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The aim of the paper is twofold: 1. To present observations based on first-year nursing students' narratives during clinical rotation in gerontological nursing care; and 2. Explore a nursing educator's reflections on these observations in relation to the didactic and ethical challenges that occurred. The teaching of ethics is included in nurse education worldwide. Students are in their first clinical placement in residential care of older persons confronted with the moral complexities of gerontological care, where they get little possibility to share emotions and thoughts about ethically challenging nursing situations with a supervising registered nurse. A critical discussion paper. The educator's reflections in this discussion paper are based on a narrative assignment in ethics where first-year nursing students reflect on and describe a nursing situation during their clinical rotation in the residential care of older persons. Most students were acting as mere spectators in the described nursing situation where an older person, ethical standards, or evidence-based care was violated. Some students acted as advocates to the older person and intervened in the situation and a few as inspirers showing alternative ways of handling ethically challenging situations. Educators in nursing programs at the undergraduate level require time for student-centered formative guidance to foster moral courage and practice. During first-year students' clinical rotation, the learning goals in long-term residential care of older persons are focused on evidence-based basic nursing care. In this, students are confronted with ethically challenging situations, where the possibility to learn from a critical reflective practice is rare. When observing situations where an older person is subjected to unethical or unsafe nursing care it is common that the students take the spectators' role, not knowing how to deal with what is observed. Some students are taking an intervening role by trying to alleviate the vulnerability of the older person. A few are showing moral courage by directly intervening when experiencing unethical or unsafe nursing care or conduct. In this the student can inspire fellow students or staff during their clinical rotation in alternative ways of handling ethically challenging situations. As older persons are the largest demographic group that nurses will experience, educators need a sound knowledge of ethics as well as gerontological care to be able to meet and nurture students' ethical reflections during clinical practice and to foster practical wisdom in nursing. [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]

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]

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]

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 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: 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 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]

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]

Purpose: The goal of integrated, multidisciplinary and person-centered care is on the welfare policy agenda in many countries, but how about integrated service delivery in action? This paper describes a three-year service journey of an elderly person from home to a nursing home through home care, specialized hospital and inpatient care. The aim of this viewpoint paper is to consider how customer orientation and integration are realized when an older lady living an active life becomes seriously ill and loses the ability to conduct daily functions. Design/methodology/approach: The service path will be described from the perspective of a relative. Findings: The paper raises questions related to governance as well as multidisciplinary and customer orientation in integrated care. Originality/value: The paper discusses a real-life experience of an elderly care journey from active senior life to a nursing home in Finland. When making visible an elderly care journey, this gives real-life information about the challenges and the needs for development. Better practical understanding helps to remove inter-organizational barriers toward more integrated and patient safe care. [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: To study the relationship between three variables, namely, the number of supermarkets around, the average distance to medical institutions designated to be covered by basic medical insurance, and the presence of parks around, and the sustainable development of elderly care institutions.Patients and Methods: This paper is based on the census database of elderly care institutions in Beijing. We ran a self-developed Python program to mine the database after adding three variables, namely, the number of supermarkets around, the average distance to medical institutions designated to be covered by basic medical insurance (hereinafter referred to as "designated medical institutions"), and the presence of parks around, and then used the least squares method in regression analysis.Results: The number of years of depreciation for fixed assets had some degree of influence on the occupancy rate of an elderly care institution under sustained operation. The occupancy rate of above 80% was efficient for an elderly care institution. There was a progressive relationship between the external spatial factors and the internal resources of an elderly care institution in terms of influencing the occupancy rate of the institution. Optimizing the spatial distribution of elderly care institutions should first optimize the choice of location.Conclusion: The occupancy rate of an elderly care institution was closely related to the convenience of living conditions and that site selection was crucial for such a facility. We arrived at two recommendations for the future development of elderly care institutions, 1. Reducing the number of the institutions in areas with unfavorable geographic positions and serving senior care needs within an appropriate close distance, so as to better optimize the spatial distribution of senior care facilities, improve the efficiency of resource allocation. 2. Strike a balance between the economic benefits of operating entities and the social benefits associated with older people. [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]

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]

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]

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]

Purpose: The digital age requires people of all ages to communicate and organise their lives through digital technologies. The project EQualCare investigates how the growing population of older people living alone is managing this transition, how it shapes their (non-)digital social networks and what changes on a local level need to be brought about. This paper aims to give insight into the process of participatory action research (PAR) with older people in the community across four countries and reflects on experiences made by academic and co-researchers. Design/methodology/approach: Following the emancipatory underpinnings of PAR, which aims to reduce inequalities through collaboration and co-design, EQualCare involved nine teams of co-researchers across Finland, Germany, Latvia and Sweden making older people the centre of policy development. Co-researchers were involved in formulating research aims, collecting data, reflecting on data, formulating and disseminating recommendations for local policy stakeholders. Findings: Co-researchers' motivation to invest considerable time and effort was driven by a desire to create a more equal future for older people living alone. Moreover, they were keen to involve marginalised older people and became frustrated when this proved difficult. Power dynamics played a role throughout the process but became productive as roles and responsibilities were renegotiated. Doing PAR with older people can be emotionally challenging for co-researchers when negative feelings around ageing are encountered. Originality/value: The paper advances understanding on the process of PAR in ageing research by reflecting on the social, cultural and political contexts of doing PAR with diverse sets of older people. [ABSTRACT FROM AUTHOR]

Digital transformation in healthcare improves the safety of health systems. Within our health service, a new digital hospital has been established and two wards from a neighbouring paper-based hospital transitioned into the new digital hospital. This created an opportunity to evaluate the impact of complete digital transformation on medication safety. Here we discuss the impact of transition from a paper-based to digital hospital on voluntarily reported medication incidents and prescribing errors. This study utilises an interrupted time-series design and takes place across two wards as they transition from a paper to a digital hospital. Two data sources are used to assess impacts on medication incidents and prescribing errors: (1) voluntarily reported medication incidents and 2) a chart audit of medications prescribed on the study wards. The chart audit collects data on procedural, dosing and therapeutic prescribing errors. There are 588 errors extracted from incident reporting software during the study period. The average monthly number of errors reduces from 12.5 pre- to 7.5 post-transition (p < 0.001). In the chart audit, 5072 medication orders are reviewed pre-transition and 3699 reviewed post-transition. The rates of orders with one or more error reduces significantly after transition (52.8% pre- vs. 15.7% post-, p < 0.001). There are significant reductions in procedural (32.1% pre- vs. 1.3% post-, p < 0.001), and dosing errors (32.3% pre- vs. 14% post-, p < 0.001), but not therapeutic errors (0.6% pre- vs. 0.7% post-, p = 0.478). Transition to a digital hospital is associated with reductions in voluntarily reported medication incidents and prescribing errors. [ABSTRACT FROM AUTHOR]

Person-centred care (PCC) in residential care facilities (RCFs) is valuable but creates challenges for care professionals balancing involvement and a partnership approach for residents while considering the health and safety outcomes of all residents. This review evaluates what is known about the substance use and misuse of residents living in RCFs and what is important to study in future research to enhance PCC, especially in cases in which residents wish to choose unhealthy behaviours. A scoping review was conducted and exclusion criteria were set. The included papers were assessed on methodological quality using the Mixed Methods Appraisal Tool and the results were qualitatively analysed. The included papers consisted of studies regarding alcohol, tobacco and illicit drugs. The results showed that care professionals are involved in facilitating and regulating alcohol and tobacco. The focus of the included papers is on alcohol and tobacco. Five of the 16 papers assessed the residents' perspective. This review highlights the importance of incorporating the perspectives of residents, care professionals and the organisation to enhance PCC and enable residents to make shared and well-informed decisions in dialogue with care professionals. Future research should also assess the distinction between substance use and misuse, and how this affects implementing PCC in RCFs. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim was to conduct a synthesis of the literature on value‐creating care for older persons with incontinence provided with toileting assistance and containment strategies, from the perspectives of older persons and healthcare professionals. Background: Incontinence is a health problem for many persons worldwide and the problem will increase as the global population ages. It can have a profound impact on a person's wellbeing, and assistance with toileting and containment strategies is common in home care settings and nursing homes. Design: The design was a literature review with an iterative, reflexive and critical approach. Methods: A critical interpretive synthesis was conducted. Ten papers published between 2011 and 2019 were analysed. The PRISMA ‐ScR Checklist was used in this review. Results: Based on the findings, the conceptual construct 'The art of connectedness' was developed, built on co‐created care, personalised care and reflective care between the older person and healthcare professionals. Co‐created care is based on establishing a relationship, building trust and respecting preferences. Personalised care consists of meeting the person's needs, promoting comfort and maintaining self‐determination. Reflective care entails showing empathy, upholding the person's dignity and developing professional competence. Conclusions: Value‐creating care consists conceptually of a connectedness that starts with co‐creating the care together with the older person in a close relationship. Assistance is given and received based on the older person's individual needs and is highly valued by the older person as it helps them maintain self‐determination. Reflective care is of importance for healthcare professionals. Relevance for practice: The findings are hoped to enhance healthcare professionals' understanding of how to improve the clinical encounter in nursing when providing assistance. They may also stimulate critical reflection among healthcare professionals on how to improve assistance to meet the older person's values. [ABSTRACT FROM AUTHOR]

Introduction: Australia's population is ageing, resulting in more older adults living in residential aged care facilities. Occupational therapy scope of practice in Australian residential aged care facilities is significantly influenced by the government funding instrument. As the current government funding instrument is administratively inefficient, insufficiently discriminates between residents' care needs and provides perverse incentives, a new funding model is set to be implemented. This creates an opportunity for a review of the current evidence base to support the lobbying of national associations to shape occupational therapy practice. The research question that guided this systematic mapping review was as follows: What is the current state of scholarship about occupational therapy in Australian residential aged care facilities? Methods: A search of four databases (CINAHL, Medline, Embase and Scopus) was conducted and 1,617 papers were identified. All papers were screened through a two‐phase process: (i) title and abstract review and (ii) full text review, using pre‐determined inclusion and exclusion criteria to identify papers relevant to this review. A data extraction tool was designed in Microsoft Excel® and was used to extract data from the included papers. Results: Twelve Australian articles were published between 1986 and 2020, most frequently authored by an occupational therapist. Included articles were classified into four groups: articles including occupational therapists as participants, articles about occupational therapy practice, articles exploring an occupational perspective of residents and articles with limited exploration of occupational therapy. Conclusion: This review identified that there is a dearth of Australian occupational therapy literature. This creates challenges for occupational therapists seeking evidence to guide their practice to optimise resident health and well‐being and for national associations seeking to lobby for the profession. Consequently, there is a crucial need to develop the evidence base to support the profession within this practice setting and, ultimately, residents. [ABSTRACT FROM AUTHOR]

Select research has indicated that widespread migration is catalysing the novel reimagining of eldercare and transformative changes in the local eldercare economy in the Global South. Yet research on ageing and migration from the South has largely focused on transnational care practices of providing emotional support and economic remittances. Drawing on ethnographic research among the privileged and affluent community of Syrian Christians of Kerala, India, I argue for a diverse and complex Southern reconfiguration of eldercare at the intersection of migration, which also includes 'market transfer' of proximate care services as reciprocal filial care. Further, the paper illuminates how specificities of migration, ageing and care are locally nuanced and shape diverse transnational care practices. In turn, transnational care strategies employed by the migrants to overcome distances transform the local eldercare economy and (re)produce class-stratified eldercare spaces. Through the study of a privileged community, the paper highlights the increasing marketisation of the eldercare landscape in the sending countries of the South and contributes to furthering diversified understandings of the ageing-migration nexus. [ABSTRACT FROM AUTHOR]

With interest growing in social robots for older people, it is crucial to consider how robots can be designed to support wellbeing and ethical values in residential aged care. By applying Tronto's ethics of care framework and the Care Centred Value-Sensitive Design methodology to existing literature, this paper investigates how caring values are expressed, achieved, or undermined in interactions among older adults, caregivers, and social robots in real-world aged care practices. We conducted a comprehensive review of 18 qualitative and mixed-method studies on the deployment of humanoid social robots in residential aged care settings. Our analysis of the literature through a care ethics lens identified ways in which robots may either augment or limit care. The analysis particularly highlights the ethical importance of effective collaboration among robots, caregivers, and designers. We argue that a care ethics framework can enhance such collaboration and thereby promote good care. We further propose four design principles to guide designers in integrating care ethics into robot design requirements. These practical principles should help to promote the wellbeing of both residents and caregivers in aged care. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to critique and evaluate need-driven dementia compromised behavior theory and the health behavioral model using Meleis' (2010) criteria of theory evaluation. Design/methodology/approach: Theory critique using Meleis' (2010) criteria of theory evaluation. Findings: This paper provides a conclusion about each theory in terms of agitation in the elderly. Meleis's (2010) criteria will be used for both theories to evaluate different components such as the relationship between structure and function, diagram of the theory, circle of the contagiousness, usefulness and external components. Originality/value: The critique of the two theories broadened the nurses' understanding of the connection between the NDB model and the behavior symptoms, including agitation and its related issues. Further studies need to be conducted to shed light on the other aspects of the behavioral symptoms in elderly with dementia that supports the results of this study, like its specific causes, trigger factors and other intervention strategies. Nurses should be able not only to understand the patient's behavior symptoms but also to decode them into communication signals to meet their needs in a more effective way. [ABSTRACT FROM AUTHOR]

Purpose: Despite continuing workforce challenges over the last decade, the social care system is considered a key enabler in keeping older people out of hospital. In response to the workforce challenges, White Paper was released, which acknowledged the opportunities afforded by digital technology to assist older people ageing at home, often supported by informal caregivers. Given the policy emphasis on digital-enabled care, the most appropriate methods for evaluating its impact on social care outcomes have yet to be determined. The purpose this study was to review the current literature using a systematic approach to understand the methodological limitations to inform more robust evaluations in their use in future research. Design/methodology/approach: This scoping review used a systematic approach adopting the framework of Arksey and O'Malley to examine studies examining the adoption of digital technologies to assist in older people's ability to age in place. Findings: The 21 relevant studies identified on digital technology to assist ageing-in-place are evolving. To date, it has focused on the efficacy and usability of the digital technologies themselves rather than investigating the impact of such technologies on re/enablement outcomes for older people. To rebalance this emphasis, there needs to be more research investigating the factors that enhance useability of digital technologies by older people and exploiting narrative data gained from qualitative research as they can provide valuable insights. Originality/value: To the best of the authors' knowledge, this is the first scoping review to consider qualitative methodological approaches for exploring ageing in place. [ABSTRACT FROM AUTHOR]

The phenomenon of population aging in rural China presents a compelling societal challenge, necessitating a growing demand for both the quantity and quality of facilities supporting the needs of older people. However, a lack of comprehensive understanding concerning the underlying mechanisms that drive the emergence of these facilities, coupled with the distinctive historical backdrop and social development stage of the nation, engenders complexities in achieving sustainable rural eldercare services. This paper endeavors to comprehensively elucidate diverse eldercare facility types in rural China, delineating their intrinsic characteristics and prerequisites for construction. Additionally, the research delves into the political and economic contexts and advancements in healthcare and eldercare services, culminating in the formulation of an integrated framework that interconnects eldercare support patterns with the political landscape and public service provisions. The implications derived from this nuanced framework provide insightful reflections on significant historical transitions, intricacies faced by rural eldercare facilities, and strategic pathways for fostering future eldercare service delivery systems and allied facilities. The paper's findings furnish insights for bolstering the well-being of the aging population in rural China and lay a substantive foundation for addressing the evolving requisites of eldercare within this distinctive context. [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]

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]

The development of smart elderly industry is an inevitable way to cope with the aging of the population. This research takes the smart elderly care service supply chain as the object, combines the social emotional choice theory for the first time, and uses the time perception to refine the elderly care demand into future-orientation demand and present-orientation demand. This paper analyzes the coordination effect of suppliers' efforts to meet the needs of the elderly under the two conditions of no contract and benefit-sharing contract on the dual-channel supply chain of smart elderly care services. The results show that the benefit-sharing contract is more conducive to maximizing the profit of the supply chain, and the segmentation of elderly demand is conducive to giving full play to the advantages of dual-channel differentiated services, which is conducive to forming a win-win situation of improving the service efficiency of the smart elderly service supply chain and increasing the happiness index of elderly users. The main contributions of this paper are: Using geriatric behavioral psychology to analyze the motivation of the elderly and designing the service effort level index considering the needs of the elderly. Match online and offline channels with personalized services to give full play to the "smart" effect. Based on the game method of Hotelling and Stackelberg, the coordination and optimization of the smart elderly care services dual-channel supply chain, considering the needs of the elderly are realized. This is of great research significance for maximizing the benefits of the smart elderly service supply chain and promoting the development of the smart elderly industry. [ABSTRACT FROM AUTHOR]

Objective: The objective of this scoping review is to identify factors that influence the implementation of innovation in aged care. Introduction: Aged care is a dynamic sector experiencing rapid change. Implementation of innovations in aged care has received relatively little research attention compared with health care. Inclusion criteria: This review included studies of any design that examined the implementation of innovations in aged care settings. Methods: Searches were conducted in MEDLINE, CINAHL, AgeLine, and ProQuest Social Sciences Premium Collection for studies published between January 1, 2012 and December 31, 2022. The titles and abstracts of retrieved citations were screened by two independent reviewers. Full-text articles were screened by one reviewer to determine eligibility. Data were extracted in NVivo using a tool developed by the research team. Factors that influenced implementation were inductively coded, interpreted, and grouped into categories. Results: Of the 2530 studies that were screened, 193 were included. Of the included papers, 74% related to residential aged care, 28% used an implementation theory or framework, and 15% involved consumers. Five key categories of factors influencing implementation were identified: organizational context, including resourcing and culture; people's attitudes and capabilities; relationships between people; the intervention and its appropriateness; and implementation actions, such as stakeholder engagement or implementation strategies. Conclusions: Our findings can be used to develop practical resources to support implementation efforts, and highlight the importance of resourcing for successful implementation. Attention to community-based aged care and greater engagement with theory and community are needed to promote research rigor, relevance, and applicability. [ABSTRACT FROM AUTHOR]

This special issue examines how older adults anticipate and manage their futures through migration. Although ageing is often associated with decline towards the end-of-life, it is still a life stage where (the lack of) planning for the future can profoundly impact the life outcomes of older adults and their caregivers. This collection illustrates different ways migration can impact ageing. For some, perceptions and depictions of the future lead older adults to turn to migration to improve their prospects of ageing well although they continue to face constraints while ageing abroad. For others, the migration of younger family members exacerbates the stress of eldercare felt by non-migrant caregivers. Collectively, the papers focus on how countries in Asia function as source and destination sites for ageing-related migration, while also forging transnational connections with the Global North. Focusing on ageing futures allows us to link the current and future lives of migrants and non-migrants, across generations and space. [ABSTRACT FROM AUTHOR]

Background: Based on the Chinese model of medical-elderly care integration, this paper aims to explore the impact of different investment levels on the performance of the medical-elderly care integrated institutions.Methods: Using the method of system dynamics, this paper establishes the performance evaluation model of medical-elderly care integrated institutions, sets the system element input, service level, and policy support as the key factors, and uses Vensim PLE software for simulation.Results: The three key factors have different degrees of positive impact on the performance of medical-elderly care integrated institutions. On the whole, policy support has the most significant impact on the performance of institutions, followed by the level of medical-elderly care integrated services. Institutional input mainly has a great impact on the performance of institutions in the early stage. In addition, the model simulation results also show the emergence effect: the improvement rate of institutional performance under the comprehensive simulation is higher than the sum of the improvement rates under the separate action of single factor.Conclusion: Government policies have played an important role in promoting the development of medical-elderly care integrated institutions. The service level and resource input can effectively promote the performance of medical-elderly care integrated institutions. Institutions should formulate development strategies from a systematic perspective, and pay attention to the integration of "medical" and "elderly care" resources. [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]