The need for institutional long-term care(LTC)services,including nursing homes(NHs),is increasing in China's Mainland in part due to the aging population and changing family structures.In developing NH staff train...The need for institutional long-term care(LTC)services,including nursing homes(NHs),is increasing in China's Mainland in part due to the aging population and changing family structures.In developing NH staff training programs,a review is needed to synthesize knowledge about staff and resident characteristics,and care provided in NHs.This systematic review aims to describe,in Chinese NHs,(1)NH staff characteristics and the care they provide,(2)resident characteristics and care needs,and (3)the role of family members.The 45 articles included in this review covered both urban and rural areas of China's Mainland.We found that staff in Chinese NHs were older and had lower education levels in comparison with those in western countries.Most direct caregivers in urban areas were migratory workers from rural area.Chinese NHs had few qualification standards for staff preparation for their roles in NHs.Also,functional levels of residents in Chinese NHs were higher compared to NH residents in western countries.In addition,family members played important roles in caring for NH residents.These findings suggest a need for staff development programs that tailor for lower educated NH staff and care needs of residents with widely varying levels in function from independent to bedbound in China's Mainland.The findings also suggest that staff qualification standards require critically policy development to improve the capacity of Chinese NHs to provide competent and safe care.展开更多
Objectives:Pressure ulcer(PU)is one of the most common problem among the bedridden elderly and has significantly more burden on elderly and caregivers.This study is aimed to evaluate the effects of the training progra...Objectives:Pressure ulcer(PU)is one of the most common problem among the bedridden elderly and has significantly more burden on elderly and caregivers.This study is aimed to evaluate the effects of the training program for caregivers to prevent PUs among elderly residents at geriatric homes.Methods:A quasi-experimental design was used to carry out the current study.A purposive sample comprised of all formal(39 nurses)or informal caregivers(39)and all immobilized elderly residents(35)who are found in all geriatric centers in Helwan district.A structured questionnaire was used to assess caregivers’socio-demographic characteristics,knowledge,attitude,and observational checklists for their practice for prevention of PU at pre-and posttest and during follow-up.Results:After the training program,there were improvements in the level of knowledge,practice,and positive attitude of caregivers about PU prevention with a statistically significant difference between pre-,post-,and follow-up training programs(P<0.001).Conclusions:The study revealed that the training program seemed to change the knowledge,practice,and attitude of the subjects to PU prevention.This,in turn,implies that adequate knowledge affects directly the elderly caregivers’attitudes as well as practice for prevention could be important in reducing the burden of PU among the elderly.Thus,conducting a training program for caregivers at different geriatric homes about caring skills for elders can prevent PU,and using spontaneous reposition is very effective to prevent PUs.展开更多
Objective:The institutionalization of care for patients with dementia is becoming a trend.Understanding the burden on employed caregivers and exploring associated factors are of great importance in practice.Therefore,...Objective:The institutionalization of care for patients with dementia is becoming a trend.Understanding the burden on employed caregivers and exploring associated factors are of great importance in practice.Therefore,this study aimed to examine the relationship between basic attributes,caring ability,and caregiver burden in employed caregivers practicing in nursing homes.Methods:This cross-sectional study included 541 employed caregivers in 11 four-star nursing homes in Zhejiang Province from April to December 2022.Caregiver burden was assessed using the Zarit Burden Interview(ZBI).Demographic characteristics of participants,characteristics of the older patients with dementia,caring characteristics,training in dementia care,and caring abilities were collected for analysis of influencing factors.A hierarchical multiple regression analysis was conducted to explore the factors influencing the burden on employed caregivers in nursing homes.Results:The ZBI score of employed caregivers in nursing homes was 40.42±10.18,representing a moderate caregiver burden.Factors such as age(U=27.82,P<0.001),residence(U=7.89,P<0.001),educational level(H=55.81,P<0.001),self-care of older patients with dementia(H=85.21,P<0.001),daily care hours(H=73.25,P<0.001),number of older people with dementia cared for(H=14.56,P<0.012)and training in dementia care(U=-9.43,P<0.001)were significantly associated with caregiver burden.Caring ability was negatively associated with caregiver burden(r=-0.22,P<0.01).Furthermore,after controlling for demographic characteristics,the characteristics of older people with dementia,caring characteristics,training in dementia care,and caring ability explained 8.5%,5.8%,and 4.8%of the caregiver burden,respectively.Conclusion:The burden of employed caregivers on patients with dementia in nursing homes can be attributed to various factors.We recommend tailored interventions,such as dementia care training and reviewing the number and duration of hours worked to reduce the burden experienced by caregivers.展开更多
Anomaly detection in smart homes provides support to enhance the health and safety of people who live alone.Compared to the previous studies done on this topic,less attention has been given to hybrid methods.This pape...Anomaly detection in smart homes provides support to enhance the health and safety of people who live alone.Compared to the previous studies done on this topic,less attention has been given to hybrid methods.This paper presents a two-steps hybrid probabilistic anomaly detection model in the smart home.First,it employs various algorithms with different characteristics to detect anomalies from sensory data.Then,it aggregates their results using a Bayesian network.In this Bayesian network,abnormal events are detected through calculating the probability of abnormality given anomaly detection results of base methods.Experimental evaluation of a real dataset indicates the effectiveness of the proposed method by reducing false positives and increasing true positives.展开更多
Objective:To examine how nursing aides in nursing homes perceived their caring work.Methods:Twenty-four nursing aides from one public and one private nursing home in Fuzhou,Fujian Province,China were selected and inte...Objective:To examine how nursing aides in nursing homes perceived their caring work.Methods:Twenty-four nursing aides from one public and one private nursing home in Fuzhou,Fujian Province,China were selected and interviewed in focus groups.Phenomenological analysis was performed.Results:Two themes(positive and negative working experiences)and six sub-themes were drawn:companionship,happiness,trust,achievement,hard work,and grievance.Conclusion:A reasonable work arrangement,positive psychological intervention,and the strengthening of professional,medical and social supports are recommended to improve the work quality and satisfaction of nursing aides in elderly homes.展开更多
Smart appliances and renewable energy resources are becoming an integral part of smart homes. Nowadays, home appliances are communicating with each other with home short-range home area gateways, using existing netwo...Smart appliances and renewable energy resources are becoming an integral part of smart homes. Nowadays, home appliances are communicating with each other with home short-range home area gateways, using existing network communication protocols such as ZigBee, Bluetooth, RFID, and WiFi. A Gateway allows homeowners and utilities to communicate remotely with the appliances via long-range communication networks such as GPRS, WiMax, LTE, and power liner carrier. This paper utilizes the Internet of Things （IoT） concepts to monitor and control home appliances. Moreover, this paper proposes a framework that enables the integration and the coordination of Human-to-Appliance, Utility-to- Appliance, and Appliance-to-Appliance. Utilizing the concepts of Internet of Things leads to one standard communication protocols, TCP/IPV6, which overcomes the many diverse home area networks and neighborhood area networks protocols. This work proposes a cloud based framework that enables the IoTs integration and supports the coordination between devices, as well as with device-human interaction. A prototype is designed, implemented, and tested to validate the proposed solution.展开更多
Elderly inhabitants have a strong influence to healthcare facilities globally in the last few years as a result of the high demand on the healthcare services and the gap between the services provided by caregivers and...Elderly inhabitants have a strong influence to healthcare facilities globally in the last few years as a result of the high demand on the healthcare services and the gap between the services provided by caregivers and the increasing number of older people. Radio Frequency Identification (RFID) technologies have been increasingly adopted in smart homes and used widely for indoor localisation. These technologies have been benefiting to healthcare domain where they improve the quality of services delivering by healthcare providers. This article presents a comprehensive review on RFID systems and healthcare research works in smart homes. We also compare RFID-based solutions in healthcare and distinguish challenges of smart home technologies in indoor environment. We also discuss research challenges related to Activity in Daily Living (ADL) in smart homes for wellbeing.展开更多
This study described the evolution of programs to improve the efficiency of patient movement between hospitals and nursing homes in the metropolitan area of Syracuse, New York. These programs were needed in order to i...This study described the evolution of programs to improve the efficiency of patient movement between hospitals and nursing homes in the metropolitan area of Syracuse, New York. These programs were needed in order to improve coordination among providers in the absence of networks that included both acute and long term care providers. The mechanisms included the exchange of data and monitoring the movement of Difficult to Place patients from hospitals to nursing homes. Between 2006 and 2014, the annual number of Difficult to Place patients increased from 983 to 1836. During this period, annual hospital medical/surgical discharges increased by 7.5 percent, severity of illness increased by 13.7 percent, and the population aged 65 years and over increased by 9.8 percent. Most of the Difficult to Place patients were admitted by the four largest facilities in the community, which accounted for 60 percent of the nursing home beds. The initiatives also included Subacute and Complex Care Programs that provided financial incentives for admission of certain types of patients, such as intravenous therapy and extensive wound care. The programs described how these programs were implemented using minimal financial resources and without adding positions to the participating provider organizations.展开更多
Background:Poor sleep quality of the elderly in nursing homes will reduce the quality of life,which needs to be treated properly.The purpose of the study is to investigate the effect of group mindfulness therapy on sl...Background:Poor sleep quality of the elderly in nursing homes will reduce the quality of life,which needs to be treated properly.The purpose of the study is to investigate the effect of group mindfulness therapy on sleep quality of the elderly in nursing homes.Methods:A parallel randomized controlled trial was used in this study.The semi-structure interview and the mindfulness therapy intervention was used as the intervention.The Pittsburgh sleep quality index scale and Glaizzi phenoenological data for a 7-step was used to analyze the results.Results:After 8 weeks of intervention,the sleep quality of elderly people was improved to a certain extent(P<0.05).Our investigation showed that some elderly people think that through this kind of training they had reduced the frequency of taking sleeping pills.Conclusion:Group mindfulness therapy could improve sleep quality to some extent.展开更多
Energy is essential to practically all exercises and is imperative for the development of personal satisfaction.So,valuable energy has been in great demand for many years,especially for using smart homes and structure...Energy is essential to practically all exercises and is imperative for the development of personal satisfaction.So,valuable energy has been in great demand for many years,especially for using smart homes and structures,as individuals quickly improve their way of life depending on current innovations.However,there is a shortage of energy,as the energy required is higher than that produced.Many new plans are being designed to meet the consumer’s energy requirements.In many regions,energy utilization in the housing area is 30%–40%.The growth of smart homes has raised the requirement for intelligence in applications such as asset management,energy-efficient automation,security,and healthcare monitoring to learn about residents’actions and forecast their future demands.To overcome the challenges of energy consumption optimization,in this study,we apply an energy management technique.Data fusion has recently attracted much energy efficiency in buildings,where numerous types of information are processed.The proposed research developed a data fusion model to predict energy consumption for accuracy and miss rate.The results of the proposed approach are compared with those of the previously published techniques and found that the prediction accuracy of the proposed method is 92%,which is higher than the previously published approaches.展开更多
The revolution in Internet of Things(IoT)-based devices and applications has provided smart applications for humans.These applications range from healthcare to traffic-flow management,to communication devices,to smart...The revolution in Internet of Things(IoT)-based devices and applications has provided smart applications for humans.These applications range from healthcare to traffic-flow management,to communication devices,to smart security devices,and many others.In particular,government and private organizations are showing significant interest in IoT-enabled applications for smart homes.Despite the perceived benefits and interest,human safety is also a key concern.This research is aimed at systematically analyzing the available literature on smart homes and identifying areas of concern or risk with a view to supporting the design of safe and secure smart homes.For this systematic review process,relevant work in the most highly regarded journals published in the period 2016–2020(a section of 2020 is included)was analyzed.A final set of 99 relevant articles(journal articles,book sections,conference papers,and survey papers)was analyzed in this study.This analysis is focused on three research questions and relevant keywords.The systematic analysis results and key insights will help researchers and practitioners to make more informed decisions when dealing with the safety and security risks of smart homes,especially in emergency situations.展开更多
Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Reside...Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services;2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.展开更多
The aim of the study was to de-termine the oral health status and treatment needs of elderly residents of residential homes in Riyadh, Saudi Arabia. Methods: Among 129 elderly residents, 83 (51 males, and 32 females) ...The aim of the study was to de-termine the oral health status and treatment needs of elderly residents of residential homes in Riyadh, Saudi Arabia. Methods: Among 129 elderly residents, 83 (51 males, and 32 females) of them were interviewed and clini-cally examined according to WHO criteria by two calibrated dentists. Results: The mean age of the subjects was 72 ± 8.5. Male subjects had a higher smoking rate than females. Among elderly subjects below 74 years old, 20.8% had a functional dentition (> or = 20), while only 6.7% for those aged greater or equal to 75 years (p = 0.0004). Mean number of the sound teeth in all subjects was 6.7 ± 8.5. The mean number of DMFT was 18.6 ± 12.6. The missing component was the highest (16 ± 13) for both genders. The mean number of decayed roots was 2.75 ± 3.95 in males and 0.63 ± 1.96 in females. Overall, males had more sound and decayed teeth and less filled and missed teeth than females. There was no significant difference between males and females in periodontal problems except the calculus scores. The majority of subjects in need for tooth extraction were male subjects. With no gender difference 63% were in need for restorations, 40% needed upper and lower full dentures. Need for partial dentures was 38% upper and 48% lower. Conclusion: The oral health of the institutionalized elderly population in Saudi Arabia is generally poor and their treatment needs are high.展开更多
This paper aims to describe the socioeconomic and epidemiological profile, as well as the standards of medicine consumption in a group of 154 elderly people from five homes for the aged in Brasilia, in order to expand...This paper aims to describe the socioeconomic and epidemiological profile, as well as the standards of medicine consumption in a group of 154 elderly people from five homes for the aged in Brasilia, in order to expand the understanding about some characteristics and individual needs of this population and its influence on the quality of drug’s therapy. Data were collected between January and December of 2007, it was used a questionnaire adapted from Dader’s method (2002) and a pharmacotherapeutic follow up method and it was responded by the elders and caregivers. Data were supplemented with information from medical records and prescriptions available in the institutions. The studied group has an average age of 74.6 years, living in their current homes for about 5.4 years and the group consists mainly of men with preserved cognitive status. The members of the group have low monthly income, low education level and are sedentary. They consume 4 - 5 drugs and are affected mainly by cardiovascular and psychiatric diseases. Results suggest that low monthly income, low education level, the prevalence of sedentary lifestyle, elders with compromised cognitive status, the increasing number of chronic diseases and the high consumption of drugs in the researched group may be important factors for the emergence or injury drugs-related problems (DRP) as non-adherence to treatment, medication errors, drug interactions and adverse drug reactions compromising the quality of medication therapy. This study points out the necessity of including a pharmacotherapeutic follow-up for the elderly people in order to minimize such problems and provide better quality of life for patients.展开更多
This report documents the findings of a mixed-methods study focused on the advanced directives of 182 residents of three LTC facilities in southern Ontario, Canada. Although almost all had a completed advance directiv...This report documents the findings of a mixed-methods study focused on the advanced directives of 182 residents of three LTC facilities in southern Ontario, Canada. Although almost all had a completed advance directive within 3 months of death, most did not have a palliative designation or directive until a few days before they died. Each facility’s written Progress Notes revealed staff members usually sought additional confirmation of care preferences from residents’ substitute decision-makers within a few days of the death. It was thus common for advance directives to change from a more interventionist approach to the least interventionist approach near death. This change indicates that the meaning and significance of advance care planning and resulting advance directives must be considered in light of the processes and temporal factors involved in their completion and use within this distinct population. The relational nature of advance care planning and concern about ageism as a factor for withholding or withdrawing life support for LTC residents are considered as possible explanatory factors. These findings and their implications are described in relation to end-of-life care policies and practices in LTC facilities.展开更多
This research addresses the planning and scheduling problem in and among the smart homes in a community microgrid. We develop a bi-linear algorithm, named ECO-Trade to generate the near-optimal schedules of the househ...This research addresses the planning and scheduling problem in and among the smart homes in a community microgrid. We develop a bi-linear algorithm, named ECO-Trade to generate the near-optimal schedules of the households’ loads, storage and energy sources. The algorithm also facilitates Peer-to-Peer (P2P) energy trading among the smart homes in a community microgrid. However, P2P trading potentially results in an unfair cost distribution among the participating households. To the best of our knowledge, the ECO-Trade algorithm is the first near-optimal cost optimization algorithm which considers the unfair cost distribution problem for a Demand Side Management (DSM) system coordinated with P2P energy trading. It also solves the time complexity problem of our previously proposed optimal model. Our results show that the solution time of the ECO-Trade algorithm is mostly less than a minute. It also shows that 97% of the solutions generated by the ECO-Trade algorithm are optimal solutions. Furthermore, we analyze the solutions and identify that the algorithm sometimes gets trapped at a local minimum because it alternately sets the microgrid price and quantity as constants. Finally, we describe the reasons of the cost increase by a local minimum and analyze its impact on cost optimization.展开更多
<strong>Introduction:</strong> Due to the growth of the elderly population, there is a notable lack of preparation among family members and society to face the challenges of this new reality, resulting in ...<strong>Introduction:</strong> Due to the growth of the elderly population, there is a notable lack of preparation among family members and society to face the challenges of this new reality, resulting in an increasing demand for homes for the aged (HA). It is necessary to understand how the impairment of physical health, mental health and the level of depression can affect the functional capacity of the institutionalized elderly who live in homes for the aged. <strong>Objective:</strong> To describe the correlation between depression and functionality of elderly people who live in homes for the aged. <strong>Method:</strong> A cross-sectional, descriptive study with 70 elderly people of both sexes, aged 60 years or older, who live in HA in the state of Rio de Janeiro. <strong>Result: </strong>It was verified that the female gender was predominant in the HA consulted. The majority of elderly live in HA voluntarily 48.6% and that 41.43% did not complete elementary school. The majority of the elderly 81.43% had the ability to perform basic activities of daily living and the elderly 52.86% had normal psychological pictures. The worsening of the depressive picture is associated with the worse functioning of elderly who live in HA (p < 0.02). <strong>Conclusion: </strong>Depression is a factor that is associated with the functional capacity of the institutionalized elderly. The worse the functional level of the institutionalized elderly, the greater the chances of presenting a depressive state.展开更多
“Let them eat cake”： a retrospective service evaluation of Focus on Undernutrition in care homes. Introduction： Undernutrition is a major cause and consequence of poor health in older people, affecting 35% of res...“Let them eat cake”： a retrospective service evaluation of Focus on Undernutrition in care homes. Introduction： Undernutrition is a major cause and consequence of poor health in older people, affecting 35% of residents in care homes. Focus on Undernutrition （FoU）, a dietetic service delivered by dietetic assistants uses a multifaceted approach to undernutrition management. This study aims to evaluate FoU’s impact on undernutrition outcome measures in care homes; including FoU’s influence on weight change in residents “at risk” of undernutrition, and prevalence of undernutrition and pressure ulcers （PU）. Methods： A retrospective pragmatic service evaluation was undertaken using pseudonymised data collected over 13 years on weight, undernutrition risk and PU from long-stay residents’ notes before and six months after training （FoU）. Results： Analysis completed on 104 homes, 4,315 residents （71.3% female; mean stay 10.8 （1-278） months） in County Durham. Following FoU a significant difference was identified for： improved rate of weight change for “at risk” residents （p 〈 0.001）. Undernutrition risk significantly influenced weight change （low： B1.04 kg, E0.01 kg; moderate： B-1.79 kg, E-0.38 kg; high： B-0.83kg, E1.00 kg, Bp 〈 0.001, Ep = 0.001）. Reduced undernutrition prevalence （p 〈 0.001） from 32.7% to 29.1% residents “at risk” of undernutrition （moderate： B13.1%, E8.9%; high： B19.6%, E15.9%）. Nutrition screening significantly improved （B76.3%, E98.7%, p 〈 0.001）, reduced prevalence PU （51%, p 〈 0.001）. PU prevalence significantly increased with undernutrition severity at baseline （p 〈 0.001）, but not following FoU （p = 0.233） （low： B5%, E2.3%; moderate： B6.9%, E1.6%; high： B10.5%, E3.9%）. Odds of developing PU reduced 53% （OR： 0.47）. B：baseline; E：evaluation; OR： odds ratio. Conclusion： These results demonstrate dietetic assistants delivering FoU significantly improves weight, undernutrition and PU prevalence in care homes. Indicating FoU is an effective model for improving undernutrition outcomes, with the potential of reducing possible harm, such as PU in care homes.展开更多
These hames are welfare-oriented units run by villages and another form of old age support in rur al China.in addition to family support of the elderly.They are dlesigned to accommodate the helpless el-derlies and orp...These hames are welfare-oriented units run by villages and another form of old age support in rur al China.in addition to family support of the elderly.They are dlesigned to accommodate the helpless el-derlies and orphans enjoying fve guaran-tees,and are mainly funded by villages and townships with a subsidy from local dlepartments of avil affairs.Recently some of these homes begin to qpen to the public and take in with pay retirees who live separately from their sons and daugh-ters.展开更多
This year has seen big success for China’s home stay industry,as more and more people have become the owners of homestays.According to the 2023 Insight into the Homestay Industry released by tujia.com,the number of h...This year has seen big success for China’s home stay industry,as more and more people have become the owners of homestays.According to the 2023 Insight into the Homestay Industry released by tujia.com,the number of homestay owners has increased by 77%from 2019.In addition,the booking volume of homestays with the labels of ceramic art,beachcombing and planting experiences has increased by 90-230%.展开更多
文摘The need for institutional long-term care(LTC)services,including nursing homes(NHs),is increasing in China's Mainland in part due to the aging population and changing family structures.In developing NH staff training programs,a review is needed to synthesize knowledge about staff and resident characteristics,and care provided in NHs.This systematic review aims to describe,in Chinese NHs,(1)NH staff characteristics and the care they provide,(2)resident characteristics and care needs,and (3)the role of family members.The 45 articles included in this review covered both urban and rural areas of China's Mainland.We found that staff in Chinese NHs were older and had lower education levels in comparison with those in western countries.Most direct caregivers in urban areas were migratory workers from rural area.Chinese NHs had few qualification standards for staff preparation for their roles in NHs.Also,functional levels of residents in Chinese NHs were higher compared to NH residents in western countries.In addition,family members played important roles in caring for NH residents.These findings suggest a need for staff development programs that tailor for lower educated NH staff and care needs of residents with widely varying levels in function from independent to bedbound in China's Mainland.The findings also suggest that staff qualification standards require critically policy development to improve the capacity of Chinese NHs to provide competent and safe care.
文摘Objectives:Pressure ulcer(PU)is one of the most common problem among the bedridden elderly and has significantly more burden on elderly and caregivers.This study is aimed to evaluate the effects of the training program for caregivers to prevent PUs among elderly residents at geriatric homes.Methods:A quasi-experimental design was used to carry out the current study.A purposive sample comprised of all formal(39 nurses)or informal caregivers(39)and all immobilized elderly residents(35)who are found in all geriatric centers in Helwan district.A structured questionnaire was used to assess caregivers’socio-demographic characteristics,knowledge,attitude,and observational checklists for their practice for prevention of PU at pre-and posttest and during follow-up.Results:After the training program,there were improvements in the level of knowledge,practice,and positive attitude of caregivers about PU prevention with a statistically significant difference between pre-,post-,and follow-up training programs(P<0.001).Conclusions:The study revealed that the training program seemed to change the knowledge,practice,and attitude of the subjects to PU prevention.This,in turn,implies that adequate knowledge affects directly the elderly caregivers’attitudes as well as practice for prevention could be important in reducing the burden of PU among the elderly.Thus,conducting a training program for caregivers at different geriatric homes about caring skills for elders can prevent PU,and using spontaneous reposition is very effective to prevent PUs.
基金supported by the Department of Science and Technology of Zhejiang Province(LGF22H250002)the Health Commission of Zhejiang Province(2024KY002 to L.C.,2024KY617 to L.W.,2022KY004 to J.B.)The views expressed are those of the authors and not necessarily those of the funders.
文摘Objective:The institutionalization of care for patients with dementia is becoming a trend.Understanding the burden on employed caregivers and exploring associated factors are of great importance in practice.Therefore,this study aimed to examine the relationship between basic attributes,caring ability,and caregiver burden in employed caregivers practicing in nursing homes.Methods:This cross-sectional study included 541 employed caregivers in 11 four-star nursing homes in Zhejiang Province from April to December 2022.Caregiver burden was assessed using the Zarit Burden Interview(ZBI).Demographic characteristics of participants,characteristics of the older patients with dementia,caring characteristics,training in dementia care,and caring abilities were collected for analysis of influencing factors.A hierarchical multiple regression analysis was conducted to explore the factors influencing the burden on employed caregivers in nursing homes.Results:The ZBI score of employed caregivers in nursing homes was 40.42±10.18,representing a moderate caregiver burden.Factors such as age(U=27.82,P<0.001),residence(U=7.89,P<0.001),educational level(H=55.81,P<0.001),self-care of older patients with dementia(H=85.21,P<0.001),daily care hours(H=73.25,P<0.001),number of older people with dementia cared for(H=14.56,P<0.012)and training in dementia care(U=-9.43,P<0.001)were significantly associated with caregiver burden.Caring ability was negatively associated with caregiver burden(r=-0.22,P<0.01).Furthermore,after controlling for demographic characteristics,the characteristics of older people with dementia,caring characteristics,training in dementia care,and caring ability explained 8.5%,5.8%,and 4.8%of the caregiver burden,respectively.Conclusion:The burden of employed caregivers on patients with dementia in nursing homes can be attributed to various factors.We recommend tailored interventions,such as dementia care training and reviewing the number and duration of hours worked to reduce the burden experienced by caregivers.
文摘Anomaly detection in smart homes provides support to enhance the health and safety of people who live alone.Compared to the previous studies done on this topic,less attention has been given to hybrid methods.This paper presents a two-steps hybrid probabilistic anomaly detection model in the smart home.First,it employs various algorithms with different characteristics to detect anomalies from sensory data.Then,it aggregates their results using a Bayesian network.In this Bayesian network,abnormal events are detected through calculating the probability of abnormality given anomaly detection results of base methods.Experimental evaluation of a real dataset indicates the effectiveness of the proposed method by reducing false positives and increasing true positives.
基金This study was supported by grants from the National key clinical specialist construction Programs of China(NO.2010)Fujian Province Science and Technology Plan Key Projects(NO.2012Y0013).
文摘Objective:To examine how nursing aides in nursing homes perceived their caring work.Methods:Twenty-four nursing aides from one public and one private nursing home in Fuzhou,Fujian Province,China were selected and interviewed in focus groups.Phenomenological analysis was performed.Results:Two themes(positive and negative working experiences)and six sub-themes were drawn:companionship,happiness,trust,achievement,hard work,and grievance.Conclusion:A reasonable work arrangement,positive psychological intervention,and the strengthening of professional,medical and social supports are recommended to improve the work quality and satisfaction of nursing aides in elderly homes.
基金supported in part by the Department of Computer Science and Engineering at the American University of Sharjah,UAE
文摘Smart appliances and renewable energy resources are becoming an integral part of smart homes. Nowadays, home appliances are communicating with each other with home short-range home area gateways, using existing network communication protocols such as ZigBee, Bluetooth, RFID, and WiFi. A Gateway allows homeowners and utilities to communicate remotely with the appliances via long-range communication networks such as GPRS, WiMax, LTE, and power liner carrier. This paper utilizes the Internet of Things （IoT） concepts to monitor and control home appliances. Moreover, this paper proposes a framework that enables the integration and the coordination of Human-to-Appliance, Utility-to- Appliance, and Appliance-to-Appliance. Utilizing the concepts of Internet of Things leads to one standard communication protocols, TCP/IPV6, which overcomes the many diverse home area networks and neighborhood area networks protocols. This work proposes a cloud based framework that enables the IoTs integration and supports the coordination between devices, as well as with device-human interaction. A prototype is designed, implemented, and tested to validate the proposed solution.
文摘Elderly inhabitants have a strong influence to healthcare facilities globally in the last few years as a result of the high demand on the healthcare services and the gap between the services provided by caregivers and the increasing number of older people. Radio Frequency Identification (RFID) technologies have been increasingly adopted in smart homes and used widely for indoor localisation. These technologies have been benefiting to healthcare domain where they improve the quality of services delivering by healthcare providers. This article presents a comprehensive review on RFID systems and healthcare research works in smart homes. We also compare RFID-based solutions in healthcare and distinguish challenges of smart home technologies in indoor environment. We also discuss research challenges related to Activity in Daily Living (ADL) in smart homes for wellbeing.
文摘This study described the evolution of programs to improve the efficiency of patient movement between hospitals and nursing homes in the metropolitan area of Syracuse, New York. These programs were needed in order to improve coordination among providers in the absence of networks that included both acute and long term care providers. The mechanisms included the exchange of data and monitoring the movement of Difficult to Place patients from hospitals to nursing homes. Between 2006 and 2014, the annual number of Difficult to Place patients increased from 983 to 1836. During this period, annual hospital medical/surgical discharges increased by 7.5 percent, severity of illness increased by 13.7 percent, and the population aged 65 years and over increased by 9.8 percent. Most of the Difficult to Place patients were admitted by the four largest facilities in the community, which accounted for 60 percent of the nursing home beds. The initiatives also included Subacute and Complex Care Programs that provided financial incentives for admission of certain types of patients, such as intravenous therapy and extensive wound care. The programs described how these programs were implemented using minimal financial resources and without adding positions to the participating provider organizations.
文摘Background:Poor sleep quality of the elderly in nursing homes will reduce the quality of life,which needs to be treated properly.The purpose of the study is to investigate the effect of group mindfulness therapy on sleep quality of the elderly in nursing homes.Methods:A parallel randomized controlled trial was used in this study.The semi-structure interview and the mindfulness therapy intervention was used as the intervention.The Pittsburgh sleep quality index scale and Glaizzi phenoenological data for a 7-step was used to analyze the results.Results:After 8 weeks of intervention,the sleep quality of elderly people was improved to a certain extent(P<0.05).Our investigation showed that some elderly people think that through this kind of training they had reduced the frequency of taking sleeping pills.Conclusion:Group mindfulness therapy could improve sleep quality to some extent.
文摘Energy is essential to practically all exercises and is imperative for the development of personal satisfaction.So,valuable energy has been in great demand for many years,especially for using smart homes and structures,as individuals quickly improve their way of life depending on current innovations.However,there is a shortage of energy,as the energy required is higher than that produced.Many new plans are being designed to meet the consumer’s energy requirements.In many regions,energy utilization in the housing area is 30%–40%.The growth of smart homes has raised the requirement for intelligence in applications such as asset management,energy-efficient automation,security,and healthcare monitoring to learn about residents’actions and forecast their future demands.To overcome the challenges of energy consumption optimization,in this study,we apply an energy management technique.Data fusion has recently attracted much energy efficiency in buildings,where numerous types of information are processed.The proposed research developed a data fusion model to predict energy consumption for accuracy and miss rate.The results of the proposed approach are compared with those of the previously published techniques and found that the prediction accuracy of the proposed method is 92%,which is higher than the previously published approaches.
基金supported by Qatar University Internal Grant No.IRCC2020-009.
文摘The revolution in Internet of Things(IoT)-based devices and applications has provided smart applications for humans.These applications range from healthcare to traffic-flow management,to communication devices,to smart security devices,and many others.In particular,government and private organizations are showing significant interest in IoT-enabled applications for smart homes.Despite the perceived benefits and interest,human safety is also a key concern.This research is aimed at systematically analyzing the available literature on smart homes and identifying areas of concern or risk with a view to supporting the design of safe and secure smart homes.For this systematic review process,relevant work in the most highly regarded journals published in the period 2016–2020(a section of 2020 is included)was analyzed.A final set of 99 relevant articles(journal articles,book sections,conference papers,and survey papers)was analyzed in this study.This analysis is focused on three research questions and relevant keywords.The systematic analysis results and key insights will help researchers and practitioners to make more informed decisions when dealing with the safety and security risks of smart homes,especially in emergency situations.
文摘Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services;2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.
文摘The aim of the study was to de-termine the oral health status and treatment needs of elderly residents of residential homes in Riyadh, Saudi Arabia. Methods: Among 129 elderly residents, 83 (51 males, and 32 females) of them were interviewed and clini-cally examined according to WHO criteria by two calibrated dentists. Results: The mean age of the subjects was 72 ± 8.5. Male subjects had a higher smoking rate than females. Among elderly subjects below 74 years old, 20.8% had a functional dentition (> or = 20), while only 6.7% for those aged greater or equal to 75 years (p = 0.0004). Mean number of the sound teeth in all subjects was 6.7 ± 8.5. The mean number of DMFT was 18.6 ± 12.6. The missing component was the highest (16 ± 13) for both genders. The mean number of decayed roots was 2.75 ± 3.95 in males and 0.63 ± 1.96 in females. Overall, males had more sound and decayed teeth and less filled and missed teeth than females. There was no significant difference between males and females in periodontal problems except the calculus scores. The majority of subjects in need for tooth extraction were male subjects. With no gender difference 63% were in need for restorations, 40% needed upper and lower full dentures. Need for partial dentures was 38% upper and 48% lower. Conclusion: The oral health of the institutionalized elderly population in Saudi Arabia is generally poor and their treatment needs are high.
文摘This paper aims to describe the socioeconomic and epidemiological profile, as well as the standards of medicine consumption in a group of 154 elderly people from five homes for the aged in Brasilia, in order to expand the understanding about some characteristics and individual needs of this population and its influence on the quality of drug’s therapy. Data were collected between January and December of 2007, it was used a questionnaire adapted from Dader’s method (2002) and a pharmacotherapeutic follow up method and it was responded by the elders and caregivers. Data were supplemented with information from medical records and prescriptions available in the institutions. The studied group has an average age of 74.6 years, living in their current homes for about 5.4 years and the group consists mainly of men with preserved cognitive status. The members of the group have low monthly income, low education level and are sedentary. They consume 4 - 5 drugs and are affected mainly by cardiovascular and psychiatric diseases. Results suggest that low monthly income, low education level, the prevalence of sedentary lifestyle, elders with compromised cognitive status, the increasing number of chronic diseases and the high consumption of drugs in the researched group may be important factors for the emergence or injury drugs-related problems (DRP) as non-adherence to treatment, medication errors, drug interactions and adverse drug reactions compromising the quality of medication therapy. This study points out the necessity of including a pharmacotherapeutic follow-up for the elderly people in order to minimize such problems and provide better quality of life for patients.
文摘This report documents the findings of a mixed-methods study focused on the advanced directives of 182 residents of three LTC facilities in southern Ontario, Canada. Although almost all had a completed advance directive within 3 months of death, most did not have a palliative designation or directive until a few days before they died. Each facility’s written Progress Notes revealed staff members usually sought additional confirmation of care preferences from residents’ substitute decision-makers within a few days of the death. It was thus common for advance directives to change from a more interventionist approach to the least interventionist approach near death. This change indicates that the meaning and significance of advance care planning and resulting advance directives must be considered in light of the processes and temporal factors involved in their completion and use within this distinct population. The relational nature of advance care planning and concern about ageism as a factor for withholding or withdrawing life support for LTC residents are considered as possible explanatory factors. These findings and their implications are described in relation to end-of-life care policies and practices in LTC facilities.
文摘This research addresses the planning and scheduling problem in and among the smart homes in a community microgrid. We develop a bi-linear algorithm, named ECO-Trade to generate the near-optimal schedules of the households’ loads, storage and energy sources. The algorithm also facilitates Peer-to-Peer (P2P) energy trading among the smart homes in a community microgrid. However, P2P trading potentially results in an unfair cost distribution among the participating households. To the best of our knowledge, the ECO-Trade algorithm is the first near-optimal cost optimization algorithm which considers the unfair cost distribution problem for a Demand Side Management (DSM) system coordinated with P2P energy trading. It also solves the time complexity problem of our previously proposed optimal model. Our results show that the solution time of the ECO-Trade algorithm is mostly less than a minute. It also shows that 97% of the solutions generated by the ECO-Trade algorithm are optimal solutions. Furthermore, we analyze the solutions and identify that the algorithm sometimes gets trapped at a local minimum because it alternately sets the microgrid price and quantity as constants. Finally, we describe the reasons of the cost increase by a local minimum and analyze its impact on cost optimization.
文摘<strong>Introduction:</strong> Due to the growth of the elderly population, there is a notable lack of preparation among family members and society to face the challenges of this new reality, resulting in an increasing demand for homes for the aged (HA). It is necessary to understand how the impairment of physical health, mental health and the level of depression can affect the functional capacity of the institutionalized elderly who live in homes for the aged. <strong>Objective:</strong> To describe the correlation between depression and functionality of elderly people who live in homes for the aged. <strong>Method:</strong> A cross-sectional, descriptive study with 70 elderly people of both sexes, aged 60 years or older, who live in HA in the state of Rio de Janeiro. <strong>Result: </strong>It was verified that the female gender was predominant in the HA consulted. The majority of elderly live in HA voluntarily 48.6% and that 41.43% did not complete elementary school. The majority of the elderly 81.43% had the ability to perform basic activities of daily living and the elderly 52.86% had normal psychological pictures. The worsening of the depressive picture is associated with the worse functioning of elderly who live in HA (p < 0.02). <strong>Conclusion: </strong>Depression is a factor that is associated with the functional capacity of the institutionalized elderly. The worse the functional level of the institutionalized elderly, the greater the chances of presenting a depressive state.
文摘“Let them eat cake”： a retrospective service evaluation of Focus on Undernutrition in care homes. Introduction： Undernutrition is a major cause and consequence of poor health in older people, affecting 35% of residents in care homes. Focus on Undernutrition （FoU）, a dietetic service delivered by dietetic assistants uses a multifaceted approach to undernutrition management. This study aims to evaluate FoU’s impact on undernutrition outcome measures in care homes; including FoU’s influence on weight change in residents “at risk” of undernutrition, and prevalence of undernutrition and pressure ulcers （PU）. Methods： A retrospective pragmatic service evaluation was undertaken using pseudonymised data collected over 13 years on weight, undernutrition risk and PU from long-stay residents’ notes before and six months after training （FoU）. Results： Analysis completed on 104 homes, 4,315 residents （71.3% female; mean stay 10.8 （1-278） months） in County Durham. Following FoU a significant difference was identified for： improved rate of weight change for “at risk” residents （p 〈 0.001）. Undernutrition risk significantly influenced weight change （low： B1.04 kg, E0.01 kg; moderate： B-1.79 kg, E-0.38 kg; high： B-0.83kg, E1.00 kg, Bp 〈 0.001, Ep = 0.001）. Reduced undernutrition prevalence （p 〈 0.001） from 32.7% to 29.1% residents “at risk” of undernutrition （moderate： B13.1%, E8.9%; high： B19.6%, E15.9%）. Nutrition screening significantly improved （B76.3%, E98.7%, p 〈 0.001）, reduced prevalence PU （51%, p 〈 0.001）. PU prevalence significantly increased with undernutrition severity at baseline （p 〈 0.001）, but not following FoU （p = 0.233） （low： B5%, E2.3%; moderate： B6.9%, E1.6%; high： B10.5%, E3.9%）. Odds of developing PU reduced 53% （OR： 0.47）. B：baseline; E：evaluation; OR： odds ratio. Conclusion： These results demonstrate dietetic assistants delivering FoU significantly improves weight, undernutrition and PU prevalence in care homes. Indicating FoU is an effective model for improving undernutrition outcomes, with the potential of reducing possible harm, such as PU in care homes.
文摘These hames are welfare-oriented units run by villages and another form of old age support in rur al China.in addition to family support of the elderly.They are dlesigned to accommodate the helpless el-derlies and orphans enjoying fve guaran-tees,and are mainly funded by villages and townships with a subsidy from local dlepartments of avil affairs.Recently some of these homes begin to qpen to the public and take in with pay retirees who live separately from their sons and daugh-ters.
文摘This year has seen big success for China’s home stay industry,as more and more people have become the owners of homestays.According to the 2023 Insight into the Homestay Industry released by tujia.com,the number of homestay owners has increased by 77%from 2019.In addition,the booking volume of homestays with the labels of ceramic art,beachcombing and planting experiences has increased by 90-230%.
