. Mentally or physically ill aged faced medical rational with psychodynamic treatment considered as waste of time. The aged are less likely to be regarded salvageable when they enter a hospital in serious conditions due to the lack of specialists and geriatric units for them. The implication of this study is to sensitization the stake holders for an urgent need to extend special care units for the aged and aging diseases in this context.

Keywords: challeng, therapy, agtng, diseases cameroon

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Authors: Ellina Zipman

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This research investigates the place of music education in aged care facilities through the implementation of a program of regular piano lessons for residents. Using a qualitative case study methodology, the research explores aged care residents’ experiences in learning to play the piano. Since the aged care homes are unlikely places for formal learning and since older adults, especially in residential care, are not considered likely candidates for learning, this research opens the door for innovative and transformative thinking about where and to whom educational programs can be delivered. By addressing the educational needs of residents in aged care facilities, this research fills the gap in the literature. The research took place in Australia in two of Melbourne’s residential aged care facilities, engaging two residents (a nonagenarian female and an octogenarian male) to participate in 12-months weekly individual piano lessons. The data was collected through video recording of lessons, observations, interviews, emails, and a reflective journal. Data analysis was done using Nvivo and hard copy analysis with identifications of themes. The case studies revealed that passion for music was a major driver in participants’ motivation to engage in a long-term piano lessons program. This participation led to experiences of positive emotions, positive attitude, successes and challenges, the exercise of control, maintaining and building new relationships, improved self-confidence through autonomy and independent skills development, and discovering new identities through finding a new purpose and new roles in life. Speaking through participants’ voices, this research project demonstrates the importance of music education for older adults and hopes to influence transformation in the residential aged care sector.

Keywords: adult music education, quality of life, passion, positive ageing, wellbeing

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Authors: Robert John Godby

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To be responsive now and in the future, workplaces must address the demands of multicultural teams as they become more common elements of the global labor force. This is especially the case for aged care due to the aging population, industry growth and migrant recruitment. This research identifies influences on and improvements for learning in these environments. Its unique contribution is to illuminate how culturally diverse workplaces can work and learn together more effectively. A mixed-methods approach was used to gather data about this topic in two phases. Firstly, the research methods included a survey of 102 aged care workers around Australia from two multi-site aged care organisations. The questionnaire elicited both quantitative and qualitative data about worker characteristics and perspectives on working and learning in aged care. Secondly, a case study of one aged care worksite was formulated drawing on worksite information and interviews with workers. A review of the literature suggests that learning in multicultural work environments is influenced by three main factors: 1) the individual workers themselves, 2) their interaction with each other and 3) the environment in which they work. There are various accounts of these three factors, how they are manifested and how they lead to a change in workers’ disposition, knowledge, or expertise when confronted with new circumstances. The study has found that a key individual factor influencing learning is cultural background. Their unique view of the world was shown to affect their approach to both their work and co-working. Interactional factors suggest that the high requirement for collaboration in aged care positively supports learning in this context; however, it can be hindered by cultural bias and spoken accent. The study also found that environmental factors, such as disruptions caused by the pandemic, were another key influence. For example, the need to wear face masks hindered the communication needed for workplace learning. This was especially challenging due to the diverse language backgrounds and abilities within the teams. Potential improvements for learning in multicultural aged care work environments were identified. These include more frequent and structured inter-peer learning (e.g. buddying), communication training (e.g. English language usage for both native and non-native speaking workers) and support for cross-cultural habitude (e.g. recognizing and adapting to cultural differences). Workplace learning in cross-cultural aged care environments is an area that is not extensively dealt with in the literature. This study addresses this gap and holds the potential to contribute practical insights to aged care and other diverse industries.

Keywords: cross-cultural learning, learning in aged care, migrant learning, workplace learning

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Authors: Hyunsik Park

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Objective: To provide information of charged nursing care facility for helping to establish geriatric health care policy, and to figure out which factors would be the main determinants for the choice of it. Method: 46 males and 53 females, and the same number of their caregivers admitted into the charged nursing care facility were recruited for intensive interview including personal information, disease information, and economic, familial, marital and emotional statuses. This is a cross-sectional study and we analyzed the data qualitatively. Results: Patients had 3.2 diseases and a hospitalization for 2.3 years on average. They were consists of 46 singles (46.9%), 8 unmarried (8.2%), 5 divorced (5.1%) and 32 married (32.7%). More than two third (70.1%) were supported by their eldest son or daughter. Mostly, the family caregivers decided to admit into the facilities by the doctor’s recommendation (68.4%). When they made a choice for a facility, most of them (42.9%) considered environmental and sanitary conditions. According to their expectation for management in nursing care facility, most caregivers (59.2%) wanted simple-staying for the duration, but most patients (61.3%) expected to be home after taking comprehensive rehabilitation. Three-quarter of the caregivers would agree to use nursing care facilities in the future, if they would be the same situation. Conclusion: Life style and environment are rapidly changing. In the near future, we need lots of the charged nursing care facilities for the old, thus this study can be the good reference for the preparing upcoming aged and super-aged society.

Keywords: nursing care facility, aged society, qualitative analysis, health

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Authors: Manee Arpanantikul, Pennapa Unsanit, Dolrat Rujiwatthanakorn, Aporacha Lumdubwong

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In order to continuously perform self-care based on the sufficiency economy philosophy for the length of women’s lives is not easy. However, there are different ways that women can use to carry out self-care activities regularly. Some women individually perform self-care while others perform self-care in groups. Little is known about ways to sustaining self-care of women based on the fundamental principle of Thai culture. The purpose of this study was to investigate ways to sustaining self-care based on the sufficiency economy philosophy of Thai middle-aged women living in the community in order to achieve future healthy aging. This study employed a qualitative research design. Twenty women who were willing to participate in this study were recruited. Data collection were conducted through in-depth interviews with tape recording, doing field notes, and observation. All interviews were transcribed verbatim, and data were analyzed by using content analysis. The findings showed ways to sustaining self-care of Thai community women to achieve future healthy aging consisting of 7 themes: 1) having determination, 2) having a model, 3) developing a leader, 4) carrying on performing activities, 5) setting up rules, 6) building self-care culture, and 7) developing a self-care group/network. The findings of this study suggested that in order to achieve self-care sustainability women should get to know themselves, have intention and belief, together with having the power of community and support. Therefore, having self-care constantly will prevent disease and promote healthy in women’s lives.

Keywords: qualitative research, sufficiency economy philosophy, Thai middle-aged women, ways to sustaining self-care

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Authors: Adekunle O. Afolabi, Pekka Toivanen

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The world is expected to experience growth in the number of ageing population, and this will bring about high cost of providing care for these valuable citizens. In addition, many of these live with chronic diseases that come with old age. Providing adequate care in the face of rising costs and dwindling personnel can be challenging. However, advances in technologies and emergence of the Internet of Things are providing a way to address these challenges while improving care giving. This study proposes the integration of recommendation systems into homecare to provide real-time recommendations for effective management of people receiving care at home and those living with chronic diseases. Using the simplified Training Logic Concept, stakeholders and requirements were identified. Specific requirements were gathered from people living with cancer. The solution designed has two components namely home and community, to enhance recommendations sharing for effective care giving. The community component of the design was implemented with the development of a mobile app called Recommendations Sharing Community for Aged and Chronically Ill People (ReSCAP). This component has illustrated the possibility of real-time recommendations, improved recommendations sharing among care receivers and between a physician and care receivers. Full implementation will increase access to health data for better care decision making.

Keywords: recommendation systems, Internet of Things, healthcare, homecare, real-time

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Authors: Nadeem Yousuf Khan

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This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.

Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology

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Authors: Ali Kuzu

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There are about 800 thousand chemicals in our environment and the number is increasing more than a thousand every year. While most of these chemicals are used as components in various consumer products, some are faced as industrial waste in the environment. Unfortunately, many of these chemicals are hazardous and affect humans. According to the “International Program on Chemical Safety” of World Health Organization; Among the chronic health effects of chemicals, cancer is of major concern. Many substances have found in recent years to be carcinogenic in one or more species of laboratory animals. Especially with respect to long-term effects, the response to a chemical may vary, quantitatively or qualitatively, in different groups of individuals depending on predisposing conditions, such as nutritional status, disease status, current infection, climatic extremes, and genetic features, sex and age of the individuals. Understanding the response of such specific risk groups is an important area of toxicology research. People with age 65+ is defined as “aged (or elderly)”. The elderly population in the world is about 600 million, which corresponds to ~8 percent of the world population. While every 1 of each 4 people is aged in Japan, the elderly population is quite close to 20 percent in many developed countries. And elderly population in these countries is growing more rapidly than the total population. The negative effects of chemicals on elderly take an important place in health-care related issues in last decades. The aged population is more susceptible to the harmful effects of environmental chemicals. According to the poor health of the organ systems in elderly, the ability of their body to eliminate the harmful effects and chemical substances from their body is also poor. With the increasing life expectancy, more and more people will face problems associated with chemical residues.

Keywords: elderly, chemicals’ effects, aged care, care need

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Authors: Novita Verayanti Manalu, Alvin Salim

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Background: Palliative care is caring holistically for patients and families to improve their quality of life. Experts stated that palliative care could be applied not only for terminally ill cases but also for acute illnesses. Therefore, this study wants to find out the level of knowledge about palliative care of the nurses along with the relationship with attitude and performance. Method: This study applies a cross-sectional survey design and allows the respondents to fill two questionnaires to determine the level of knowledge and attitude toward palliative care, while one questionnaire is filled out by the head nurse to evaluate nurses’ performance. The relationship was analyzed by Spearman rho’s correlation in alpha < 0,05 by SPSS. Results: The majority of respondents were females, aged above 25 years old, and married. Most of the nurses are staff nurses and the ratio of education level is not significantly different. The knowledge level is poor, while the attitude and performance are at an adequate level. Knowledge may affect attitude, but it doesn’t happen toward performance. Conclusion: There is a need for increased knowledge about palliative care to improve attitude and work performance. Future researchers might use this finding as a reference to conduct further study in improving knowledge of palliative care.

Keywords: knowledge, attitude, work performance, palliative care

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Authors: Dilara Usta, Fatos Korkmaz

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Background: Individuals who utilise health services maintain relationships with health professionals, insurers and institutions. The nature of these relationships requires service receivers to have trust in the service providers because maintaining health services without reciprocal trust is very difficult. Therefore, individual evaluations of trust within the scope of health services have become increasingly important. Objective: To investigate patients’ trust in the health-care system and their relevant socio-demographical characteristics. Methods: This research was conducted using a descriptive design which included 493 literate patients aged 18-65 years who were hospitalised for a minimum of two days at public university and training&research hospitals in Ankara, Turkey. Patients’ trust in health-care professionals, insurers, and institutions were investigated. Data were collected using a demographic questionnaire and the Multidimensional Trust in Health-Care Systems Scale between September 2015 and April 2016. Results: The participants’ mean age was 47.7±13.1; 70% had a moderate income and 69% had a prior hospitalisation and 63.5% of the patients were satisfied with the health-care services. The mean Multidimensional Trust in Health-Care Systems Scale score for the sample was 61.5±8.3; the provider subscale had a mean of 38.1±5, the insurers subscale had a mean of 12.9±3.7, and institutions subscale had a mean of 10.6±1.9. Conclusion: Patients’ level of trust in the health-care system was above average and the trust level of the patients with higher educational and socio-economic levels was lower compared to the other patients. Health-care professionals should raise awareness about the significance of trust in the health-care system.

Keywords: delivery of health care, health care system, nursing, patients, trust

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Authors: Narong Anurak

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This study aimed to find out the hair-care purchasing behavior at hypermarkets and to investigate two factors, package design and advertising channels, that influenced hair-care purchasing behavior. The subjects of the study consisted of 100 housewives aged between 20-60 who usually shopped at Big C Tiwanon. They were selected by accidental sampling, and were asked to complete a questionnaire. The main findings of the survey were that the majority of respondents regarding their brand selection of hair-care products, they gave priority to the product quality followed by a reasonable price, and fragrance, respectively. Besides, more than half of the respondents had brand loyalty while the rest were attracted by an attractive package design and advertising promotion campaigns. The respondents who were attracted by the package design said that the information on the labels influenced their purchasing decision the most, and television was a medium that best reached them as well.

Keywords: advertising channels, consumer purchasing decisions, hair-care market, package design

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Authors: Farhan Saeed

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The core objective of this work is to explicate the biochemical and therapeutic properties of aged garlic. For this purpose, two varieties of garlic were obtained from Ayub Agricultural Research Institute (AARI) Faisalabad-Pakistan. Additionally, fresh garlic was converted into aged garlic via fermentation method in the incubator at 70 to 80 % humidity level and 60C0 temperature for one month. Similarly, biochemical and antioxidant properties of fresh and aged garlic were also elucidated. Mean values showed that moisture content was decreased, whereas crude fat, crude protein, crude fiber, crude ash and total carbohydrates were enhanced after fermentation. Additionally, crude protein of fresh and aged garlic was 7.57±0.16 and 5.52±0.12%, respectively, whilst 9.68±0.41 and 8.78±0.29%, respectively, after the fermentation process. In addition, NFE contents were also enhanced up to 39% after the fermentation method. Moreover, Zn, S, Al, K, Fe, Na, Mg, and Cu contents were also increased. Furthermore, Total phenolic contents (TPC) of fresh and aged garlic were 2498.70 & 2188.50mg GAE/kg whilst 3008.59, & 2591.81mg GAE/kg for aged garlic. In conclusion, aged garlic explicated the better biochemical properties, mineral profile and antioxidant properties as compared to fresh garlic.

Keywords: aged garlic, nutritional values, bioactive properties, fermentation

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Authors: Nasim Hashemi, Abbas Sheikhtaheri

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Telemedicine is the use of telecommunication and information technologies to provide health care services that would often not be consistently available in distant rural communities to people at these remote areas. Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Thus, teleophthalmology can overcome geographical barriers and improve quality, access, and affordability of eye health care services. Since teleophthalmology has been widespread applied in recent years, the aim of this study was to determine the different applications of teleophthalmology in the world. To this end, three bibliographic databases (Medline, ScienceDirect, Scopus) were comprehensively searched with these keywords: eye care, eye health care, primary eye care, diagnosis, detection, and screening of different eye diseases in conjunction with telemedicine, telehealth, teleophthalmology, e-services, and information technology. All types of papers were included in the study with no time restriction. We conducted the search strategies until 2015. Finally 70 articles were surveyed. We classified the results based on the’type of eye problems covered’ and ‘the type of telemedicine services’. Based on the review, from the ‘perspective of health care levels’, there are three level for eye health care as primary, secondary and tertiary eye care. From the ‘perspective of eye care services’, the main application of teleophthalmology in primary eye care was related to the diagnosis of different eye diseases such as diabetic retinopathy, macular edema, strabismus and aged related macular degeneration. The main application of teleophthalmology in secondary and tertiary eye care was related to the screening of eye problems i.e. diabetic retinopathy, astigmatism, glaucoma screening. Teleconsultation between health care providers and ophthalmologists and also education and training sessions for patients were other types of teleophthalmology in world. Real time, store–forward and hybrid methods were the main forms of the communication from the perspective of ‘teleophthalmology mode’ which is used based on IT infrastructure between sending and receiving centers. In aspect of specialists, early detection of serious aged-related ophthalmic disease in population, screening of eye disease processes, consultation in an emergency cases and comprehensive eye examination were the most important benefits of teleophthalmology. Cost-effectiveness of teleophthalmology projects resulted from reducing transportation and accommodation cost, access to affordable eye care services and receiving specialist opinions were also the main advantages of teleophthalmology for patients. Teleophthalmology brings valuable secondary and tertiary care to remote areas. So, applying teleophthalmology for detection, treatment and screening purposes and expanding its use in new applications such as eye surgery will be a key tool to promote public health and integrating eye care to primary health care.

Keywords: applications, telehealth, telemedicine, teleophthalmology

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Authors: Hong Wu, Naiji Lu, Chenguang Wang, Xinming Tu

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This article analyzes the causal effects of informal care, mental health, and physical health on falls and other accidents (e.g. traffic accidents) among elderly people. To purge potential reversal causal effects, e.g., past accidents induce more future informal care, we use two-stage least squares to identify the impacts. By using longitudinal data from a representative national China Health and retirement longitudinal study of people aged 45 and older in China, our findings indicate that informal care decreases while poor health conditions increase the occurrence of accidents. We also find heterogeneous impacts on the occurrence of accidents, varying by gender, urban status, and past accident history. Our findings suggest the following three policy implications. First, policy makers who aim to decrease accidents should take informal care to elders into account. Second, ease of birth policy and postponed retirement policy are urgent to meet the demand of informal care. Third, medical policies should attach great importance to not only physical health but also mental health of elderly parents especially for older people with accident history.

Keywords: accident, China, fall, informal care, mental health, physical health

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Authors: Suhathai Tosangwarn, Philip Clissett, Holly Blake

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Background: High prevalence of depression has been reported among older adults living in care homes in Thailand, associated with physical impairment, low social support, low self-esteem and particularly stigma associated with living in a care home. However, little is understood about how such stigma is experienced among Thai care home residents. This study examines residents’ perceptions of stigma and their strategies for coping with stigma. Method/Design: Case study research was used to gain an in-depth view about the stigma of residents’ perspectives and experiences from two care homes in the northeast of Thailand by conducting an in-depth interview and non-participant observation. Qualitative interviews were conducted with 30 older residents (aged >60 years), purposively sampled from both care homes. Non-participant observation was conducted in various public spaces of the care homes, including the dining room, corridors, and activities areas for approximately one to two hours per day at different times; morning and afternoon including weekdays and weekend in both care homes for one month. Thematic analysis was used to analyse the data. Results: The study identified three major themes related to the causes of stigma, the reactions towards stigma and the mitigating factors. Negative beliefs about care homes, negative attitudes, and stereotypes toward the elderly and perceptions of unequal power relations between staff and residents were the main factors precipitating stigma. Consequently, residents exhibited negative emotions and behaviours, including depressive symptoms, while living in care homes. Residents reported the use of particular coping strategies, including accessing support from the public and staff and engaging in care home activities which these helped them to cope with their perception of stigma. Conclusion: Improved understanding of the underlying factors behind perceived stigma in care home residents may help to prevent depression and reduce perceptions of stigma associated with living in a care home, by informing strategy, supportive intervention and guidelines for appropriate care for older Thai residents.

Keywords: care home, depression, older adult, stigma, Thailand

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Authors: Tulika Bhattacharyya, Suhita Chopra Chatterjee

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Family caregivers are vital in providing physical and emotional care to the aged. Providing care to aged involves physical as well as psycho-socio-economic challenges, compels the caregiver to fit in manifold roles, feel overburdened; which in turn requires them to change their priorities in life. The study conducted on family caregivers of the hospitalized elderly explores caregiver’s burden using Zarit Burden Scale (ZBS). The data has been collected from two randomly selected Multispecialty Hospitals in Kolkata (India), after obtaining ethical clearance from the Institutional Review Board of both the hospitals. The predictors of burden were also assessed using interview schedules. Among fifty-seven caregivers who participated in the study, caregiver’s burden was identified among thirty respondents with twenty-six having mild to moderate burden and four having moderate to severe burden. Majority of the caregivers were found to be female, reflecting the gendered nature of caregiving. Family caregivers spent more than six hours per day on caregiving, which severely disturbed their work-life including loss of job. The study revealed that the caregivers’ marital status, family structure, academic qualification, occupation and time spent on caregiving are related to family caregivers’ burden. The burden of care giving was accentuated by poor access to information, counseling, and lack of supportive services. The paper concludes by indicating the need for greater state interventions for caregivers.

Keywords: caregivers burden, family caregiving, hospitalized elderly, elderly in Kolkata, India, Zarit Burden Scale

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Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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Authors: M. A. Marlow, R. Sørly, H. K. Kaatrakoski

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Social work practice produces and circulates dominant narratives of young women in residential care. These stories are characterised by negative descriptions and hopelessness while dismissing the capabilities of narrative practice. This paper gives an account of how young women with histories in residential care can resist the dominant narratives. The analysis is based on a study of five young women aged 17 to 26 years old with different backgrounds and experiences with Norwegian residential care. The meaning of the context is analysed based on two interviews that were completed and one that was cancelled in the field. The contextual narrative analysis was oriented around the understanding of stories as performances and provided insight into a possible future storytelling practice in social work. The first author’s field notes are included as part of the data material in the analysis and provide a picture of important knowledge development related to stories and the value of being able to tell one’s own experiences. Faced with the dominant narratives that define young women with negative experiences with residential care, we provide a more contextualised understanding of storytelling as a possibility for positive change. To allow young women to create new stories from their lives, we, as both social workers and researchers, must be aware of what kinds of stories we relate to our own practices.

Keywords: context analysis, narrative research, rejection, residential care, social work practice

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Authors: Cory B. Lord

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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.

Keywords: dementia, elderly, falls, STEADI

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Authors: Chuang-Chun Chiou

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Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: lean, service improvement, SERVQUAL, care home service

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Authors: Hong Wu, Naiji Lu

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Improvement of health behavior among people with chronic diseases is vital for increasing longevity and enhancing quality of life. This paper researched the causal effects of informal care on the compliance with doctor’s health advices – smoking control, dietetic regulation, weight control and keep exercising – among older people with chronic diseases in China, which is facing the challenge of aging. We addressed the selection bias by using propensity score matching in the estimation process. We used the 2011-2012 national baseline data of the China Health and Retirement Longitudinal Study. Our results showed informal care can help improve health behavior of older people. First, informal care improved the compliance of smoking controls: whether smoke, frequency of smoking, and the time lag between wake up and the first cigarette was all lower for these older people with informal care; Second, for dietetic regulation, older people with informal care had more meals every day than older people without informal care; Third, three variables: BMI, whether gain weight and whether lose weight were used to measure the outcome of weight control. There were no significant difference between group with informal care and that without for BMI and the possibility of losing weight. Older people with informal care had lower possibility of gain weight than that without; Last, for the advice of keeping exercising, informal care increased the probability of walking exercise, however, the difference between groups for moderate and vigorous exercise were not significant. Our results indicate policy makers who aim to decrease accidents should take informal care to elders into account and provide an appropriate policy to meet the demand of informal care. Our birth policy and postponed retirement policy may decrease the informal caregiving hours, so adjustments of these policies are important and urgent to meet the current situation of aged tendency of population. In addition, government could give more support to develop organizations to provide formal care, such as nursing home. We infer that formal care is also useful for health behavior improvements.

Keywords: chronic diseases, compliance, CHARLS, health advice, informal care, older people, propensity score matching

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Authors: T. Turan, Ç. Erdoğan

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As far as is known, general nursing care practices do not include specific evidence-based practices related to oral care in children. This study aimed to evaluate the evidence based nursing practice for oral care in children. This article is planned as a review article by searching the literature in this field. According to all age groups and the oral care in various specific situations located evidence in the literature were examined. It has been determined that the methods and frequency used in oral care practices performed by nurses in clinics differ from one hospital to another. In addition, it is seen that different solutions are used in basic oral care, oral care practices to prevent ventilator-associated pneumonia and evidence-based practice in mucositis management in children. As a result, a standard should be established in oral care practices for children and education for children is recommended.

Keywords: evidence-based practice, oral care, nursing, children

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Authors: Hazel S. Cometa-Lamberte

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This paper presents the residential care workers reflections in working with children who were under protective custody and placed in a residential care facility for children. Key informant interviews and focus group discussion were employed in this study to analyze the views of residential care workers on the programs and services and case management system in residential care for children. Results suggest that working in a residential care facility for children needs the interplay of both the worker’s personal and professional values, knowledge and skills in working with children. Analyzing the residential care workers experiences in handling children in residential care facilities is vital for the improvement of the policies, programs and services, the repertoire of techniques and facilitate the creation of a new social work practice framework/model in child protection specifically in residential care facilities.

Keywords: child protection, residential care, residential care workers, social workers

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Authors: Lei Liu

Abstract:

Since the famous opening up and reform strategy of China, lots of migrants have flowed from rural areas to urban areas. In this paper, the author investigates the rural elderly left behind, which are defined aged people left alone at home while their adult children have to migrant outside. This phenomenon is a quite general and serious social problem that cannot be ignored, accompanied by the process of urbanization and regional transferring of rural labor. The Chinese internal migration not only exerts great influence to China’s economy and urbanization but also obviously reduces the labor and care to rural aged people. Contrary to assumptions in some migration and aging studies, which show the inevitable negative effects of migration upon the old age care, the author highlights unique features in their daily strategies of house holding to integrate into society with the analysis of the conception of social inclusion. Through life history interviews with elderly left behind in one rural village, this article sheds light on three different factors of social inclusion, namely, economic inclusion, social identity and political inclusion and shows its necessaries to fully understand the status of the social wellbeing of rural elderly left behind.

Keywords: labor migration, elderly left behind, social inclusion, rural China

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Authors: Eduard Fosch-Villaronga

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This paper pioneers Care Robot Impact Assessment (CRIA), a methodology used to identify, analyze, mitigate and eliminate the risks posed by the insertion of non-medical personal care robots (PCR) in medical care facilities. Its precedent instruments (Privacy and Surveillance Impact Assessment (PIA and SIA)) fall behind in coping with robots. Indeed, personal care robots change dramatically how care is delivered. The paper presents a specific risk-sector methodology, identifies which robots are under its scope and presents some of the challenges introduced by these robots.

Keywords: ethics, impact assessment, law, personal care robots

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Authors: Sharmistha Mukherjee

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Health care is the basic requirement for all. The prime question is who gets what, where and how? The unequal distribution of basic facilities do have a adverse effect on the users. The paper tries to examine health care in terms of available facilities, the health care need and how people perceive to it in a small town of Jalpaiguri in the midst of tea gardens in North Bengal. The morbidity pattern is also minutely observed with a section describing the organizational structure of health care keeping in mind the utilization.

Keywords: availability, distribution, health care, utilization

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Authors: Kristine Demilou D. Santiago

Abstract:

An access to a high-quality health care system is what sets apart industrialized nations, such as the United States from other developing countries, which in this case is specifically pertaining to their older population. But what was the underrated factor in the sphere of quality healthcare rendered to elderly people in the Western context? Will this salient factor could push conviction to prorogue the existing gaps between self-denial patient-client and cheek by jowl medications? Are the natural socio-environmental approaches of caregiving the protracted remedy to healthcare disparities for aging population considering their day to day living? The conceptual framework of this model is primarily associated with addressing health and illness of human beings considering the biological, psychological and socio-environmental factors around them. The relevance of biopsychosocial formulation advancing each of the characteristics in the Biopsychosocial (BPS) model in a balance contemplation is the tumult of this study in an attempt to respond to prevailing disparities in caregiving services for old-aged patients on a day to day living. Caregiving services have been the medium path connecting between the patient and its prescribed medications. Moreover, caregivers serve as positive reinforcers in a patient’s environment. Therefore, caregivers play an important role in healthcare delivery to patients. They are considered significant people whom their acts will give an impact to a patient’s view in life. This research study intends to present the supreme importance of biopsychosocial assessment to old-aged patients with mental health illness and conditions. Biopsychosocial assessment will secure the quality of full medication to an old-aged adult suffering from a mental illness. This is because it offers a recognizably wholesome approach to medical healing of old-aged adult patients. The principle of biopsychosocial supersedes the biomedicine being offered to old-aged adults having mental illness, but it does not take away the high relevance of scientific biomedicine in healing patients. The framework presented an overlapping participation of each of its factors in its BPS model that affects in general a person’s health. The correlation between the biological (physiological), psychological (mental) and social (environment) in a person’s health condition requires equal attention according to BPS, and it always coexist with each other. Indisputably said, bio-medicine has been and is being in its unceasing endeavor to provide scientifically proven health care medications for every individual seeking medical treatments. As we grow older and eventually reach the other side of the median population, not only our physiological aspects change, our psychological and socio-environmental changes happen too. Caregiving is a salient responsibility taking place on these inevitable changes.

Keywords: biopsychosocial formulation, caregiving through natural approaches, US health care, BPS in caregiving, caregiving for aging population

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Authors: Julius Lenaerts, Ahmed Elsaadawy, Mohammed Bashir

Abstract:

Background Sedated and paralyzed patients have an impaired blink reflex leading to ophthalmic complications such as conjunctivitis, epithelial defects, bacterial keratitis, and more. These are entirely preventable complications through regular eye care. Methods Patients at level 3 or above (intubated/paralyzed) care in the Intensive Care Unit (ICU) were reviewed between February and April. Data was pulled from Metavision and adherence was compared to Royal College of Ophthalmology (RCOphth) recommendations[4]. Using a multi-pronged approach through posters, individual teaching sessions and faculty teaching, we aimed to educate staff about eye care in the ICU. Patients were reaudited in the period July to August. Results Out of 40 patients, only 23% were assessed for eye care needs on admission compared to 77% after teaching; eye care was only delivered 59% of the time it was due, compared to 61%; 2.5% of patients had eyedrops prescribed compared to 41%. This shows an overall increase in meeting RCOphth standards. Key messages Eye care is an overlooked aspect of patient care in the ICU, associated with avoidable ocular complications. Healthcare staff need further rigorous education on the provision and importance of eye care to reduce avoidable complications.

Keywords: ICU, eye care, risk, QIP

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