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In recent years, the use of Serious Games has become increasingly popular in the field of Digital Health. These games, which are designed to educate, inform, and engage users in various aspects of healthcare, have shown promising results in improving health outcomes and promoting healthy behaviours. Serious Games have shown particularly promising in the care of elderly populations. In fact, with the ageing of the global population, there is an increasing need for innovative solutions that can help older adults stay healthy, active, and independent. In this context, Serious Games have emerged as a valuable tool for promoting healthy ageing, preventing age-related diseases, reducing info-exclusion, and improving the quality of life of older adults. This paper explores the conceptualisation of a Serious Games model focused on the elderly population in a Digital Health environment. The model covers the identification and levels of eventual phase of disease allowing the definition of profiles for patients and non-patients; enables the recognition of the need for therapy and recognizes a set of characteristics like usability, accessibility and functionality considered by the state-of-the-art guidelines as essential in the definition of the Serious Games structure. The paper discusses the potential benefits and challenges of using a Serious Games model in this context. [ABSTRACT FROM AUTHOR]

Background: The paper aims to explore the elderly caregiving process in India from the perspective of both elderly as well as working women care providers, along with the challenges faced and the coping strategies adopted by them during the process. Methods: In-depth interviews with 48 participants (care providers and care receivers) from 25 multi-generational households were conducted in the slums of Mumbai and analysed using QSR-NVivo-10. Results: Working women care providers supported the needs of the dependent elderly along with performing household chores and paid work. However, the way the care was perceived and demanded, was not often same as delivered by the care providers. Care provider suffered silently with poor social, physical and emotional welling in absence of support system and lack of time. Sometimes, physically exhausted care providers unknowingly resorted to elderly abuse and neglect. At the same time, a bidirectional flow of support from elderly also existed in the form of childcare, household chores and financial support. Though caregiving overstrained the care providers, strong family ties, acknowledgement of the contributions of the elderly during their young days, and the desire to set a precedent for the young generation did not let them step back from their duties. The main coping mechanism for both care receivers and providers was largely centred around the notion of acceptance of their situation. Conclusion: Conversations between generations can help in enhancing family ties and reduce conflicts. The support of family and community can also ease the burden of caregiving. [ABSTRACT FROM AUTHOR]

Background: pilot projects in healthcare serve as strategic tools for introducing innovations, including new diagnostic methods, therapies, and technologies. ensuring patient safety and treatment efficacy is paramount, making effective risk management essential. failure in this area can jeopardize the reputation and trust of the medical community. Aim of the study: This study presents and discusses the risks and risk management strategies in a pilot project implementing telemedicine solutions in geriatrics. Materials and methods: The key risks and remedial actions in a pilot telemedicine project in geriatrics were analyzed. Systematic analyses covered various areas such as technological, financial, legal, organizational, external, clinical, and competency domains. Results: The telemedicine project targets geriatric syndromes like frailty, sarcopenia, and malnutrition, aiming to improve care for the elderly. This paper discusses risk management aspects, remedial actions, and potential implications for further research and practices. Conclusions: Collaboration among medical teams, primary care physicians, geriatric specialists, and assistants, supported by strong administrative coordination, is crucial for effective risk management. This collective effort enables swift deployment of remedial actions and ensures project success. [ABSTRACT FROM AUTHOR]

Objective: The study examined emergency department (ED) presentations, unplanned hospitalisations and potentially preventable hospitalisations in older people receiving long-term care by type of care received (i.e. permanent residential aged care or home care packages in the community), in Australia in 2019. Methods: A retrospective cohort study was conducted using the Registry of Senior Australians National Historical Cohort. Individuals were included if they resided in South Australia, Queensland, Victoria or New South Wales, received a home care package or permanent residential aged care in 2019 and were aged ≥65 years. The cumulative incidence of ED presentations, unplanned hospitalisations and potentially preventable hospitalisations in each of the long-term care service types were estimated during the year. Days in hospital per 1000 individuals were also calculated. Results: The study included 203,278 individuals accessing permanent residential aged care (209,639 episodes) and 118,999 accessing home care packages in the community (127,893 episodes). A higher proportion of people accessing home care packages had an ED presentation (43.1% [95% confidence interval, 42.8–43.3], vs 37.8% [37.6–38.0]), unplanned hospitalisation (39.8% [39.6–40.1] vs 33.4% [33.2–33.6]) and potentially preventable hospitalisation (11.8% [11.6–12.0] vs 8.2% [8.1–8.4]) than people accessing permanent residential aged care. Individuals with home care packages had more days in hospital due to unplanned hospitalisations than those in residential care (7745 vs 3049 days/1000 individuals). Conclusions: While a high proportion of older people in long-term care have ED presentations, unplanned hospitalisations and potentially preventable hospitalisations, people in the community with home care packages experience these events at a higher frequency. What is known about the topic? Unplanned hospitalisations and emergency department presentations are frequent and burdensome for older people receiving long-term aged care. What does this paper add? While unplanned hospitalisations and emergency department presentations were high in all people receiving long-term care, these events were higher in people receiving home care packages than those in residential aged care. What are the implications for practitioners? Further efforts to address the high unplanned hospitalisations and emergency department presentations experienced by the increasing number of older adults accessing home care packages are required to allow this population to remain at home successfully. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Purpose: The demand for long-term home care services has been increasing in Taiwan due to the significant growth of the older population. In order to understand the crucial roles that language and communication play in providing better long-term home care services in Taiwan, this study aims to adopt a gerontological sociolinguistic perspective to investigate how professional care workers communicate with older people in this context. Design/methodology/approach: Interviews were conducted with 58 long-term home care workers to identify their communication accommodation strategies for older people, considering their health conditions (dementia), personalities (grumpiness), living status (loneliness) and general principles of long-term home care communication. Findings: The study's findings provide practical insights for long-term home care workers to enhance their communication skills while interacting with older people. Research limitations/implications: The results could contribute to improving the quality of care services provided to older people and address their specific communication needs. Originality/value: To the best of the author's knowledge, this paper is the first attempt to identify contextually specific communication accommodations to older people in existing literature of gerontological sociolinguistics that addresses language, communication and older age. The salience of the findings in this study can be further enhanced if they were applied in the development of training programs for future Taiwanese long-term home care workers. [ABSTRACT FROM AUTHOR]

In recent years, under the influence of multiple factors such as traditional ideas and living economic conditions, the aging population in China continues to increase. Most of the elderly are more inclined to aged at home, and the first places for elderly activities are communities and the surrounding environment, which greatly affects the convenience of life and happiness of the elderly. In this paper, Changxindian area in Fengtai District of Beijing was as the research object, and detailed calculation and analysis were carried out by using POI data and arcGIS software. The relative location of residential areas and surrounding public toilets was explored, and the best location of public toilets in the daily walking area under the model of community home-based care for the elderly was further studied. [ABSTRACT FROM AUTHOR]

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The population in Singapore is ageing, adding pressure to community care as the health and social needs of its residents increase. This has accelerated the pace at which Regional Health Systems adopt and deliver its population health strategies from early prevention, chronic disease management, crisis care to end-of-life care. To this end, the Central Health Integrated Care Network (ICN) began its journey to develop Communities of Care (CoCs) with other health and social care partners to meet the needs of residents in the Central Zone of Singapore. This paper describes the processes and steps taken by Central Health ICN to build partnerships with other agencies and organisations to build place-based models of care in the local neighbourhoods. The faciliating factors and the barriers faced in the implementation of CoCs were described to allow sharing of such learnings on large scale change. Strategies in overcoming some of the challenges were also presented to demonstrate the iterative processes required in building integrated place-based models of care to meet the needs of the residents in different communities. [ABSTRACT FROM AUTHOR]

Access to allied health services offers significant benefits for people living with dementia, yet access is currently fragmented and inconsistent. The 2023–2024 budget allocated AU$445 million to further enable general practice-led, multidisciplinary teams, with integrated care located within practices, including employment of allied health professionals. Such team care models are recognised by The Royal Australian College of General Practitioners as vital to delivery of high-quality care for older adults. They are especially relevant for over 250,000 Australians who live with dementia in the community. However, not all allied health professionals are currently based within general practices. Future, sustainable general practice-led models of multidisciplinary care that connect patients with external allied health providers could be considered for a comprehensive and collaborative approach to care. Our focus is on people living with dementia, who are at greater risk of preventable vision impairment. Poor vision and/or ocular health can be detected and managed through regular eye examinations, which are predominantly delivered by community-based optometrists in Australia, in a primary care capacity. However, people living with dementia are also less likely to have regular eye examinations. In this paper, we highlight the value of ensuring access to primary eye care services as part of post-diagnosis dementia care. We illustrate the important role of primary care practitioners in building and sustaining connections with allied health professions, like optometry, through effective referral and interprofessional communication systems. This can help break down access barriers to dementia-friendly eye care, through promoting the importance of regular eye tests for people living with dementia. Access to allied health services offers significant benefits for people living with dementia, yet access is currently fragmented and inconsistent. People living with dementia are at greater risk of experiencing vision impairment, preventable through regular eye examinations usually provided by community-based optometrists in a primary care capacity. We encourage all primary care practitioners to 'think vision' when consulting with people living with dementia, and advocate for a schedule of regular eye tests post-diagnosis. This article belongs to the Collection Access to Primary Health Care. [ABSTRACT FROM AUTHOR]

Purpose: Perceptions of ageing towards the self and towards others can positively and negatively impact an older adult's mental wellbeing. This paper aims to consolidate literature examining the relationship between perceptions of ageing and depression in older adults to inform both practice and policy for older adult mental health services. Design/methodology/approach: Quantitative research articles examining perceptions of ageing and depression in older adults were identified through searches on three electronical databases, alongside forward and backwards citation searches. A total of 14 articles involving 31,211 participants were identified. Findings: Greater negative attitudes towards ageing were associated with higher levels of depressive symptoms and greater positive attitudes towards ageing were associated with lower levels of depressive symptoms or higher levels of happiness. However, the causal direction of this relationship could not be determined. Studies demonstrated that perceptions of ageing also act as a moderator in the relationship between depression and health status, hopelessness and personality traits. Future research should attempt to examine the relationship between perceptions of ageing and depression in older adults to attempt to identify the causal direction of this relationship. Originality/value: This is the only systematic review the authors are aware of consolidating literature which explores the relationship between older adults' perceptions of ageing and depression. It is hoped that these findings will be able to inform both policy and practice to improve older adults' care and support for depression. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe the perceptions that older people in Argentina have about the use of cell phones and to analyze their influence on user behavior. At the same time, it was intended to analyze whether sociodemographic factors influence these perceptions. Design/methodology/approach: The authors conducted a study with a non-experimental, cross-sectional and cross-correlational design; a non-probabilistic sample of 138 intentionally selected older people was chosen. Findings: The frequency and years of cell phone use, as well as the applications used, are influenced by the perceptions that older people have about cell phone use. In addition, it was found that age, gender and socio-educational level determine the perceptions that older people have about cell phone use. Originality/value: This research has implications for interventions aimed at improving older people's functional health. Understanding the perceptions of older people in relation to technology will enable the enhancement of its utility to foster an autonomous lifestyle and social integration in old age. [ABSTRACT FROM AUTHOR]

Background: With the intensification of China's aging population, the demand for elderly care services has become increasingly prominent. At the same time, rapid development of internet technology provides more convenience and possibilities for the elderly. However, the coordinated development between the internet and elderly care services still faces challenges. This study aims to measure the level of coupling and coordinated development between the internet and elderly care services in China, and analyze the influencing factors, in order to provide reference for promoting elderly care services. Methods: In this paper, the entropy method and coupling coordination degree model were used to measure the coupling coordination development index of the internet and elderly care services in China from 2012 to 2021. In addition, considering that the coordinated development between the two is affected by many factors, the Tobit model was used to analyze the main factors affecting the integration of the internet and elderly care services. Results: (1) The coupling and coordination of the Internet and senior care services is in its infancy, but the coupling and coordination of the two is on the rise, and there is still a lot of room for development in the future. (2) In terms of time scale, the coupling coordination development level between the internet and elderly care services in China has gone through three stages of "disorder recession-transition coordination-coordinated development". (3) In terms of influencing factors, government management ability has a more positive impact on the development of the integration of the Internet and senior care services, financial support, scientific and technological investment and the level of innovation play a mild pulling role, while the level of informatization to a certain extent restricts the level of integration of the Internet and senior care services. Conclusion: In order to promote the coordinated development of China's Internet and senior care services, it is necessary to comprehensively understand the current situation and development space of China's Internet and senior care services coupling coordination degree, accurately grasp the dynamic trend of China's Internet and senior care services coupling and coordinated development, promote the stage of leapfrogging, and fully consider the influencing factors, so as to realize the optimal allocation of policies and resources. These measures will help to promote a more coordinated and sustainable development of the internet and elderly care services in China. [ABSTRACT FROM AUTHOR]

The rapid growth of the elderly population has led to an increased demand for effective and personalized eldercare solutions. In this paper, the design and development of an eldercare robot is presented. This robot is specifically tailored to meet the two specific challenges faced by the elderly. The first is the continuous indoor tracking of the elder, while the second is the fall detection. A comprehensive overview of the hardware and software components, as well as the control architecture of the robot is presented. The hardware design of the robot incorporates a range of features, including a perception system comprising a 2D Lidar, IMU, and camera for environment mapping, localization, and fall detection. The software stack of the robot is explained as consisting of layers for perception, mapping, and localization. The robot is tested experimentally to validate its path planning capability by using Hector SLAM and the RRT* technique. Experimental path planning has shown a positioning accuracy of 93.8% on average. Elderly fall detection is achieved by using the YOLOv7 algorithm at a percentage of 96%. Experimental results have been discussed and evaluated. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic added to collective concerns, making health risks salient especially for the older population. The health emergency exacerbated an already widespread negative representation of aging, and phenomena such as ageism. With the present qualitative inquiry, 21 episodic interviews were collected with the aim of understanding the experience of older adults in residential care facilities, exploring their ideas of aging and the viewpoints that helped them to respond to the pandemic successfully. A thematic analysis was conducted using NudIst software. The results show that participants described multiple personal and relational resources they used to cope with the pandemic, and they were able to express counter-narratives to the ideas of aging as coinciding with decline, and of lockdown as a source of distress alone. The paper concludes with reflections on the relevance of research capable of challenging unhelpful dominant discourses and averting the risk of them turning into negative prophecies. [ABSTRACT FROM AUTHOR]

Background: With the growing challenge of an aging population, emerging technologies are increasingly being integrated into the production, organization, and delivery of aged care services. Geographic Information System (GIS), a computer-based tool for spatial information analysis and processing, has made significant strides in the allocation of care recources and service delivery for older adults, a notably vulnerable group. Despite its growing importance, cross-disciplinary literature reviews on this theme are scare. This scoping review was conducted to encapsulate the advancements and discern the future trajectory of GIS applications in aged care services. Methods: A comprehensive search across nine databases yielded 5941 articles. Adhering to specific inclusion and exclusion criteria, 61 articles were selected for a detailed analysis. Results: The 61 articles span from 2003 to 2022, with a notable increase in publications since 2018, comprising 41 articles (67% of the total) published between 2018-2022. Developed countries contributed 66% of the papers, with 45% focusing on accessibility issues. In the domain of aged care services, GIS has been predominantly utilized for model construction, mapping, and site selection, with a growing emphasis on addressing the unique needs of different subgroups of older adults. Conclusion: The past two decades have seen substantial growth in the application of GIS in aged care services, reflecting its increasing importance in this field. This scoping review not only charts the historical development of GIS applications in aged care services but also underscores the need for innovative research approaches. Future directions should emphasize the integration of GIS with diverse methodologies to address the heterogeneous needs of older adults and improve the overall delivery of aged care services. Such advancements in GIS applications have the potential to significantly enhance the efficiency, accessibility, and quality of care for the aging population. [ABSTRACT FROM AUTHOR]

The detection of Activities of Daily Living (ADL) holds significant importance in a range of applications, including elderly care and health monitoring. Our research focuses on the relevance of ADL detection in elderly care, highlighting the importance of accurate and unobtrusive monitoring. In this paper, we present a novel approach that that leverages smartphone data as the primary source for detecting ADLs. Additionally, we investigate the possibilities offered by ambient sensors installed in smart home environments to complement the smartphone data and optimize the ADL detection. Our approach uses a Long Short-Term Memory (LSTM) model. One of the key contributions of our work is defining ADL detection as a multilabeling problem, allowing us to detect different activities that occur simultaneously. This is particularly valuable since in real-world scenarios, individuals can perform multiple activities concurrently, such as cooking while watching TV. We also made use of unlabeled data to further enhance the accuracy of our model. Performance is evaluated on a real-world collected dataset, strengthening reliability of our findings. We also made the dataset openly available for further research and analysis. Results show that utilizing smartphone data alone already yields satisfactory results, above 50% true positive rate and balanced accuracy for all activities, providing a convenient and non-intrusive method for ADL detection. However, by incorporating ambient sensors, as an additional data source, one can improve the balanced accuracy of the ADL detection by 7% and 8% of balanced accuracy and true positive rate respectively, on average. [ABSTRACT FROM AUTHOR]

(1) Background--The forest tourism industry and the elderly care industry influence and support each other in terms of resource factors, industrial layout and policy linkage, which lays the foundation for the coupling and coordinated development of the two industries. In recent years, forest tourism has been vigorously developed in Northeast China, while population aging has been deepening. Exploring the coupling and coordination law between the forest tourism industry and the elderly care industry in Northeast China can provide theoretical reference and decision support for the coordinated development of the two industries. (2) Methods--The research data in this paper were mainly from "China Statistical Yearbook", "China Civil Affairs Statistical Yearbook", "China Forestry and Grassland Statistical Yearbook", as well as the statistical communiques on the national economic and social development of Heilongjiang, Jilin and Liaoning provinces during 2013-2022. This paper firstly constructed an evaluation indicator system for the development level of the forest tourism industry and elderly care industry. Then, the entropy method was used to measure the weight of each indicator, and the linear weighting method was used to calculate the comprehensive evaluation values of the two industrial subsystems. Finally, the coupling coordination degree model was used to calculate the degree of mutual influence of the two industries in Northeast China and determine the coupling and coordinated development status of the two subsystems. (3) Result--First, the average of the overall development index of the forest tourism industry in Northeast China is 0.4911, which is significantly higher than the comprehensive development index of the elderly care industry 0.375 8. Second, on the whole, the coupling coordination degree of the forest tourism industry and elderly care industry in Northeast China is low, and the coupling coordination degree of the two industries has changed from the near imbalance stage to the mild imbalance stage. Third, there are obvious differences in the coupling coordination degree of the two industries in different provinces. According to the grade standard of coupling coordination degree, it can be seen that the coupling coordination degree of the two industries in Heilongjiang Province is at the critical coordination level, the coupling coordination degree of the two industries in Liaoning province is at the near imbalance level, and that of the two industries in Jilin Province is at the moderate imbalance level. (4) Conclusions and Discussions--First, change the development concepts, attach importance to the coupling development between industries and the top-level design and overall planning of the two industries. Encourage the use of forest ecological resources to develop tourism, strengthen the construction of scenic spot infrastructures, improve the elderly forest tourism industry system, clarify industry norms, and formulate a standard system and supervision system. Second, deepen the supply-side structural reform, guided by industrial demand. Build a full-chain forest tourism and health care service system for the elderly, strengthen the construction of high-quality forest tourism scenic spots and summer resorts, and create high-quality forest tourism routes suitable for the elderly. Third, based on advantageous industrial resources, promote industrial optimization and coordinated development. The high-quality resources of the forest tourism industry will accurately cover the growing elderly group, extend the industrial value chain, and build an industrial supply and demand service platform. [ABSTRACT FROM AUTHOR]

Background Telehealth technologies are playing an increasing role in healthcare. This study aimed to review the literature relating to the use of telehealth technologies in care homes with a focus on teledentistry. Methods Khangura et al.'s (Evidence summaries: the evolution of a rapid review approach. Syst Rev 2012; 1 :10) rapid review method included an electronic database search on Embase, PubMed, Web of Science and OpenGrey. Out of 1525 papers, 1108 titles and abstracts were screened, and 75 full texts assessed for eligibility. Risk of bias was assessed using the Mixed Methods Assessment Tool 2018. Results Forty-seven papers (40 studies) from 10 countries, published 1997–2021, were included in the review, four studies related to teledentistry. Whilst some preferred in-person consultations, perceived benefits by stakeholders included reduced hospitalization rates (n  = 14), cost-savings (n  = 8) and high diagnostic accuracy (n  = 7). Studies investigating teledentistry using intra-oral cameras reported that teleconsultations were feasible with potentially high diagnostic accuracy (n  = 2), cost-savings (n  = 1) and patient acceptability (n  = 1). Conclusion There is limited published research on teledentistry, but wider telehealth research is applicable to teledentistry, with findings suggesting that telehealth technologies play a role in care homes consultations that are acceptable, cost-saving and with potential diagnostic accuracy. Further research is needed on the mode, utility and acceptability of teledentistry in care homes. [ABSTRACT FROM AUTHOR]

This paper investigates the planning of virtual ward (VW) capacity including the remote monitoring of frail and elderly patients. The main objective is to optimize VW hub locations across a region in the United Kingdom. Furthermore, assigning the optimal number of clinicians to different regions needs to be considered. We develop a mathematical model that minimizes the setup and travel costs of VW hubs and staff. Our experimental analysis evaluates different levels of demand considering postcode areas within different Trusts, also known as Health Boards, in the National Health Service (NHS). Furthermore, our experiments provide insights into how many hub locations should be deployed and staffed. This can be used to individually find the number of remote monitors and clinicians for each facility as well as the system overall. [ABSTRACT FROM AUTHOR]

As the number of the elderly population and the population dependency ratio increase year by year, the issue of old-age care has become the focus. However, due to the shortage of carers and the large-scale and expensive auxiliary equipment for the elderly, it is difficult to give thoughtful care to all the elderly. In view of the above background, this paper designs a set of intelligent nursing system for the elderly based on artificial intelligence (AI) algorithms, which mainly includes sensor terminals and AI processing algorithms. Among them, the sensor terminal mainly includes two parts: video monitoring and human biological signal monitoring. For video surveillance signals, this paper uses scene event detection algorithm to detect abnormal events, so as to automatically perceive possible unexpected situations. For human biological signals, such as heart rate, blood pressure, and pulse, the abnormal detection is carried out through data analysis and comparison with the normal index range. So, the possible problems in the physical state of the elderly can be judged in time. Through more comprehensive state monitoring and reliable algorithm processing, the system can effectively solve many hidden dangers in the current elderly care and provide a feasible solution for smart nursing. [ABSTRACT FROM AUTHOR]

Robotic pets (RPs) are being increasingly used with older adults to address behavioral and psychological symptoms of dementia, and as a companion in aged care facilities. Main benefits include increased well-being and better social interactions. To date, little is known about the use of RPs by healthy older adults outside institutional settings. The aim of this paper is to map the research about the use of RPs in community-dwelling healthy older adults considering the users' perspectives. A scoping review was performed using four databases (Academic Search Complete, Web of Science, PubMed, and SCOPUS), searching for papers published until May 2021. A final selection of ten documents was submitted to thematic analysis. The participants in the studies were all potential users (not actual users, since RPs were still in development). Main findings point to three themes concerning the main expected characteristics of RPs from the perspective of community-dwelling healthy older adults: (i) like reals pets, but with less maintenance; (ii) performing multiple functions, with customizability; (iii) facilitators of interactions without promoting social stigma. Community-dwelling older adults seem open to use a RP as long as it promotes their well-being without facilitating ageism. More research is needed regarding the ethics of using robotics companion pets and comprising a person-centered approach. [ABSTRACT FROM AUTHOR]

At present, there is an increasingly serious phenomenon of rural aging and mutual support for the aged in China. Taking this as the background and opportunity, this paper discusses the feasibility and realization path of the further development of the rural mutual support model based on the results of the field investigation of the mutual support network, including the study of mutual support relationship and spatial network. This paper proposes to analyze the internal mechanism by sorting out the internal driving forces and potential resources of mutual assistance and to construct a framework of rural elderly support system that meets the requirements of the mutual care model for the elderly from the three dimensions of operation, function, and space. It provides a development idea for the study of the elderly support system in the same type of rural areas. [ABSTRACT FROM AUTHOR]

When the elderly enter the old age, their physical functions gradually decline; their physical strength, vision, and hearing are weakened; and their self-care ability gradually decreases with the increase of age. At the same time, it is accompanied by different degrees of anxiety and psychological problems. The rapid development of virtual reality technology in recent years provides a way to solve this problem, and high-performance computer and processing technology are the keys to directly affect the performance of the system. The existing research is more about the material and spiritual life of the elderly, but the research on their psychological status is relatively insufficient. From the perspective of mental health, this study makes a comprehensive and objective empirical study on the psychological status of family elderly. Based on virtual reality (VR), by extracting heart rate variability (HRV) features from the elderly, this paper establishes a model to identify the psychological pressure of family elderly, which solves the problem that the elderly have adverse effects on their body, mind, and life due to long-term psychological pressure. The paper analyzes the accuracy of KNN, CNN, and RFC models in identifying three psychological stress states: relaxation and low-pressure state, relaxation and medium-pressure state, and relaxation and high-pressure state. When the pressure is higher, the accuracy of the three models will be better than that of the lower pressure state. Under high pressure, the accuracy of CNN and RFC is close, but RFC is slightly better than CNN, and the accuracy of RFC model is as high as 95.02%. [ABSTRACT FROM AUTHOR]

Purpose: Japan, the world's "oldest" society, has adopted intergenerational care programmes as one solution to the challenges of caring for its growing population of people living with dementia. Many countries are drawing inspiration from these intergenerational programmes, but research exploring factors influencing intergenerational care practice and how far these programmes can be translated in other countries is more limited. This paper aims to explore how environmental design features are used to support intergenerational initiatives in Japan. By examining four case studies, the paper illustrates how intergenerational engagement can be enabled and supported through environmental design. Design/methodology/approach: The research adopts a qualitative methodology, using observations, workshops and photographic elicitations within four case study sites: two residential care facilities, a community centre and supported housing scheme and a restaurant staffed by people with dementia. Findings: Two key themes emerge: encouraging community engagement through intergenerational shared spaces, and the role of intergenerationality in supporting social and economic participation. The paper concludes with a discussion of some of the key principles through which other countries can translate lessons gained from the Japanese experience of intergenerational programmes into their own health and social care systems. Originality/value: This paper provides international evidence of the role environmental design plays in supporting the development of intergenerational relationships among people with dementia and the wider community. Intergenerational engagement is community engagement; therefore, promoting community engagement is essential to promoting intergenerational care practice. Environmental design can play a key role in providing affordances through which such relationships can develop. [ABSTRACT FROM AUTHOR]

Background: To meet the needs of diversified pension services and the construction of aged care institutions is one of the urgent livelihood issues in China. Under the major national needs of pension and care for the elderly, it is necessary to optimize the allocation of pension and care for the elderly resources, and formulate operational coping strategies and optimization plans. It is of great significance to deal with the urgent problem of population aging in a timely and scientific way. Methods: The economic benefits and social costs of aged care institutions are regarded as objective functions. To satisfy the economic benefits, it is necessary to reduce the social costs, and its construction quantity can only be an integer. The multi-objective genetic algorithm is improved with integer programming, and the global optimal solution is achieved after several times of searching. Under the multi-objective optimization model, the improved genetic algorithm was combined with the superior and inferior solution distance method to solve the genetic algorithm, and the corresponding objective function value was obtained after rounding. Finally, Pareto optimal solution set is selected by multi-objective decision, and the result of construction planning is obtained. Results: Based on multi-attribute decision analysis and taking three years as the construction cycle, the planning scheme of aged care institutions construction in each district of Nanjing in the next 15 years was proposed. In addition, considering the intelligent trend of future pension, the proportion of home-based pension is increasing year by year, and the model is promoted to meet the needs of diversified pension services. With the gradual increase of the elderly population in Nanjing, the proportion of intelligent home-based care has been increasing year by year since 2027, and the construction demand of aged care institutions has also increased. The number of construction at all levels rises gradually in each cycle, and the increase is more obvious after 2027. Conclusions: The layout and planning of aged care institutions proposed in this paper not only considers economic and environmental benefits, but also combines the current situation of aged care institutions in various districts of Nanjing. The model is reasonable and effective, and has practical application value. It will help China optimize the allocation of elderly care resources under the target of active aging, and scientifically and comprehensively deal with the problem of population aging. [ABSTRACT FROM AUTHOR]

The literature on older migrants often focuses on identifying the characteristics of ethnic groups that constitute 'barriers' for members of these populations to access care. This paper offers an alternative conceptualisation of access to care, by combining relational approaches to place and the notion of super-diversity. From this perspective, 'access to care' is perceived as an outcome of an individual's embeddedness in relationships of care in urban places. The objective of the study is to identify relationships of care that facilitate access to aged care for older first-generation migrants. Thirty-two semi-structured interviews were conducted with older migrants who were residents of Nijmegen or The Hague, The Netherlands. All interviewees had accessed home care, home aid and/or day care. Both relationships with minority-specific services and informal relationships of care, particularly those within local minority communities, were found to facilitate access to aged care. Past experiences with health and social care were also found to influence current relationships with formal care providers. This study, therefore, suggests that policy makers and care organisations should build long-term positive relationships with new and incoming migrant groups. In addition, it argues that policy makers and care providers should identify locally relevant shared migration-related (rather than ethnic) identities around which communities can be mobilised and targeted with appropriate services. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to highlight current finding issues relating to the provision of hospice care services which are largely provided by the independent sector and heavily reliant on charitable fund raising. The primary focus is on the UK, but it is an issue of relevance to many other countries around the world. Design/methodology/approach: The paper is an opinion piece informed by contemporary reports, official publications and research findings, as well as the author's own work within the hospice sector. Findings: As with many other countries around the world, the bulk of hospice funding in the UK comes from charitable donations of various kinds. However, the impact of COVID-19 highlighted both the fragility of this funding model and the precarious nature of hospice sector finances currently. Practical implications: This is an issue of growing importance that affects older people and their families not only in the UK but in all countries with ageing populations. Hospices play an important role in providing end-of-life care and, with demand for services steadily rising due to demographic trends, there are important questions about the sustainability of the current hospice funding model. Social implications: Issues of funding require a much higher level of engagement from policymakers if hospice care is going to continue to play a significant part in achieving a good death for people from all sections of society. Originality/value: Although hotly debated within the hospice sector and in official reports, this issue has yet to be properly examined within academic circles. [ABSTRACT FROM AUTHOR]

In this paper, we analyze the changes in family structure and explore the changes in detail, based on which we construct a neural network model of smart aging. Based on the gender perspective, the individual growth model in the multilayer linear model is used to examine the effects of family structure changes on the elderly in terms of economic exchange, daily care, and emotional support. The results show that there is no significant gender difference in the family structure changes on the elderly in terms of economic exchange and daily care, but there is a significant gender difference in terms of emotional support. To solve the problem of data imbalance in the daily activity categories of the elderly, this paper resamples the data and uses different neural network models for activity recognition of the sensor data generated from the daily activities of the elderly. In this paper, the daily behavior patterns of the elderly over a while are studied by correlating three conditions of time distance, optimal path, and sensor distance to discover the daily behavior patterns of the elderly, while the abnormal behavior patterns can be well separated by EM clustering algorithm. The daily behavior of the elderly is a coarse-grained representation of their daily activities. It is not limited to a specific activity and does not require the sensor ID, trigger time, and location triggered by the activity to be consistent, but in long-term daily activity data, it abstracts the general behavior rules of the elderly activities. Through the research of this paper, the existing system is improved, and the multifaceted needs of the elderly are fully considered, from housing needs to spiritual needs, to face the current elderly care problems with a positive attitude, create a good social elderly care environment for the elderly, and realize the real elderly care. [ABSTRACT FROM AUTHOR]

This paper reports on one finding of a qualitative study using interpretive phenomenological analysis (IPA) in a mixedmethods study examining the relationship between leadership style and job satisfaction in Australian aged care employees. The qualitative data suggest that aged care employees are experiencing moral distress relating to the regulatory environment that governs the aged care sector and the compliance processes adopted by regulators and accreditors. One of the reasons for the design and operationalisation of the regulatory environment is to protect vulnerable consumers, the public and the workforce. However, the findings of this research are that it is this environment that also causes damage to the aged care workforce. The question is whether compliance requirements and the regulatory scheme are a shield or sword. The causes of the moral distress were different for leaders and raters. This paper reports on this finding. Moral distress is one of three undesirable outcomes identified in the study and labelled as Workplace Maladies. Moral distress due to regulatory systems and processes experienced by leaders appears to be caused by different factors than the moral distress experienced by raters. Leaders experienced moral distress because of the system and methods of regulatory and standards compliance. In contrast, their followership experienced other regulatory processes such as the scope of practice for health professionals and the requi rement to supervise and accept responsibility for unregulated workers who do not have a scope of practice. Unregulated workers reported that the absence of scope of practice is a cause of moral distress. Recommendations are made for changes to the system and processes of compliance assessment and action and for developing a scope of practice for unregulated workers to reduce the moral distress experienced by aged care employees and thus reduce workforce turnover in an already scarce workforce. [ABSTRACT FROM AUTHOR]

Skin‐like sensitivity, or the capability to recognize tactile information, is essential for future robots in elder care, search and rescue, entertainment and other applications involving unstructured environments. In this paper, we propose the design of a flexible one‐dimensional pressure‐sensing system that can localize deformation along a long strip and measure its magnitude with an integrated pair of sensors. The sensor system is fabricated with piezoresistive conductive foils and copper sheets encapsulated by adhesive tape with a total thickness of 0.7 mm. For the purpose of demonstration, the sensor is used to monitor the location and magnitude of kink deformation of an inflatable tube. Finite‐element modeling and simulation are conducted to investigate the behavior of the soft sensor system when subjected to kink deformation. The model‐predicted sensor output achieves good agreement with the experimental data for different deformation magnitudes. Finally, extensive experiments on a sensor prototype with dimensions of 35 × 500 mm mounted on an inflatable tube are conducted to demonstrate the capability of the proposed scheme in simultaneous measurement of deformation location and magnitude. It is shown that the specific design approach minimizes the coupling of location and magnitude measurements, resulting in minimal complexity for data processing. [ABSTRACT FROM AUTHOR]

The activities of care are often regarded as intimate and highly dependent on personal, relational and cultural contexts of care provision. In this paper, I explore how migrant care workers who do not share in the cultural logic and norms understand and mediate the expectations of intimacy in care work with their personal meanings and values in caregiving. Through multiple in‐depth interviews with 50 Filipino care workers and 1‐month of intensive fieldwork in a long‐term care facility, this paper unpacks the meanings and negotiations of intimacy in the care work of Filipino migrants in Japan. This paper analyzes intimacy in four dimensions: spatial, cultural, corporeal, and relational. It finds that Filipina care workers understand and negotiate intimacy in the care of the elderly Japanese by embodying cultural intimacy, mediating vulnerability and maintaining boundedness, attuning with the aged body, and articulating familial care. The findings offer the possibility for transformative caring relations when migrant care workers exercise intimacy in their care of the elderly residents in the institutional setting. [ABSTRACT FROM AUTHOR]

Purpose: As employed carers tend to experience work interruptions and conflict between work and care, especially women, this paper aims to assess the availability and accessibility of carer-friendly workplace policies (CFWPs) in Quebec workplaces. Design/methodology/approach: An online survey was distributed to members of the Association of Human Resources Management Counsellors in Quebec. The authors used a validating quantitative data design. The data was collected between October 2019 and the end of February 2020 and the questionnaire yielded 122 valid responses. Findings: Adult/elder care responsibilities remain systematically perceived less important than childcare or general work-life balance needs. The current distribution of CFWPs within Quebec workplaces is unlikely to ensure carers sufficient support to prevent or significantly mitigate negative repercussions. Notable differences were found between organization type and size. Practical implications: There is a need for expanding CFWPs through increased support services, educational workshops, broader access to flexible work arrangements and manager training. Social implications: The results support recent research findings pointing that women with caring responsibilities face important opportunity costs and risk falling in precariousness. Carers should be able to maintain a social income from other sources to compensate a reduced activity on the labor market. Originality/value: By investigating the availability of CFWPs in Quebec workplaces, this paper adds insights regarding the availability and access to CFWPs regionally and in small and medium size workplaces, rather than identifying best practice from workplaces across the globe. Workplace policies are analyzed for adult/elder care specifically. [ABSTRACT FROM AUTHOR]

As Singapore confronts escalating demands for eldercare labour in the face of rapid ageing, families are increasingly resorting to market-based, gender-normative options predicated on the care-chain migration of women to resolve familial care deficits. At the same time, given the prevalence of discourses of Asian familialism, the abdication of eldercare responsibilities to non-familial caregivers whose labour is purchased through market transactions often raises social anxieties decrying the decline of filial piety. This paper explores the way eldercare work is choreographed around gendered performances of intimate labour by different household members as families work through market solutions and moral dilemmas around eldercare. Following conceptualisation of the intimate that configure it along lines of mobility, emotion, materiality, belonging, alienation, we use the term intimate labour to refer to work involving embodied interactions that shape the social reproduction of everyday life. The paper is based on in-depth interviews with 34 elderly persons 'cared for' by foreign domestic workers and 35 foreign domestic workers employed to 'care for' the elderly. First, we examine the way families articulate the care logics behind the everyday division of intimate labour between live-in foreign domestic workers and spatially proximate family caregivers. Second, we show how the daily choreography of intimate labour and exchange among different household members folds into reshaping and relativizing affinal connections between 'carer' and 'cared-for' in the global household. Ultimately, we argue that home-based eldercare serve to rigidify the gendered contours of the 'woman-carer model' of care. [ABSTRACT FROM AUTHOR]

Purpose: Education and training is vital in improving age-related care provisions. However, a lack of awareness and understanding of dementia could be a factor in meeting the age-related needs of people. This paper aims to examine the impact dementia education has on caregivers' confidence to provide person-centred care for people with intellectual disability and identifies additional training needs. Design/methodology/approach: A systematic scoping review was completed using preferred reporting items for systematic reviews and meta-analyses to guide the process of mapping existing evidence of dementia education and training programmes available to caregivers of people with intellectual disability. Findings: A search of five electronic databases identified 11 articles that reported on the role of dementia education in improving the knowledge of caregivers in effectively delivering the age-related care. Findings suggest that improved training provision is needed to support early diagnosis and increase caregivers' confidence in meeting the physical and psychological needs of older adults with intellectual disability. Originality/value: This review contributes to the literature by identifying the value of and need for continued development in dementia education and training to improve person-centred dementia care. [ABSTRACT FROM AUTHOR]

Background: Issues of the aging population and disability of older persons have been rapidly developing in China over the past 20 years. Since 2016, the Chinese government has been exploring remedies to alleviate social and family burdens and ensure the dignity of the disabled old persons by implementing long-term care insurance systems in a few pilot cities across the country. Purpose: The purpose of this study is to present the current challenges faced by China's long-term care insurance system and put forth suggestions for the future, based on literature research and the feedback obtained from its implementation in pilot areas. Research Design: This paper conducts a theoretical study based on the principles of public health ethics. Study Sample: Since 2016, China has launched two batches of pilot cities for long-term care insurance. The analysis object of this study is the feedback on the policy implementation of the existing 29 pilot cities that participated. The relevant data involved in the analysis are from the authors' field research and published literature on the analysis of pilot cities. Analysis: The ethical value and importance of long-term care insurance policies in China are evaluated from the perspectives of policy philosophy and social individual interests. Results: The results of this evaluation show that the core ethical values were not met in the development of China's current long-term care insurance system. Moreover, distributive justice norms were neglected, and access to the system between different social groups and within the groups covered by it was unequal. Conclusions: This paper argues that long-term care insurance should not differentiate between urban and rural areas in allocating nursing resources. Additionally, it would be essential to build democratic supervision and manage public opinions by adopting open and transparent information-sharing policies. Standards of disability assessments and treatment payment should be at par to ensure a balance between the rights and obligations of policyholders. [ABSTRACT FROM AUTHOR]

This paper highlights an effective model for evaluating geriatric workforce enhancement professional development programs, using multiple methodologies (i.e., quantitative and qualitative). An adaptation of Kirkpatrick's (1994; 2010) model of evaluation was implemented to assess the evidence-based fall prevention program delivered at a Program for All Inclusive Care for the Elderly site. The purpose of this paper is to describe the program's design, data collection activities and instruments, and findings, and also suggest strategies for successfully replicating the approach. [ABSTRACT FROM AUTHOR]

Background: Population aging leads to change of population structure and increase care needs. Lack of proper planning in this field will lead to occur increasing problems. In this paper, the review of the elderly care plans at various levels in some European and Asian countries, comparing these countries with Iran with the goal of using their experiences to enhance elderly plans have been done. Methods: This research was a review study of library documents and resources and systematic search. Data were collected using the resources, databases, scientific databases and websites of the Ministry of Health and Welfare of the studied countries. Results: Based on this research in the studied countries, the care services of the elderly is based on the important principle of coordination between different organs of the country, followed by the creation of LTC insurance and provision of health and social services for the elderly and mainly the type of home care. In Iran country, providing appropriate services and cares for the elderly with existing plans and policies is not possible and the need to provide appropriate service packages based on the different systems of successful countries and applying the experiences of these countries is essential. Conclusion: Given the current status of the Iranian elderly population in terms of policies and plans and the types and methods of providing services, quality, access and financial resources allocated to this age group, compared to the studied countries, there is a well and integrated plan is essential. [ABSTRACT FROM AUTHOR]

Background: The communication skills of older adults living in care homes is an underexplored topic. Ageing can lead to reduced communication ability and activity; and in the care home environment there may also be fewer communication opportunities. This situation is likely to negatively impact well‐being. Previous reviews have found evidence of the effectiveness of behavioural interventions in increasing well‐being, but no systematic review to date has focused specifically on the evidence base for group language and communication interventions in this population. Aims: To identify and evaluate the evidence for behavioural interventions with older adults, delivered in groups in care homes, that specifically included a language or communication activity. To explore the impact of such intervention on the specific domains of language, communication and social interaction. To determine whether behavioural mechanisms of action can be identified. Methods & Procedures: Embase, Medline, Ovid Nursing database, Psych info and CINAHL complete were searched and produced 158 records for screening, of which 22 remained for review. In order to identify and evaluate the quality of the evidence base presented the following research questions were posed: What research has been conducted in this area? What is the methodological quality of the studies identified? How complete is the intervention reporting? How was change measured in the domains of language, communication and social interaction? Is there evidence of efficacy, indicated by statistically significant improvement, in these domains? How did the interventions work? Synthesis tools employed included the PEDro‐P Scale, the TIDieR checklist and the ITAX. Main contribution: A total of 22 studies met the criteria for review. One study used solely language or communication interventions, but the remaining 21 studies used behavioural interventions which incorporated language and communication activities to varying degrees. Studies fell into four broad intervention types: reminiscence or life review; cognitive stimulation; narrative or storytelling; and multi‐modality group communication. The majority of studies were of fair methodological quality, with a moderate level of detail provided in treatment reporting. Statistically significant improvement was reported by authors in all four intervention types and across language, communication and social domains. Social interaction, social support and behavioural skills were the most consistent mechanisms of action in the reviewed behavioural interventions. Conclusions & Implications: Despite limitations in the evidence base, there are important positive signs for the beneficial effects of supporting language and communication in care homes. Blinding of assessors, and the accuracy and accessibility of statistical reporting are important areas to address in order to improve the quality of the evidence base. What this paper adds: Ageing can lead to reduced communication ability and activity, and in the care home setting there may also be fewer communication opportunities. This situation is likely to negatively impact well‐being. Previous reviews have found evidence of the effectiveness of behavioural interventions in increasing well‐being. The communication skills of older adults living in care homes is an underexplored topic. No systematic review to date has focused specifically on the evidence base for group language and communication interventions in this population. This review reveals important positive signs for the beneficial effects of supporting language and communication in care homes. Social interaction, social support, and behavioural skills were the most consistent mechanisms of action in the reviewed behavioural interventions. [ABSTRACT FROM AUTHOR]

Worldwide, the geriatric population rate is 690 million which is alarmingly high and calls for an increasing need for preventive and curative services. In Pakistan, the elderly population is 11.3 million and is expected to increase to 43.3 million by 2050. With the increasing aging population there is an urgent need to improve standards and provision of elderly care in the country. Few geriatric healthcare organizations exist with weak infrastructure resulting in negligence and poor care of the elderly. Older adults have one or more chronic illnesses and complications that contribute to out-of-pocket payments in 73% of the population. Moreover, due to rapidly changing family value systems and sociocultural values, the elderly population is faced with additional challenges such as elder abuse, loneliness, and social isolation. The shrinking of family structure, industrialization, poverty, and prevalence of chronic illnesses among older adults put a massive burden on the family caregivers. Using SWOT and PESTLE analysis, the paper identifies several gaps and discusses various challenges contributing to the access, implementation, and provision of adequate geriatric care services in Pakistan. The paper proposes several strategies including quality home health screening, evidenced based informed care, and training of healthcare professionals to enhance the provision of compassionate and ethical geriatric services to improve the quality of life of elderly and their caregivers in Pakistan. [ABSTRACT FROM AUTHOR]

According to a 2019 report from the Agency for Healthcare Research and Quality, racial and ethnic minorities face more barriers to care and receive poorer quality of care when they can get it. Findings from the report included: Blacks received worse care than whites, and Hispanics received worse care than non-Hispanic whites for about 40% of quality measures. American Indians and Alaska Natives received worse care than whites for one-third of quality measures. It is especially important to notice that the diversity will improve patient-nurse communication, collaboration and clinical practice for patients of all backgrounds. Experts believes the preparation to attain a formal education begins with good prenatal care, proper nutrition and support for parents. Also, there is a difference between caregivers who tend to look more toward the physical aspects of illness, and the ones who are accustomed to a holistic way of viewing a person. This paper presents the dimension of significance of socio-cultural and physical differences, both between medical staff and patients. On the basis of the stated, it is pointed out that it is necessary to respect the diversity and to emphasize mutual cooperation and positive communication in order to maximize the retention of professionalism, both between the medical staff and the sister-patient relationship. Increasing the numbers of minority and disadvantaged persons in the health and allied health professions to care for the underserved, such as the elderly, is an important component of health care reform. Shortages of minority providers may adversely affect access, cost, and quality of care. At the same time, the background and characteristics of many elderly nursing home staff may adversely affect their job performance. The lives of many nursing assistants, in particular, are beset with personal problems and tragedies that leave them with too few personal resources to respond effectively to residents and that interfere with their ability to provide quality care to the frail, dependent elderly. In their ethnographic study on quality of care, nursing homes, and nurse aides' cultures, Tellis-Nayak and Tellis-Nayak (2015, 307) concluded that the 'institutional culture of the average nursing home not only ignores the affective needs of the nurse's aides, but it even assaults their self-esteem." This paper presents the dimension of significance of socio-cultural and physical differences, both between medical staff and patients. On the basis of the stated, it is pointed out that it is necessary to respect the diversity and to emphasize mutual cooperation and positive communication in order to maximize the retention of professionalism, both between the medical staff and the sister-patient relationship. Regarding the methodological framework, the paper uses the method of content analysis, method of comparison, method of synthesis and generalization, in order to draw relevant recommendation. In conclusion, increasing diversity in the workforce, will take individual and group efforts. In addition, some organizations have very active programs to promote diversity in leadership, but the diversity gap in leadership continues. Following, it is important for the minorities to be able to participate in making changes to improve the practice environment and outcomes, which is very important. [ABSTRACT FROM AUTHOR]

This paper presents a new approach called EmbedHDP, which aims to enhance the evaluation models utilized for assessing sentence suggestions in nursing care record applications. The primary objective is to determine the alignment of the proposed evaluation metric with human evaluators who are caregivers. It is crucial due to the direct relevance of the provided provided to the health or condition of the elderly. The motivation for this proposal arises from challenges observed in previous models. Our analysis examines the mechanisms of current evaluation metrics such as BERTScore, cosine similarity, ROUGE, and BLEU to achieve reliable metrics evaluation. Several limitations were identified. In some cases, BERTScore encountered difficulties in effectively evaluating the nursing care record domain and consistently providing quality assessments of generated sentence suggestions above 60%. Cosine similarity is a widely used method, but it has limitations regarding word order. This can lead to potential misjudgments of semantic differences within similar word sets. Another technique, ROUGE, relies on lexical overlap but tends to ignore semantic accuracy. Additionally, while BLEU is helpful, it may not fully capture semantic coherence in its evaluations. After calculating the correlation coefficient, it was found that EmbedHDP is effective in evaluating nurse care records due to its ability to handle a variety of sentence structures and medical terminology, providing differentiated and contextually relevant assessments. Additionally, this research used a dataset comprising 320 pairs of sentences with correspondingly equivalent lengths. The results revealed that EmbedHDP outperformed other evaluation models, achieving a coefficient score of 61%, followed by cosine similarity, with a score of 59%, and BERTScore, with 58%. This shows the effectiveness of our proposed approach in improving the evaluation of sentence suggestions in nursing care record applications. [ABSTRACT FROM AUTHOR]

Background: This paper aimed to describe the legal worries of Australian general practitioners (GPs) and nurses regarding end-of-life care provided in the aged care setting. Methods: An analysis of responses to the final, open-ended question of a cross-sectional online survey of GPs and nurses practising in aged care settings in Queensland, New South Wales and Victoria was undertaken. Results: Of the 162 GPs and 61 nurses who gave valid responses to the survey, 92% (151 GPs and 55 nurses) responded to the open-ended question. Participants identified concerns across all relevant areas of end-of-life law. The most common concerns were substitute decision-makers or family member(s) wanting to overrule an Advance Care Directive, requests for futile or non-beneficial treatment and conflict about end-of-life decision-making. Participants often also identified concerns about their lack of legal knowledge and their fear of law or risk related to both end-of-life care generally and providing medication that may hasten death. Conclusions: Australian GPs and nurses working in aged care have broad-ranging legal concerns about providing end-of-life care. Legal concerns and knowledge gaps identified here highlight priority areas for future training of the aged care workforce. The law supports good end-of-life clinical practice by facilitating health care that aligns with the values and goals of patients, including those residing in residential aged care facilities. GPs and nurses here reported broad-ranging legal concerns relevant to providing end-of-life care within aged care, including substitute decision makers/family members wanting to overrule Advance Care Directives, requests for futile or non-beneficial treatment and conflict about decision-making. Participants' concerns can inform end-of-life legal training for aged care GPs and nurses. [ABSTRACT FROM AUTHOR]

Background: The implementation of a data-driven approach within the health care system happens in a rapid pace; including in the eldercare sector. Within Swedish eldercare, data-driven health approach is not yet widely implemented. In the specific context of long-term care for older adults, quality of care is as much determined by how social care is being performed as it is by what kind medical care that is provided. In particular, relational aspects have been proven to have a crucial influence on the experience of quality of care for the actors involved. Drawing on ethnographic material collected at a Swedish nursing home, this paper explores in what way the relational aspects of care could potentially become affected by the increased use of a data-driven health approach. Methods: An ethnographic approach was adopted in order to investigate the daily care work at a long-term care facility as it unfolded. Fieldwork was conducted at a somatic ward in a Swedish long-term care facility over 4 months (86 h in total), utilizing the methods of participant observation, informal interviews and document analysis. The material was analyzed iteratively throughout the entire research process adopting thematic analysis. Results: Viewing our ethnographic material through an observational lense problematising the policy discourse around data-driven health approach, two propositions were developed. First, we propose that relational knowledge risk becoming less influential in shaping everyday care, when moving to a data-driven health approach. Second, we propose that quality of care risk becoming more directed on quality of medical care at the expense of quality of life. Conclusion: While the implementation of data-driven health approach within long-term care for older adults is not yet widespread, the general development within health care points towards a situation in which this will become reality. Our study highlights the importance of taking the relational aspects of care into consideration, both during the planning and implementation phase of this process. By doing this, the introduction of a data-driven health approach could serve to heighten the quality of care in a way which supports both quality of medical care and quality of life. [ABSTRACT FROM AUTHOR]

This article provides information on a comparison of elderly care systems in two regions in Indonesia with different ethnicities and cultures, namely the Minangkabau in West Sumatra and the Abui of Alor. This article shows how the saparuik kinship in the Minangkabau community which is matrilineal with different customary constellations and how the patrilineal moknehi kinship in the Abui community takes care of elderly women. This paper explains the influence of caregivers' life journey on their burdens of life. The burden of life perceived by caregivers arises from various factors. Among the various influencing factors are emotions, economy, knowledge, kinship and the right to manage inheritance. Kinship is a form of reciprocal relationship between various elements in both Minangkabau and Abui societies. In the Minangkabau ethnic group, the smallest kinship system in society is called saparuik kinship (Minang language), while the smallest kinship system in Abui is called moknehi (Abui language) which means "brother". Paruik can be interpreted as "stomach". While the word moknehi, which has variants in Abui such as muknehi, mokneng and motneng, likely derives from words moku "child" and neng "male", whose meaning is equivalent to "brother, sibling". Literally, saparuik are people who come from the same stomach or mother, while moknehi refers to people who come from the same mother and or father. People who are in saparuik are people who come from the same grandmother, while moknehi are male brothers who come from the same grandfather, who then develop into several extended families. Both extended families in paruik or moknehi consist of several nuclear families. Likewise, saparuik and moknehi consist of several extended families. The extended family in saparuik is formed in one grandmother (not a literal grandmother, the grandmother in this case is the mother of the grandmother or the grandmother of the grandmother), in one "rumah gadang", and sharing inheritance. Otherwise, moknehi are not only formed in one grandfather, but also male great-grandfather and great-great-grandfather (male great-grandfather and great-great-grandfather in this case are father of grandfather and grandfather of grandfather), in one clan, and sharing inheritance. [ABSTRACT FROM AUTHOR]

OBJECTIVES AND IMPORTANCE OF STUDY The objective of this systematic review of the literature was to examine the evidence relating to consumer-directed care (CDC) in the aged care environment. CDC entails providing individuals with the option of choice and flexibility in their care, to empower aged care recipients with autonomous decisions over their healthcare choices. Additionally, the researchers found evidence relating to the vulnerability of users of aged care services and the lack of understanding towards a true consumer-oriented approach which was highlighted during the Royal Commission into Aged Care Safety and Quality. STUDY TYPE AND METHOD The research team used the PRISMA Method to review the available literature systematically. This qualitative review of the literature on consumer choice in the aged and social care sectors assessed sixteen high-quality research papers and identified themes that emerged to promote authentic consumer voice in aged care services. These articles provided insight into what aged care providers require to increase transparency and facilitate effective, meaningful consumer choice. RESULTS Six themes emerged from the literature reviewed: Informed Choice, See Me Hear Me, Funding My Choices, My Choice My Way, Policy, and Know Me, Include Me. The authors found significant challenges to authentic consumer voice in terms of reliable information, complex, inflexible service provision, and a trusted and skilled carer workforce. CONCLUSION Authentic consumer choice requires collaboratively designed care plans with consumers, integrating their care-related preferences and values. Providers who have embraced CDC principles, and innovative practices have enhanced person-centred care, and consumer experience and autonomy. Cultivating inclusive, transparent, and collaborative environments to empower older Australians to shape and control their care provision and wellbeing is a key challenge for providers. [ABSTRACT FROM AUTHOR]

Aged care management roles have evolved over the last decade from a focus on clinical skills to encompassing governance, business, facilities and service management skills. The role requirements have changed in response to the 2021 Royal Commission into Aged Care Quality and Safety findings [1], which were echoed in the 2022 NSW Parliamentary Committee report into health outcomes and access to health and hospital services in rural, regional and remote NSW [2]. Both reports identified workforce issues impacting on the management of aged care services and a need to improve governance, financial management, and service management. The reports indicated the breadth of the contemporary aged care manager role, the skill gap between traditional clinician-managers, and possibilities for appropriately trained non-clinical health services managers. Recruiting and retaining skilled aged care managers is a critical issue facing a sector that was already experiencing significant 'churn' prior to the burnout associated with the COVID-19 pandemic [3]. This paper, informed by a marketorientated job skill valuation approach [4], reviewed 100 consecutive aged care management position descriptions advertised on public media between October and December 2020. Content analysis of each position description was conducted to identify key competencies, specific ski lls, experiences, and personal attributes required of managers of aged care services in Australia. Our study identified five main themes relating to aged care manager competencies: (i) interpersonal communication, (ii) organisational and time management, (iii) quality improvement, (iv) business development, and (v) leadership and human resources. These competencies are congruent with the revised Australasian College of Health Service Management competency domains and action competencies [5]. [ABSTRACT FROM AUTHOR]

Faced with the severe situation of global population aging, smart elderly care services have become an effective way to solve the dilemma of elderly care. In recent years, the Chinese government has frequently issued policies to promote the rapid development of smart elderly care service. This paper constructs a three-dimensional analysis framework of "policy objectivepolicy tool-value chain" and uses content analysis method, which is a structured research method that analyzes the content of text, to analyze 126 policies at the national level of China's Smart elderly care service from 2012 to 2022. Through the quantitative statistical analysis, this study finds that the distribution of policy objectives is uneven, the structure of policy tools is imbalanced, the support strength of each link of the value chains is different, and the cross-fitting effect of dimensions is insufficient. In the future, pay attention to the balanced development of the needs of the elderly; Promote the complementarity of various policy tools; Strengthen the systematization of all links of the value chains; Improve the fitting effect between policy objectives, policy tools and value chains, and strive to improve the weak points of each combination model. [ABSTRACT FROM AUTHOR]

Purpose: Older people living in nursing homes have complex care needs and frequently need specialists' advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager. Design/methodology/approach: A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model. Findings: The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase. Originality/value: This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings. [ABSTRACT FROM AUTHOR]