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Purpose: The purpose of this paper is to emphasize the need for holistic geriatric health care in rural India. Many older people in Indian villages suffer from chronic ailments without any relief or intervention because of inaccessible and unaffordable health-care services. This paper explores how holistic health care can be assured for older people in Indian villages. Design/methodology/approach: This paper is based on reflections of the authors who have had experiences as caregivers to older persons within their respective families rooted in the Indian villages. Besides, they interacted with 30 older persons (18 males and 12 females in the age group of 60–80 years) living in the villages in three states of India, namely, Haryana, Rajasthan and Madhya Pradesh to develop a comprehensive viewpoint on the need of geriatric health care in rural India. Relevant reports, newspaper articles and research papers were also reviewed while developing viewpoints on such an important topic. Findings: Geriatric health-care facilities in rural India are abysmal. The older people in the villages cannot leverage health-care facilities that are generally inaccessible, inadequate and unaffordable. Even the government support for medical treatment is minuscule. Furthermore, there is lack of trained health-care professionals at all levels, namely, doctors, nurses and paramedic personnel. Training opportunities in geriatrics are also negligible. The scenario vis-à-vis geriatric health care in rural India can be upturned by increasing public spending on health-care infrastructure, increasing numbers of health-care professionals and expanding training programmes in geriatrics. Originality/value: This paper is based on the critical reflections of the authors as well as their informal interactions with some of the older people in the Indian villages. [ABSTRACT FROM AUTHOR]

During rapid urbanization, megacities see disparities in the spatial distribution of basic public service facilities and the urban built environment. Current research on basic public service facilities focuses on equal spatial distribution, leading to the overlook of their match with the surrounding built environment. Based on a case study on education, healthcare, and elderly care facilities in Chengdu central urban area, this paper analyzes the spatial distribution of these facilities and the built environment, and examines their spatial matching degree using a bivariate spatial autocorrelation model. The findings reveal the following insights: firstly, education and healthcare facilities present a "one core and multi-center" spatial distribution pattern, with the city center serving as the core and suburban subdistricts acting as the multiple centers, while elderly care facilities present a core-edge distribution pattern in contrast; secondly, the built environment presents a core-edge radial distribution pattern, with the city center acting as the nucleus that connects suburban subdistricts; thirdly, the spatial matching degree between the facilities and the urban built environment from the city center outwards is characterized by high, low, medium, and high levels. Notably, a significant spatial mismatch is observed in urban-rural transitional zones. In light of these findings, the paper comes to a conclusion that during urbanization, the efforts to equalize basic public service facilities in the urban-rural transitional zones may lead to spatial mismatches, to which urban planners and managers should pay close attention. [ABSTRACT FROM AUTHOR]

This article discusses the application of artificially intelligent robots within eldercare and explores a series of ethical considerations, including the challenges that AI (Artificial Intelligence) technology poses to traditional Chinese Confucian filial piety. From the perspective of Confucian ethics, the paper argues that robots cannot adequately fulfill duties of care. Due to their detachment from personal relationships and interactions, the "emotions" of AI robots are merely performative reactions in different situations, rather than actual emotional abilities. No matter how "humanized" robots become, it is difficult to establish genuine empathy and a meaningful relationship with them for this reason. Even so, we acknowledge that AI robots are a significant tool in managing the demands of elder care and the growth of care poverty, and as such, we attempt to outline some parameters within which care robotics could be acceptable within a Confucian ethical system. Finally, the paper discusses the social impact and ethical considerations brought on by the interaction between humans and machines. It is observed that the relationship between humans and technology has always had both utopian and dystopian aspects, and robotic elder care is no exception. AI caregiver robots will likely become a part of elder care, and the transformation of these robots from "service providers" to "companions" seems inevitable. In light of this, the application of AI-augmented robotic elder care will also eventually change our understanding of interpersonal relationships and traditional requirements of filial piety. [ABSTRACT FROM AUTHOR]

With the advancement of artificial intelligence, the home care environment for elderly users is becoming increasingly intelligent and systematic. The context aware human–computer interaction technology of sustainable aging-friendly smart homes can effectively identify user needs, enhance energy efficiency, and optimize resource utilization, thereby improving the convenience and sustainability of smart home care services. This paper reviews literature and analyzes cases to summarize the background and current state of context-aware interaction experience research in aging-friendly smart homes. Targeting solitary elderly users aged 60–74, the study involves field observations and user interviews to analyze their characteristics and needs, and to summarize the interaction design principles for aging-friendly smart homes. We explore processes for context-aware and methods for identifying user behaviors, emphasizing the integration of green, eco-friendly, and energy-saving principles in the design process. Focusing on the living experience and quality of life for elderly users living alone, this paper constructs a context-aware user experience model based on multimodal interaction technology. Using elderly falls as a case example, we design typical scenarios for aging-friendly smart homes from the perspectives of equipment layout and innovative hardware and software design. The goal is to optimize the home care experience for elderly users, providing theoretical and practical guidance for smart home services in an aging society. Ultimately, the study aims to develop safer, more convenient, and sustainable home care solutions. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to provide a response to the previously published paper on "Gerontocracy". Design/methodology/approach: This paper views care services through the lens of safeguarding, risks and responsibility in contradistinction from the largely economic and cost relevant argument put forward in the original paper. Findings: This paper articulates the contribution of informal carers to integrated care solutions solely from an economic perspective overlooks the wider human and social dimensions of care provision in society. Originality/value: Engaging in the wider debate about the status, contribution of informal carers to care solutions highlights the complexity of the carers' role in society which should evoke a more holistic debate of this important topic. [ABSTRACT FROM AUTHOR]

This paper compares mortality transition in China and India in the period 1950-2021, highlighting similarities and differences. Mortality transition has been inconsistent in both countries, but differences remain. In China, the transition has been spread evenly across the age range, while in India, it has primarily been confined to younger ages, being markedly slow in ages 35-90. This difference in the older ages appears to explain the main difference between the respective mortality transition in the two countries. To address its ongoing mortality transition, the paper concludes, India needs to reinvigorate its health-care delivery system to meet the health care needs of the old people. The paper also emphasises using geometric mean of the age-specific probabilities of death as an appropriate measure to analyse mortality transition. [ABSTRACT FROM AUTHOR]

Background and purpose: The number of older people in prisons is increasing across the globe. Many have poor physical and mental health, higher prevalence of head injury, cognitive impairment and dementia than found in community populations. Meeting the complex needs of this vulnerable group has become an increasing concern for prison and prison healthcare services. The aim of this multi method qualitative study was to investigate how men with diagnosed or suspected dementia were identified, assessed, and cared for in Scottish prisons. It also explored the lived experience of individuals being assessed for or diagnosed with dementia within four prisons. The data from twenty nine interviews was thematically analysed and used to collaboratively propose principles for dementia care in prison and present the resultant co-designed care pathway. Results: At the time of data collection almost all the men known to have a dementia diagnosis or suspected dementia had complex health and social care needs, and some were living with advanced dementia. Prison healthcare staff reported taking a 'case by case' approach to their pre- and post-diagnostic care. Meeting these prisoner's needs was complicated by the absence of organisational leads for care of older adults or people with dementia and there was no pathway or model in place to guide staff. Prison healthcare teams often had difficulty accessing specialist community services to support diagnosis. There was a lack of dementia education and knowledge about how to provide pre and post diagnostic dementia care in this setting amongst staff. The findings arising from this research have informed the co-production of two important evidence informed innovations namely a Model of Care and a pre- and post-diagnostic Care Pathway. Conclusion: This research adds insights critical to understanding the adequacy of current approaches to meeting dementia related needs within the prison setting. To our knowledge this paper offers the first co-produced evidence informed pre- and post- diagnostic dementia care pathway and model of care for use in prisons. These could serve as tools for change that could enable prison healthcare staff to deliver the right care, at the right time, by the right people, and provide an opportunity to assess risk and plan care for the future. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the national variation in government-subsidised healthcare costs of residents in long-term care facilities (LTCFs) and costs differences by resident and facility characteristics. Methods: A retrospective population-based cohort study was conducted using linked national aged and healthcare data of older people (≥65 years) living in 2112 LTCFs in Australia. Individuals' pharmaceutical, out-of-hospital, hospitalisation and emergency presentations direct costs were aggregated from the linked healthcare data. Average annual healthcare costs per resident were estimated using generalised linear models, adjusting for covariates. Cost estimates were compared by resident dementia status and facility characteristics (location, ownership type and size). Results: Of the 75,142 residents examined, 70% (N = 52,142) were women and 53.4% (N = 40,137) were living with dementia. The average annual healthcare cost (all costs in $A) was $9233 (95% CI $9150–$9295) per resident, with hospitalisation accounting for 47.2% of the healthcare costs. Residents without dementia had higher healthcare costs ($11,097, 95% CI $10,995–$11,200) compared to those with dementia ($7561, 95% CI $7502–$7620). Residents living in for-profit LTCFs had higher adjusted average overall annual healthcare costs ($11,324, 95% CI $11,185–$11,463) compared to those living in not-for-profit ($11,017, 95% CI $10,895–$11,139) and government ($9731, 95% CI $9365–$10,099) facilities. Conclusions: The healthcare costs incurred by residents of LTCFs varied by presence of dementia and facility ownership. The variation in costs may be associated with residents' care needs, care models and difference in quality of care across LTCFs. As hospitalisation is the biggest driver of the healthcare costs, strategies to reduce preventable hospitalisations may reduce downstream cost burden to the health system. What is known about the topic? Residents living in long-term care facilities have high health and care needs, but little research exists on how downstream healthcare costs vary based on facility and individual characteristics. What does this paper add? Using linked national aged care and healthcare data, this study determined that the average annual healthcare cost per resident was $9233 (95% CI $9150–$9295), with hospitalisation accounting for nearly half of these costs. Furthermore, healthcare costs varied based on facility ownership and size, as well as whether individuals had dementia. What are the implications for practitioners? Understanding sectoral variation and learning from long-term care facilities with lower hospitalisation rates could be a strategic approach to reducing healthcare costs for long-term care residents. [ABSTRACT FROM AUTHOR]

Over the past few years, life expectancy has increased significantly. However, elderly individuals living independently often require assistance due to mobility issues, symptoms of dementia, or other health-related challenges. In these situations, high-quality elderly care systems for the aging population require innovative approaches to guarantee Quality of Service (QoS) and Quality of Experience (QoE). Traditional remote elderly care methods face several challenges, including high latency and poor service quality, which affect their transparency and stability. This paper proposes an Edge Computational Intelligence (ECI)-based haptic-driven ECI-TeleCaring system for the remote caring and monitoring of elderly people. It utilizes a Software-Defined Network (SDN) and Mobile Edge Computing (MEC) to reduce latency and enhance responsiveness. Dual Long Short-Term Memory (LSTM) models are deployed at the edge to enable real-time location-aware activity prediction to ensure QoS and QoE. The results from the simulation demonstrate that the proposed system is proficient in managing the transmission of data in real time without and with an activity recognition and location-aware model by communication latency under 2.5 ms (more than 60%) and from 11∼12 ms (60∼95%) for 10 to 1000 data packets, respectively. The results also show that the proposed system ensures a trade-off between the transparency and stability of the system from the QoS and QoE perspectives. Moreover, the proposed system serves as a testbed for implementing, investigating, and managing elder telecaring services for QoS/QoE provisioning. It facilitates real-time monitoring of the deployed technological parameters along with network delay and packet loss, and it oversees data exchange between the master domain (human operator) and slave domain (telerobot). [ABSTRACT FROM AUTHOR]

With the development of the social economy and the arrival of the aging era, the issue of elderly care has increasingly gained social attention. This matter not only concerns the personal interests of individuals but also represents a significant focal point in the construction of social welfare systems, influencing the development direction of multiple industries. As the elderly population continues to grow, there is a pressing need for innovative and sustainable care solutions. Among the diverse elderly care models, the forest therapy industry emerges as a new direction, providing seniors with a comfortable natural environment that promotes physical and mental health. This approach not only enhances the well-being of older adults but also serves as an important avenue for rational and sustainable development through the utilization of forest ecological products. This paper explores the connection between elderly care models and the forest therapy industry, offering insights into the current state and future development of the Chinese elderly care sector. By examining the benefits of integrating forest therapy into existing care frameworks, this study aims to provide practical recommendations. It is hoped that these insights will serve as a reference for stakeholders in the Chinese elderly care industry, promoting the positive role of forest therapy in optimizing and enhancing elderly care models for a healthier, happier aging population. [ABSTRACT FROM AUTHOR]

The multiple changes in population, economy, and social structure have significantly impacted China's traditional home-based elderly care and social welfare. The importance of institutional care is becoming increasingly prominent. One of the critical considerations for the development of institutional care is its social sustainability, which pursues the realization of human well-being and aims to bring about good quality of life. However, this issue has not received due attention. The purpose of this paper is to investigate the social sustainability of the institutional care environment. Based on stakeholder theory and content analysis, this research identified and discussed the problems of the institutional care environment mentioned in the news coverage on eight major Chinese portal websites. The results indicate that seven of the eight problems that employees, the elderly, and their relatives encounter in providing and receiving elderly care services in the institutional environment are related to social sustainability. Employees' health and safety is a concern; they lack education and training opportunities and have been unequally treated in the employment process. The elderly's psychological, physical, and safety needs should also be further satisfied. Unequal access to institutional care and the inaccessibility of elderly care institutions is another problem that needs to be solved urgently. These findings will help government departments and investors become aware of the issues and implement countermeasures to create a successful, socially sustainable institutional care environment. They can also provide valuable insights for the elderly and their relatives in choosing appropriate elderly care institutions. [ABSTRACT FROM AUTHOR]

In many countries, elder citizens residing in long-term care facilities (LTCFs) were disproportionately affected by the SARS-Cov-2. However, The risk of contracting the virus, the incidence of infection, and mortality rates varied greatly between different facilities. This variation has motivated a growing literature examining the association between structural characteristics of LTCFs and COVID-19 outcomes. This paper present the findings of a rapid review of empirical studies investigating the link between ownership status, facility size and staffing, on the one hand, characteristics with COVID-19 outcomes among LTCFs, on the other. The reviewed literature is characterised by the lack of consensus. The review reveals a lack of consensus in the literature. Variation in COVID-19 outcomes is not systematically linked to ownership type, and factors related to facility size and staffing characteristics also show inconsistent associations with the presence of infection cases, infection rates, and mortality. [ABSTRACT FROM AUTHOR]

With population ageing, frailty is an increasingly critical global health matter. Many studies have focused on physical aspects of frailty, but more recently on the psychosocial aspects of frailty. Within western societies frailty is often linked with fear and suffering. This paper outlines a previously understudied perspective; the spiritual dimension in frailty, bringing a holistic view to this complex condition. The paper presents the main findings of a mixed methods study that focused on the lived experience of older people, receiving high-level care living in residential care or at home. Participants (n = 25) were identified as being frail by staff of the residential aged care organisation, and confirmed by psychometric testing. The quantitative component of the study comprised a survey of psychometric measures of mental health, wellbeing and an index of activities of daily living. The qualitative component followed a phenomenological approach, using the Spiritual Tasks and Process of Ageing model (STPA) as a study framework. Analysis focused on the lived experience of participants and where they found meaning in their perceived vulnerability and through self-transcendence, with reports of things they found hardest in life, and inner strength forming the most important themes. [ABSTRACT FROM AUTHOR]

Aim: This study aims to (1) introduce the emergent concept of the retrograde plunge experienced by people living with Alzheimer's disease and (2) illustrate how nurses can accompany those experiencing this phenomenon, as well as their family and formal carers, using the seven‐phase inquiry process proposed by Smith and Liehr. Design: Discursive paper. Methods: After describing the phenomenon and the Story Theory, the 7‐phase Inquiry Process presents the fictional story of Mrs. Lurie, a nursing home resident. Results: Story theory allows nurses to accompany Mrs. Lurie. The emergent concept of retrograde plunge is explained. Different tools such as genograms, story paths and eco‐maps are presented. This discussion demonstrates how some perspectives can contribute to a better description of the retrograde plunge phenomenon. The narrative care approach can help give voices to people experiencing retrograde phenomena. The adoption of a perspective that considers embodied language could help to better understand the needs of a person. Conclusion: There is a lack of consistency and uniformity regarding the understanding of the retrograde phenomenon. This impacts the quality of care for people and the scientific knowledge, research and education of healthcare professionals. This issue should be addressed in future studies. Implications for the Profession and/or Patient Care: This article shows how story theory helps nurses accompany those facing a retrograde plunge phenomenon, helps them tell their own stories and finds a way to resolve the situation. Impact: This article paves the way for further developments that must now be realized by the international community of experts involved in the care of people with Alzheimer's disease, from practical, academic and research perspectives. No Patient or Public Contribution: No patient or public was involved in the design or drafting of the discursive paper. What Problem did the Study Address?: The retrograde plunge is a phenomenon in which people living with Alzheimer's disease return to their past lives and re‐experience with certain events.The retrograde plunge is a well‐known concept that is poorly described in scientific literature and is sometimes misunderstood by families and professional caregivers.This discursive article explains the retrograde plunge phenomenon experienced by people living with Alzheimer's disease. What were the Main Findings?: This article demonstrates how story theory helps nurses and families support people with retrograde plunges.This highlights the lack of consistency and uniformity in this phenomenon, which has implications for the quality of care, education and research.Story theory and the seven‐phase inquiry process proposed by Smith and Liehr (in Middle‐range theory for nursing, Springer Publishing Company, 2023) help to better understand and explain the retrograde plunge phenomenon. Where and on Whom will the Research have an Impact?: This article advances nurses' knowledge in the different fields of practice, teaching and research.This article proposes links among the retrograde plunge phenomenon, embodied language and narrative care approach; this could offer further ways to develop nursing knowledge.This study has the potential to advance the knowledge of practice and education and offers new opportunities for research. Trial and Protocol Registration: There was no trial or protocol registration as this article is a discussion. [ABSTRACT FROM AUTHOR]

Background: Adult Day care centres provide an important aspect of care provision through all phases of the dementia illness from diagnosis to the end of life (Dabelko HI 2008) supporting the well-being of both older people living with dementia and their care partners. Services within adult day care settings are designed to provide biopsychosocial health benefits to participants as well as care partner respite. Objective: To examine research studies, literature reviews and grey literature and identify and map the literature on psychosocial interventions used in day care services for older people living with dementia and chart their use, evaluation and outcomes. The research review question is "what are the psychosocial interventions used in day care service for older people living with dementia?" Psychosocial interventions are important non-pharmacological interventions which support people's wellbeing. Methods: Inclusion/Exclusion criteria were identified and guided the search strategy. Participants were people aged 60 years and over living with dementia attending day care services. The use of psychosocial interventions for this cohort was the focus of the review. Databases were searched (Cochrane Reviews, CINAHL, Embase, Medline EBSCO, Medline Ovid, Medline PubMed, PsycINFO, Scopus, Open Grey, Lenus and WHO Global Index Medicus databases) using keywords/terms with Boolean operators from 2011 to 2023. Rayyan was used to extract and manage the data. Results: The findings present a narrative and charting of the data from the 45 papers that met the review criteria, and this data is mapped onto the five objectives. Within this review, interventions were grouped into five broad types: nature (n = 6 papers), memory/cognitive (n = 11 papers), social (n = 17 papers), animal (n = 4 papers), or physical/sensory (n = 7 papers) based interventions. Conclusions: This review has illustrated the wide variety in the types, range and facilitation of psychosocial interventions within adult day care services. This review highlights the potential benefits of these interventions. However, findings must be considered in the context that many were provided as brief intervention studies with little evidence of continuation after the study and further research is required given the complex and diverse range of interventions. Results will be of interest to practitioners planning to implement or evaluate psychosocial interventions used in day care services for older people living with dementia. [ABSTRACT FROM AUTHOR]

Background: With the increase in the aging population, informal caregivers have become an essential pillar for the long-term care of older individuals. However, providing care can have a negative impact and increase the burden on caregivers, which is a cause for concern. Objective: This study aimed to comprehensively depict the concept of "informal caregiver burden" through bibliometric and content analyses. Methods: We searched the Web of Science (WoS) database to obtain bibliometric data and included only papers published between 2013 and 2022. We used content analysis to extract and identify the core concepts within the text systematically. Results: Altogether, 934 papers were included in the bibliometric analysis, from which we selected 19 highly impactful papers for content analysis. The results indicate that researchers have focused on exploring the factors that impact informal caregiver burden. Meanwhile, there has been a widespread discussion regarding the caregiver burden among those caring for recipients with specific illnesses, such as dementia, Alzheimer's disease, and cancer, as these illnesses can contribute to varying levels of burden on informal caregivers. In addition, questionnaires and interviews emerged as the predominant methods for data collection in the realm of informal caregiver research. Furthermore, we identified 26 distinct assessment tools specifically tailored for evaluating burden, such as caregiver strain index (CSI). Conclusion: For future studies, we suggest considering the intersectionality of factors contributing to the burden on informal caregivers. This approach could enhance the well-being of both caregivers and older care recipients. [ABSTRACT FROM AUTHOR]

In the context of integrating sports and medicine domains, the urgent resolution of elderly health supervision requires effective data clustering algorithms. This paper introduces a novel higher-order hybrid clustering algorithm that combines density values and the particle swarm optimization (PSO) algorithm. Initially, the traditional PSO algorithm is enhanced by integrating the Global Evolution Dynamic Model (GEDM) into the Distribution Estimation Algorithm (EDA), constructing a weighted covariance matrix-based GEDM. This adapted PSO algorithm dynamically selects between the Global Evolution Dynamic Model and the standard PSO algorithm to update population information, significantly enhancing convergence speed while mitigating the risk of local optima entrapment. Subsequently, the higher-order hybrid clustering algorithm is formulated based on the density value and the refined PSO algorithm. The PSO clustering algorithm is adopted in the initial clustering phase, culminating in class clusters after a finite number of iterations. These clusters then undergo the application of the density peak search algorithm to identify candidate centroids. The final centroids are determined through a fusion of the initial class clusters and the identified candidate centroids. Results showcase remarkable improvements: achieving 99.13%, 82.22%, and 99.22% for F-measure, recall, and precision on dataset S1, and 75.22%, 64.0%, and 64.4% on dataset CMC. Notably, the proposed algorithm yields a 75.22%, 64.4%, and 64.6% rate on dataset S, significantly surpassing the comparative schemes' performance. Moreover, employing the text vector representation of the LDA topic vector model underscores the efficacy of the higher-order hybrid clustering algorithm in efficiently clustering text information. This innovative approach facilitates swift and accurate clustering of elderly health data from the perspective of sports and medicine integration. It enables the identification of patterns and regularities within the data, facilitating the formulation of personalized health management strategies and addressing latent health concerns among the elderly population. [ABSTRACT FROM AUTHOR]

Dementia Day Care Centres (DDCCs) are defined as services providing care and rehabilitation to people with dementia associated with behavioural and psychological symptoms (BPSD) in a semi-residential setting. According to available evidence, DDCCs may decrease BPSD, depressive symptoms and caregiver burden. The present position paper reports a consensus of Italian experts of different disciplines regarding DDCCs and includes recommendations about architectural features, requirements of personnel, psychosocial interventions, management of psychoactive drug treatment, prevention and care of geriatric syndromes, and support to family caregivers. DDCCs architectural features should follow specific criteria and address specific needs of people with dementia, supporting independence, safety, and comfort. Staffing should be adequate in size and competence and should be able to implement psychosocial interventions, especially focused on BPSD. Individualized care plan should include prevention and treatment of geriatric syndromes, a targeted vaccination plan for infectious diseases including COVID-19, and adjustment of psychotropic drug treatment, all in cooperation with the general practitioner. Informal caregivers should be involved in the focus of intervention, with the aim of reducing assistance burden and promoting the adaptation to the ever-changing relationship with the patient. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis is a major disease state associated with significant morbidity, mortality, and health care costs. Less than half of the individuals sustaining a low energy hip fracture are diagnosed and treated for the underlying osteoporosis. Objective: A multidisciplinary Canadian hip fracture working group has developed practical recommendations to meet Canadian quality indicators in post hip fracture care. Methods: A comprehensive narrative review was conducted to identify and synthesize key articles on post hip fracture orthogeriatric care for each of the individual sections and develop recommendations. These recommendations are based on the best evidence available today. Conclusion: Recommendations are anticipated to reduce recurrent fractures, improve mobility and healthcare outcomes post hip fracture, and reduce healthcare costs. Key messages to enhance postoperative care are also provided. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA), a prevalent chronic disease among the elderly, presents a complex pathogenesis and currently lacks effective treatment. Traditional observational studies are time-consuming, labor-intensive, susceptible to confounding factors, and cannot establish causal relationships. Mendelian randomization (MR) analysis, leveraging genetic variation to assess causal associations between exposures and outcomes, offers a cost-effective and efficient alternative. Over the past decade, large-scale genome-wide association studies have identified numerous genetic variants linked to OA risk factors, facilitating MR study design. In this review, we systematically identified 52 MR studies meeting specific criteria and evaluated their quality, exploring the impact of lifestyle, nutrition, comorbidities, circulating metabolites, plasma proteins, and other health factors on OA risk. We discuss the results and potential mechanisms of MR findings, addressing conflicting evidence based on existing literature and our prior research. With the ongoing expansion of genome-wide association data, we anticipate MR's role in future OA studies to broaden, particularly in drug development research using targeted MR approaches. We thus aim for this paper to offer valuable insights for researchers and clinicians in related fields. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Stigma associated with care homes has been found to influence residents' lives, and it is a known risk factor for depression among older adults worldwide.Older residents in Asia and particularly, in Thai care homes commonly experience stigma due to being strongly influenced by a traditional cultural paradigm of filial piety.The understanding of how residents perceive and experience the stigma associated with residing in care homes, as well as its link to the development of depression, remains very limited. What does the paper add to existing knowledge?: This research explains the dynamics of the process of the stigma associated with living care homes among Thai older residents.This research highlights the various ways in which stigma impacts residents, their families and care home staff.This study identifies mitigating stigma factors, including social support, coping strategies (karma, mindfulness and religious devotions) and activities that may mitigate perceived stigma associated with care home residency. What are the implications for practice?: There is a compelling need to improve the well‐being of older people living in care homes and to combat the cultural stigma associated with living in care homes through promoting positive attitudes and educational interventions in society, communities and care homes themselves and involving residents' families in the planning and delivery of care for residents. We advocate that the government promotes security and sustainable life for all Thai older adults. Introduction: Stigma associated with living in care homes is a known risk factor for depression among care home residents in Asia, including Thailand. However, little is understood about how such stigma is experienced among residents and care home staff. Aims: To examine older adults' perceptions of stigma and to understand how stigma associated with living in care homes causes or exacerbates depressive symptoms. Methods: A qualitative case study approach was used to gain an in‐depth view of stigma, from two public care homes in northeast Thailand. Data were collected by in‐depth interviews with 50 participants (30 older residents and 20 care home staff), and non‐participant observation was conducted over 1 month. Thematic analysis was used to analyse the data. Results: The study identified three major themes of stigma, comprising the causes of stigma, reactions toward stigma, and mitigating factors. Discussion: Negative beliefs about care homes and residents, contribute to stigma. Residents exhibited negative emotions and behaviours, including depressive symptoms. Residents reported using particular coping strategies that helped them cope with their perceptions of stigma. Implications for Practice: Future research should focus on strategies or research to combat stigma in order to prevent depression and reduce perceptions of stigma. [ABSTRACT FROM AUTHOR]

A lack of personnel in care institutions and high proportions of older people in need of care pose central challenges for today's aging society, often resulting in the hospitalization of geriatric patients. In many cases, these hospitalizations are not medically necessary and cause deterioration of health. Applying telemedicine in nursing homes represents one approach aimed at a reduction of unnecessary hospitalizations of geriatric patients and supporting care personnel in medically uncertain situations. For a sustainable and successful implementation of technical innovations such as telemedical consultations, the care personnel's perspectives and acceptance are especially essential. The Optimal@NRW project implemented telemedical consultations in 24 nursing homes in Germany, investigating medical and economic efficiency and in particular also the social acceptance of digital care in nursing homes. This paper presents quantitative results comparing the acceptance evaluations before (PRE: N = 130) and after (POST: N = 87) the implementation of the telemedical consultations in the nursing homes from the perspective of care professionals. The results showed positive evaluations of the telemedical consultations in both evaluation phases: POST evaluations especially showed a lower evaluation of perceived barriers of using telemedical consultations in nursing homes. This study's insights enable one to derive guidelines and recommendations regarding the communication and information of telemedical applications considering the needs and wishes of care personnel as a central user group. [ABSTRACT FROM AUTHOR]

Extra care housing (ECH) is a type of housing with care and support designed to enable older people to age in place. Approximately one fifth of residents living in ECH are living with dementia and yet, there remains gaps as to how best to support people to live well with dementia in the context. ECH stock across the United Kingdom (UK) includes a diverse range of options that can be grouped into integrated, specialist and separated accommodation. Integrated models involve residents with dementia living alongside residents without dementia. Specialist ECH offer accommodation exclusively for people living with dementia. Separated models offer a separate area for residents with dementia within a larger, integrated site. How these different models work for residents living with dementia is little known and has remained a significant gap in knowledge that impairs both professionals and people living with dementia when choosing housing and care. This paper reports on findings from a large study of residents living with dementia in ECH. The focus is on the potential benefits and challenges of different models of provision. Data were generated from interviews with 100 participants (residents, family members, staff, and adult social care professionals) at eight case study sites across England. Findings demonstrated that there are potential benefits and challenges within each model, but the limited diversity of stock limits choice. Multiple variables beyond the model of provision affect the lived experience, meaning that there is no universal model of optimal support. Rather, the approach and resources of each site is more important than the model of provision. Suggestions for future research directions are considered. [ABSTRACT FROM AUTHOR]

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This paper examines moral dilemmas faced by family caregivers of older adults who employ live-in migrant care workers. Being both a family caregiver as well as an employer of a live-in migrant care worker often puts family members at a crossroad, where moral decisions must be made. Lacking a formal role, family members do not have a professional code of ethics or other clear rules that can guide their actions, and their choices are rooted in cultural, community, familial, and personal values. This paper discusses moral dilemmas that result from family caregivers' dual commitment, to the wellbeing of their older sick relative who is the recipient of care, and to the wellbeing of the live-in care worker whom they employ. The paper uses relational ethics as a theoretical framework to discuss three cases that involve complex moral decision making in real life. [ABSTRACT FROM AUTHOR]

Aim: To analyse the risk factors and incidence of falls in geriatric outpatients in a university hospital ward in Hangzhou, China. Methods: From May 2020 to August 2022, 1712 geriatric outpatients in a university hospital ward in Hangzhou, China, were screened using a socio‐demographic questionnaire (e.g. gender, age, living arrangement, etc.) and assessment scales. The correlation between each factor and falls was preliminarily analysed by chi‐squared tests. Finally, binary logistic regression analysis was conducted to further analyse the risk factors of falls. The STROBE checklist was used in reporting this study. Results: Of the 1712 geriatric outpatients recruited, 1626 participants (60–79 and ≥ 80 years old) with complete questionnaire and assessment data were included. The occurrence of falls for those in the 60–79 age group was 8.4%, and for those in the ≥80 age group it was 13.4%. Age (p =.007), use of a walking assistance device (p <.001), the Stay Independent Brochure Questionnaire (SIB) (OR = 7.751, 95% CI = 5.089–11.806, p <.001), living arrangement (p =.004), timed up and go test (TUGT) (p =.007) and three diseases or above (OR = 2.496, 95% CI = 1.358–11.4.586, p =.003) reached statistical significance. Conclusions: Older people have a high incidence of falls. In this study, age, disease history, SIB scores (≥4 points), living arrangement, TUGT and walking assistance device increased the probability of falls in older Chinese adults. Personalised interventions should be carried out according to the specific situation of older people to effectively reduce their incidence of falls and improve their quality of life. Relevance to Clinical Practice: The basic characteristics and fall risk factors of the older can help nurses identify fall risk, and early intervention by caregivers can reduce fall‐related injuries, which has practical significance for promoting healthy aging. Patient or Public Contribution: The subjects of this study were older patients ≥60 years old, and the demographic characteristics and fall‐related information of patients were obtained by questionnaire. The team worked closely with a team of experts in the field of health care. Some researchers collect data and rewrite them, while other researchers analyse the information and write a paper. All authors read and approved the final manuscript. [ABSTRACT FROM AUTHOR]

Drawing on narratives recorded from family members of residents in long-term care homes in Ontario, Canada, during the 2020 COVID-19 lockdown, in this paper, I present a two-pronged argument. First, following Taylor (2008) and Seaman (2018, 2020) I suggest that family caregiving for residents of longterm care homes helps to sustain residents’ personhood: the recognition of their identity as an ongoing participant in their social universe. The second part of my argument is that caregiving is a multifaceted and paradoxical endeavour. While caregiving can be a transformative and reciprocal practice of selfactualization (cf. Kleinman 2012; Kleinman and van der Geest 2009), at times it can also be troubled, ambivalent, and stressful (Cook and Trumble 2020). At its best, caregiving is a two-way street, enabling the maintenance of personhood for the care recipient, and validating the caregiver’s sense of ‘moral agency,’ or what medical anthropologist Neely Myers (2015, 13) defines as the capacity to be recognized in one’s local sphere as a good person who can make intimate connections to others. When caregiving goes awry, however, it leads to frustration, despair, and a sense of moral failure for the caregiver. For the care recipient, non-recognition and the loss of personhood can lead to social death and may also hasten physical decline. I conclude that for both professional and family caregivers of long-term care residents, systemic improvement of social and material support is needed to mitigate the challenges inherent in the recognition of personhood in caregiving relationships [ABSTRACT FROM AUTHOR]

In this paper, we argue that AI systems for aged care can be paternalistic towards older adults. We start by showing how implicit age biases get embedded in AI technologies, either through designers' ideologies and beliefs or in the data processed by AI systems. Thereafter, we argue that ageism oftentimes leads to paternalism towards older adults. We introduce the concept of technological paternalism and illustrate how it works in practice, by looking at AI for aged care. We end by analyzing the justifications for paternalism in the care of older adults to show that the imposition of paternalistic AI technologies to promote the overall good of older adults is not justified. [ABSTRACT FROM AUTHOR]

Background: A range of strategies are available that can improve the outcomes of older persons particularly in relation to basic activities of daily living during and after an acute care (AC) episode. This paper outlines the original development of outcome-oriented quality indicators (QIs) in relation to common geriatric syndromes and function for the care of the frail aged hospitalized in acute general medical wards. Methods: Design QIs were developed using evidence from literature, expert opinion, field study data and a formal voting process. A systematic literature review of literature identified existing QIs (there were no outcome QIs) and evidence of interventions that improve older persons' outcomes in AC. Preliminary indicators were developed by two expert panels following consideration of the evidence. After analysis of the data from field testing (indicator prevalence, variability across sites), panel meetings refined the QIs prior to a formal voting process. Setting: Data was collected in nine Australian general medical wards. Participants: Patients aged 70 years and over, consented within 24 h of admission to the AC ward. Measurements: The interRAI Acute Care – Comprehensive Geriatric Assessment (interRAI AC-CGA) was administered at admission and discharge; a daily risk assessment in hospital; 28-day phone follow-up and chart audit. Results: Ten outcome QIs were established which focused on common geriatric syndromes and function for the care of the frail aged hospitalized in acute general medical wards. Conclusion: Ten outcome QIs were developed. These QIs can be used to identify areas where specific action will lead to improvements in the quality of care delivered to older persons in hospital. [ABSTRACT FROM AUTHOR]

Aging is a challenging process for people with gender nonconformity. Indeed, the older transgender population faces several disparities in accessing and using health care and social support services. Furthermore, the clinical management of gender transition in later life is empirical since clear research evidence is lacking. This paper aimed to present the problems encountered by older transgender adults in their access to social support and health care and to propose insightful solutions to address them both from a social and medical/nursing perspective. Trans elders face profound disparities in health and social care due to factors associated with limited accessibility to health services, social restrictions, administrative failures, and physical vulnerabilities. The medical treatment of older transgender adults also needs a careful approach to achieve satisfying gender affirmation without clinically significant risks. The potential induction of hormone-sensitive malignancies and the provocation of major adverse vascular events are the main concerns. Gender transition in older adults without a prior history of following gender-affirming therapy is challenging due to biological factors related to advanced age. Caring for elderly trans people unfolds at multiple levels. International organizations and governmental bodies should address the underprivileged status of elderly transgender people by creating and implementing inclusive policies. Safe and respectful clinical and residential environments and the formation of clearer medical guidelines could meet the unique needs of older trans adults. Care providers must advocate for their patients and be equipped to provide safe and effective services. [ABSTRACT FROM AUTHOR]

Introduction: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. The purpose of this paper is to review these recommendations and the Australian Government's policy responses and explore the emerging changes in allied health service provision in residential aged care. Methods: Data from the four available Quarterly Financial Reports from the 2022–2023 financial year were extracted and analysed in relation to staff costs and time per person per day across personal care, nursing, and allied health workers. Supplementary data sources including the 2020 Aged Care Workforce Census were accessed to provide contextual data relating to individual allied health professions, including occupational therapy. Results: The analysis shows a modest increase in median registered nurse minutes per person per day, and cost per person per day, from the first to second quarter, and again in the third and fourth. By contrast, median time and cost for allied health declined. From 5.6 minutes per person per day in the first quarter, reported allied health minutes fell to 4.6 minutes per person per day in the second quarter, an 18% decrease, and by the fourth quarter was 4.3 minutes per person per day. This is just over half the Australian average of 8 minutes reported to the RCACQS in 2019. Conclusion: Under recent residential aged care reforms, aged care providers have regulatory incentives to concentrate their financial resources on meeting the mandated care hours for registered nurses, enrolled nurses, personal care workers, and assistants in nursing. These same reforms do not mandate minutes of allied health services. Although providers of residential aged care in Australia continue to employ and value allied health, we argue that mandating care minutes for personal and nursing care without mandating the provision of allied health creates a perverse incentive whereby access to allied health services is unintentionally reduced. PLAIN LANGUAGE SUMMARY: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. In this paper, we argue that despite the positive intentions of some of the reforms following the Royal Commission, there have been unintended consequences that have reduced the spending on allied health in residential aged care and reduced the minutes residents receive of allied health. Consideration to mandating allied health care minutes in residential aged care should be considered. [ABSTRACT FROM AUTHOR]

Objective: To explore the training needs of the home care workforce in supporting the social and emotional wellbeing (SEWB) of Aboriginal and Torres Strait Islander peoples receiving aged care services through the Home Care Package (HCP) Program. Methods: A mixed-methods design including (1) a focus group and interview with coordinators of HCP Program services for Aboriginal and Torres Strait Islander peoples across metropolitan and rural South Australia in April and June 2022, and (2) a desktop review of training, professional development opportunities and resources for existing and pre-entry workforce addressing the SEWB of Aboriginal and Torres Strait Islander peoples in aged care across the Vocational Education Training and higher education sectors in South Australia, the Australian Indigenous HealthInfoNet, the Department of Health and Aged Care website and aged care email alerts between December 2021 and September 2022. Results: Five themes representing workforce training needs were identified: cultural safety, trauma-informed care, case management, compliance with funding rules and preferred formats for training. The desktop review identified a paucity of formal training, professional development and resources within the context of addressing the SEWB of Aboriginal and Torres Strait Islander peoples in aged care. Conclusions: These findings suggest that ongoing practice-based professional development learning opportunities are needed within organisations to enhance peer-learning and support. These need to be available together with dedicated formal training programs and practical resources on meeting Aboriginal and Torres Strait Islander peoples' SEWB in aged care. What is known about the topic? Supporting social and emotional wellbeing is an important aspect of delivering quality aged care for Aboriginal and Torres Strait Islander peoples. What does this paper add? Insights into workforce training needs which support the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples in home-based aged care. What are the implications for practitioners? Ongoing practice-based learning opportunities, training and resources are needed to enhance peer-learning and support workforce in supporting Aboriginal and Torres Strait Islander peoples' social and emotional wellbeing in aged care. [ABSTRACT FROM AUTHOR]

Background: Elder abuse is a global human rights issue, particularly in residential care settings where there is limited understanding of older people's experiences of this phenomenon. This scoping review aims to map and describe the existing literature on this phenomenon. Methods: Using Arksey and O'Malley's scoping review methodology, further developed by Levac et al. and the Joanna Briggs Institute, a systematic search of six databases was conducted to identify relevant studies published from inception to January 2023. Studies were included if they focused on older people's experience of abuse within residential care settings. A comprehensive data extraction process was employed to identify key themes from the included studies. Results: The initial search yielded a total of 3701 articles of which eight met the inclusion criteria. The findings revealed a range of abusive experiences encountered by older people living in residential care settings, including psychological, physical, financial, neglect and sexual abuse. The common attributes of residents vulnerable to abuse were evident throughout each of the studies. Finally, the theme of organizational neglect was apparent through the absence of effective safeguarding measures in the included studies. The findings revealed the insufficient implementation of safeguarding measures increases the risk of abuse among residents. Conclusion: This scoping review highlights the limited research on the experiences of older people who have encountered elder abuse in residential care settings. The findings stress the need for further research exploring the complex interplay of factors contributing to elder abuse within aged care settings. The insights gained from this scoping review can inform the development of comprehensive safeguarding strategies to prevent and address elder abuse in residential care settings, promoting the well‐being and safety of older people. Patient or Public Contribution: This project is a scoping review of the literature; therefore, no patient or public contribution was deemed necessary. What this paper contributes to the wider global community: Most research on elder abuse has been conducted in the community rather than in Residential Care Settings where there is a limited understanding of older people's experiences of abuse within the published literature.The scoping review highlights the presence of inadequate safeguarding strategies in Residential Care Settings within the reviewed studies, providing recommendations for developing and improving safeguarding measures in Residential Care Settings to prevent abuse, neglect, and harm in the future. [ABSTRACT FROM AUTHOR]

Meeting individuals' social care needs is a core element of UK social policy. However, the conceptualisation and operationalisation of 'unmet need' remain a challenge. This paper advances our understanding by incorporating a temporal dimension into the conceptual framework on unmet need to investigate the dynamics of met and unmet need for social care over time. Using data from Waves 8 and 9 of the English Longitudinal Study of Ageing, this paper examines five possible trajectories among individuals with a social care need for bathing or dressing at baseline: (a) no longer having such a need; (b) having continued needs met; (c) delayed needs met; (d) newly arisen unmet needs; and (e) repeated unmet needs. The results indicate that amongst those with need at baseline, unmet need has decreased over time – indicating that some needs for social care may be fulfilled with a delay. However, a significant proportion of older people experienced repeated unmet needs, particularly those who were younger, with no spouse or civil partner, and those whose activities of daily living index scores worsened over time. Understanding the dynamics of unmet need can support policy makers in better ensuring that those facing an elevated risk of repeated unmet need over time do not fall through the social care safety net. [ABSTRACT FROM AUTHOR]

This paper studies new changes in elderly care in urban areas against the background of population aging with data from the China Social Survey 2021. The study revealed that urban families mainly adopt two models—the "living-with-the-elderly" model and the "providing-economic-support" model—and that there is a substitution effect between the two models. Regarding individual characteristics, younger individuals with higher education levels tend to use the providing-economic-support model instead of the living-with-the-elderly model. In terms of family features, the greater the number of underage children in a family is, the greater the probability of giving economic support and the lower the probability of living with elderly people, reflecting a family resource allocation model centered on "children". This paper further explores the impact of urban female employment on family care model choice and finds that employed women are more inclined to use economic support instead of living with elderly people. The study suggested that the government should gradually improve the public resource support system, promote community service infrastructure development, and expand professional service supply capabilities. [ABSTRACT FROM AUTHOR]

Copyright of New Architecture is the property of New Architecture Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Assistive bathing robots have become a popular point due to their metrics, such as a humanoid working approach in the solution of elder care. However, the abilities of dynamic recognition and path planning are the key to obtain the advantages. This paper proposes a novel approach to recognize and track the dynamical human back, and path planning on it via a 3D point cloud. Firstly, the human back geometric features are recognized through coarse-to-fine alignment. The Intrinsic Shape Signature (ISS) algorithm combined with the Fast Point Feature Histogram (FPFH) and the Sample Consensus Initial Alignment (SAC-IA) algorithm are adopted to complete the coarse alignment, and the Iterative Closest Point (ICP) algorithm is applied to the fine alignment to improve the accuracy of recognition. Then, the dynamic transformation matrix between the contiguous recognized back is deduced based on spatial motion between two adjacent recognized back point clouds. The path can be planned on the tracked human back. Finally, a set of testing experiments are conducted to verify the proposed algorithm. The results show that the running time is reduced by 66.18% and 96.29% compared with the other two common algorithms, respectively. [ABSTRACT FROM AUTHOR]

There is an urgent and unmet need for specialist palliative care services in residential aged care. The Specialist Palliative Care in Aged Care (SPACE) Project aimed to improve palliative and end-of-life care for older people living in residential aged care facilities in Queensland. A representative working group developed a series of service principles around palliative care practice in aged care (comprehensive resident-focused care, streamlined service, and capacity building). Funding was allocated by population to the health services in Queensland to adapt and implement models of care aligned with these principles. SPACE successfully implemented a variety of decentralised models of care across Queensland. The critical elements for the success of SPACE were the use of an expert working group to define the core innovation, networking and implementation support from the central project team and community of practice, and adaptable models of care led by local facilitators. Lessons learned from this real-world case study could be adopted to guide and ensure the successful implementation and sustainability of future complex interventions in healthcare settings, both nationally and internationally. What is known about the topic? There is limited palliative care support for the 36% of Australians who die in residential aged care. What does this paper add? This paper describes the development of the Specialist Palliative Care in Aged Care (SPACE) Project, using locally tailored models of care to improve palliative and end-of-life care in aged care facilities across Queensland. What are the implications for practitioners? Critical elements for improving residents' palliative and end-of-life care included creation of an expert working group to define the innovation state-wide, a central project team that supported implementation, a community of practice, and local facilitation. [ABSTRACT FROM AUTHOR]

This paper examines the tensions and struggles over elder care that are happening in South Africa between family caregivers, care workers and the state. These struggles are experienced and expressed at the familial and community level but are best understood by examining how the state has de-funded facilities in favour of 'ageing in place' without any additional investment in community and home-based care support. The findings reveal that stresses on unpaid and paid carers are expressed in terms of individual failings and interpersonal conflict rather than through a socio-political contextual lens. These findings contribute to how a familialist care regime impacts the everyday personal relationships between paid and unpaid carers of older persons. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Problematic integration theory is a theory in communication that deals with the processing of messages by humans. It is helpful to study challenges and their solutions in the health communication context to develop effective relationships, treat patients, and, ultimately, ensure the well-being of society. A scoping review was conducted. Three databases were searched following the PRISMA‐ScR statement without a time frame. Independent screening of titles, abstracts, and full texts was performed, and the studies selected based on the inclusion and exclusion criteria were assessed. The required information was then extracted from the studies and entered into Excel software. A total of 43 studies related to PI theory were identified in the databases. The results indicated that PI theory is used to interpret feelings, beliefs, challenges, concerns, and problematic dilemmas in five thematic categories: elderly care, cancer care, infertility, pregnancy, and childbirth care, illness care, and sexual care. Each of the papers also offers distinctive and valuable considerations for interventions such as communication strategies, coping mechanisms, uncertainty and certainty management, information management, education, training, support groups, and campaigns to improve decision-making and meet the challenges of health communication. [ABSTRACT FROM AUTHOR]

Hiring migrant live-in caregivers to take care of older adults with dementia, chronic disease or frailty has become more common in Europe, North America, the Middle East, and Asia. When older couples hire a non-relative to provide live-in caregiver services for a family member, the attendant household transformation – from couple to triad – gives rise to social and psychological challenges. Although live-in caregivers can be indispensable, living together can be very stressful for older adults and live-in caregiver. This article describes the emotional distress of two older adult wives in their eighties, and the therapeutic methods used to reduce it, including empathic understanding, legitimation of emotions, promotion of open communication, and formulation of a household 'management strategy,' establishing specific expectations concerning the parties' roles and a daily activity schedule. Involvement of older couples' children was found helpful, and was aided through psychoeducation. Gerontologists, therapists, educators, and social workers who serve the needs of older adults can effectively assist this population in the evolution of their perceptions of their new situation, the regaining of a sense of equilibrium, mastery and control over their lives, and the development of greater tolerance and understanding of migrant live-in caregivers' work burden, native culture, and individual practices. Professionals should actively screen for risks of burden, stress, depression, and anxiety in households in which live-in caregiver services may be considered. Psychoeducation and preparation of both the older adults and their live-in caregivers entering the new relationship may lessen the incidence of potential stressors. Implications: Clinical and Practical implications: Professionals need to triage and diagnose the difficulties and stressors that arise when older couples or their children invite a paid live-in caregiver into the home, changing the day-to-day routine and relationship dynamics of the household. Professionals should actively screen for risk of burden, stress, depression, and anxiety among healthier older spouses, who may feel discomfort and frustration when their independence and privacy are compromised and their primary role seems to be eclipsed by the activity of a paid live-in caregiver. Older adults, their family members, and paid live-in caregivers can benefit from psychoeducation to understand and address emotional difficulties inherent in situations where serious health decline leads to the hiring of a paid live-in caregiver. Following the clinical implications, this paper suggest some practical implications when proving therapy to older adults. It includes outreach and work with the spouses, and if possible with the children of the frail older adult. While frail older adults are usually the primary object of physical and emotional support, their healthier older spouses also require significant emotional support, especially in the early period after a paid live-in caregiver is hired. The children of older adults can be a very useful resource in promoting early intervention and providing continuing support for parents coping with the addition of a paid live-in caregiver to their parents' household. [ABSTRACT FROM AUTHOR]

Objectives Informal care provided by adult children is of great importance for older adults' well-being in China. This paper investigates and compares the functional transitions among older adults living in rural areas who receive care from daughters' and from sons' families. Methods This study utilizes the "Well-being of Elderly Survey in Anhui Province" (WESAP) from 2001 to 2021. Our sample included 2,797 individuals aged 60 years or older. Functional status was based on the activities of daily living and the instrumental activities of daily living. We employed a random-effects ordered logit model to examine the functional transitions among the older adults. Results Receiving care from daughters' families is significantly associated with a lower likelihood of functional decline compared to receiving care from sons' families in rural China. The advantage associated with daughter care becomes more pronounced among older individuals with a severe functional difficulty compared to those with a mild or moderate functional difficulty. The difference is prevalent among older adults aged 75 and older, with less wealth or multiple chronic diseases, or who live alone. Furthermore, among those with severe functional difficulties, the daughter advantage is more significant for fathers as compared to mothers. Discussion Nowadays, daughters' families can provide high-quality informal care, often surpassing that offered by sons' families. This daughter advantage becomes even more significant among older adults who have a higher need for family care, such as those with severe disabilities and limited financial resources. [ABSTRACT FROM AUTHOR]

The future welfare of older adults is a worldwide concern. By 2034, it is estimated that individuals 65 and older in the U.S. will be 77 million. Consequently, this reality will impact healthcare facilities and increase Medicare and Medicaid costs, resulting in higher incidents of homeless older adults, children caring for parents, the need for more caregivers, and an increased number of older individuals experiencing various forms of dementia. To address these concerns, the current trend for treating the onset of dementia and Alzheimer's disease has been moving toward nonpharmaceutical interventions. Even though researchers have tapped into the benefits of several nonpharmaceutical treatments, there appears to be a constant debate on establishing which method is most effective. Deciding on best practices and methods to slow down and/or halt the progression of dementia is the gap this research needs to fill. To provide clarity on the topic, an analysis of alternative interventions to treat the onset of dementia is what this paper strived to achieve. The analysis involved comparing and contrasting the benefits of each intervention as well as illustrating the implications of the findings. In this regard, a systematic review was conducted examining the benefits of five nonpharmaceutical strategies; mental training, music therapy, technology usage, physical activity, and social interaction. Although findings revealed some form of improvement in each of the nonpharmacological interventions examined, the overarching theme appeared to lean toward providing mental stimulation. It was also not conclusive that physical activity prevented cognitive decline. More research is recommended. [ABSTRACT FROM AUTHOR]

The International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee aims to improve the use of drugs in older adults and develop new therapeutic approaches for the syndromes and diseases of old age through advocacy, education, and research. In the present paper, we propose strategies relevant to drug development and evaluation, spanning preclinical and the full range of clinical studies. Drugs for older adults need to consider not only age, but also other characteristics common in geriatric patients, such as multimorbidity, polypharmacy, falls, cognitive impairment, and frailty. The IUPHAR Geriatric Committee's position statement on 'Measurement of Frailty in Drug Development and Evaluation' is included, highlighting 12 key principles that cover the spectrum of translational research. We propose that where older adults are likely to be major users of a drug, that frailty is measured at baseline and as an outcome. Preclinical models that replicate the age, frailty, duration of exposure, comorbidities, and co‐medications of the proposed patients may improve translation. We highlight the potential application of recent technologies, such as physiologically based pharmacokinetic–pharmacodynamic modeling informed by frailty biology, and Artificial Intelligence, to inform personalized medicine for older patients. Considerations for the rapidly aging populations in low‐ and middle‐income countries related to health‐care and clinical trials are outlined. Involving older adults, their caregivers and health‐care providers in all phases of research should improve drug development, evaluation, and outcomes for older adults internationally. [ABSTRACT FROM AUTHOR]

Objective: This scoping review aimed to explore topics on which the views of residents of Australian residential aged care facilities (RACFs) have been sought. Methods: Scoping review methodology as outlined by Arksey and O'Malley was used to identify, explore and report on the range of literature regarding views of RACF residents. Seven electronic databases were searched using broad search terms relevant to the RACF context. Descriptive numerical analysis was completed for publication year, journal name and target profession, research methods and participant types. Thematic analysis then focussed on the aims of the included studies. Results: Four thousand two hundred and ninety studies were screened, and 104 publications met the inclusion criteria. A broad range of topics were explored by researchers, with the largest number of papers focused on residents' views of systems within RACFs (n = 24) and new programs and interventions (n = 21). Smaller topic areas included health conditions and health‐care services (n = 13), socialisation (n = 13), physical activity (n = 3), self‐care (n = 4), leisure (n = 4), general everyday life (n = 20) and aspects of the residential aged care environment (n = 15). There was limited exploration of meaningful activity (n = 13). The inclusion of residents with cognitive impairment was inconsistent, and the voices of other stakeholders were often privileged. Conclusions: Voices of residents must be heard in order to prioritise the health and well‐being of this population. More research which focuses on what is important to residents is needed and must include residents with cognitive impairment more effectively. Identification of optimal research methods with this population would make an important contribution in this area. [ABSTRACT FROM AUTHOR]

The pandemic has undoubtedly affected almost every aspect of life for people around the world. However, the most affected are older adults living in developing countries like India. In fact, the second wave of the pandemic in India was the most devastating wave so far. Now that the worst appears to be over, there is a need to study the impact of the pandemic on the wellbeing of older adults recovering from the virus in the country. Hence, the aim of the present study is to examine the long-term impact of covid 19 on older adults, its connection with wellbeing, and the role of social workers in their recovery. A total of 203 older adults from India took part in the study. The results show that the majority of the respondents have poor wellbeing and have been more frequently plagued by chest pain, fatigue, and isolation, ever since they became infected. Moreover, respondents who are female, those with co-morbidities, and are suffering from other problems such as frequent chest pain, fatigue, and feelings of isolation, have lower levels of wellbeing. The implications of social work practice have also been discussed in the full paper. [ABSTRACT FROM AUTHOR]

In the context of current and expected demographic changes, the issues of which services the welfare state should offer and, ultimately, the very function of the welfare state are currently debated in Norway. The political discourse on health and care services for older adults has morphed into an accepted reality in which the system must be altered, prompting policy makers and stakeholders to find new and novel solutions to problems associated with population ageing. In this paper, we discuss one such proposed solution: the transformation of health and care services for the older adult population through the increased involvement of volunteers. We ask how volunteer efforts are articulated and delineated through official accounts and discuss the implications of such an articulation and delineation. We seek answers to these questions through a critical discourse analysis of recent governmental white papers. We investigate, in other words, volunteer efforts as a political instrument. We argue that the official representation of how efforts in health and care services should be re-aligned take the form of a distinct discourse of 'voluntarism'. Within this 'voluntarism', volunteer efforts have been altered from a third sector comprising charity and non-profit organisations that contribute within or as a supplement to the largely public-run welfare system to a limitless and extensive concept that is blurring the boundaries to informal care. [ABSTRACT FROM AUTHOR]

Background: The ageing of the population has become an escalating problem in China, which has led to an increasing demand for healthcare throughout society. The care services of elderly institutions, as a more mature way of aging, can alleviate various social problems brought about by ageing to a certain extent. The aim of this paper is to explore the degree of acceptance of institutional care by rural elderly people in Shandong Province and the factors that influence whether rural elderly people accept institutional care services. Methodology: Based on the theory of planned behavior, an analytical framework was constructed for the willingness of rural elderly people to receive nursing services from elderly care institutions. Using survey data from 192 rural elderly people in Shandong Province, descriptive statistics, binary logistic regression, and horizontal comparative analysis methods were used to analyze the willingness of rural elderly people to provide for the elderly and its influencing factors. Result: Only 17.71% of respondents expressed willingness to receive services from elderly care institutions. Among them, education level, trust in elderly care institutions, and support from adult children have a significant positive impact on whether rural elderly people receive nursing services from elderly care institutions; The number of children, the level of understanding of elderly care institutions, neighbors' choices of elderly care methods, and their ability to contribute to the family have a significant negative impact on whether rural elderly people receive nursing services from elderly care institutions. There are significant differences in the willingness and influencing factors of rural elderly people to provide for the elderly among different regions. Conclusion: The non-acceptance of institutional care by rural older people is a general phenomenon rather than a sample characteristic, thus justifying the supplementary status of institutional care services. The pension intention of the rural elderly in Shandong Province is obviously affected by personal will factors, and the influencing factors are various. The traditional concept of old-age care in Shandong province has a strong path-dependent effect on the choice of the rural elderly. There is heterogeneity in the willingness and influencing factors of the rural elderly in different regions and countries. Based on this, this paper puts forward the following suggestions: strengthen the spiritual and cultural construction of residents; The government should pay attention to the correct guidance of public opinion; And increase pension subsidies. It is hoped that reduce the burden of national elderly care through these suggestions. [ABSTRACT FROM AUTHOR]

Assessing nutritional status in older people is essential to screen for malnutrition and identify the individuals requiring nutritional intervention for a better quality of life and longer life expectancy. This review aimed to investigate malnutrition and the role of nutritional assessment tools among older people in Malaysia. We systematically reviewed the publications from 2000 to 2019 using PubMed/MEDLINE and Scopus databases, recovering 15 original articles published until January 2022. This systematic review was conducted from May to September 2022. Two reviewers were involved in the process of the selection of articles and data extraction. Only research papers on malnutrition among older people in institutionalized settings in Malaysia were included. Four articles related to malnutrition in older people in old folk homes in Malaysia were included in this review. The tools with the most significant evidence were Mini Nutritional Assessment (MNA) and Nutritional Health Checklist (NHC) in residential care for the elderly. It was found that the incidence of malnutrition among the elderly in old folk homes in Malaysia ranged from 12.3% to 17.4%. Meanwhile, 40.4% to 57.7% of the population are documented to be at risk of malnutrition. NA and DETERMINE NHC were found to be most suitable for use in residential care due to their high sensitivity and specificity. A subsequent study is proposed to build and implement a scoring system to rate screening tools based on the validity, suitability, and practicability of the tools to help with malnutrition screening research and clinical practice in Malaysia and internationally. [ABSTRACT FROM AUTHOR]