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Background:Wearable devices have the advantage of always being with individuals, enabling easy detection of their movements. In this study, we developed and implemented a smart-care system using smart clothing for persons with dementia and with hip fracture. Objective:This paper reports conducted a preliminary study to understand family caregivers’ and care receivers’ experiences of receiving a smart technology-assisted (STA) home-nursing care program. Methods: The STA model of a home-nursing care program for older persons with dementia or hip fracture included a remote-monitoring system with a smart-vest to facilitate family caregivers’ detection of the care receivers’ movements. These movements included getting up at night, staying in the bathroom time, not moving time during the day, leaving the house, and daily activity level. Participants included 12 families with five patients with hip fracture and seven with dementia. A description of the process of setting up the individual STA in-home systems, measures that were monitored and the difficulties encountered. Results: Difficulties encountered were due to multiple problems. They were comprised of three categories: incompatibility of the home environment, interruptions in data transmissions and inaccuracies in data transmissions. Conclusions: Three main difficulties impeded implementation of the STA home care for persons with dementia or hip fracture. Each of these difficulties had their own unique problems and strategies to resolve them. Our findings can provide a reference for futureimplementation of similar smart-home systems.

Influences of nutritional status on hip fractured persons with diabetes mellitus (DM) following surgery have not been reported.To explore the trajectory groups of nutritional status and their influences on post-operative recovery for older persons with hip fracture and DM.A total of 169 patients with DM and hip fracture from a clinical trial were included in this analysis. Mini Nutritional Assessment was used to assess the nutritional status of the participants. Outcome variables included self-care ability, muscle strength, depressive symptoms, health related quality of life, and cognitive function, which were collected before discharge and 1-, 3-, 6-, 12-, 18-, and 24-months following hospital discharge.Among hip fractured older persons with DM, within two years following surgery there were three nutritional trajectory groups: malnourished (28.3%), at-risk of malnutrition (41.9%) and well-nourished (29.8%). A decline in nutritional status, especially for the malnourished group, was seen in the second year. A better nutritional trajectory was associated with better recovery outcomes, including self-care ability, health related quality of life, cognitive function and less depressive symptoms.Close to 30% of hip fractured persons with DM were considered to have a malnourished trajectory over 2 years following surgery. A poor nutritional trajectory was associated with poor mental health and physical recovery.Continuous nutrition assessment during the first 2 years following hip fracture surgery for older persons with DM is important. Development and implementation of interventions targeting the malnourished trajectory group are suggested.

This study examined trajectories of social support and their relationships with health outcomes over 2 years post hip-fracture surgery for older adults with diabetes mellitus (DM).This was a secondary analysis of data derived from a clinical trial, which included 158 hip fractured older adults with DM who had completed the Medical Outcomes Study Social Support Survey at 1-, 12-, 18-, and 24-months following hospital discharge. Health outcomes for self-care, physical and nutritional status, mental health, and depression were assessed at 3-month intervals up to 24-months after hospital discharge. Trajectories of social support were derived with latent class analysis while hierarchical linear models were employed to assess the associations of social-support trajectory with health outcomes.Four social-support trajectories were derived for persons with DM following hip-fracture surgery: poor and declining (n = 18, 11.4%), moderate and stable (n = 29, 18.4%), high but declining (n = 34, 21.5%), and high and stable (n = 77, 48.7%). Relative to those in the poor and declining group, participants in the high and stable trajectory group performed better in Activities of Daily Living and quadriceps muscle power, had better mental Health-Related Quality of Life and nutritional status, and had fewer depressive symptoms. These differences persisted over the 2 years following hospital discharge.These results suggest social support for persons with DM should be continually assessed following hip-fracture surgery.