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Chronic non‐healing wounds are a burden in the Long‐Term Care (LTC) sector, increasing costs, morbidity, and mortality and causing pain and suffering. The objective of this LTC Innovation pilot was to test the value of a promising new neuromuscular stimulation device in elevating the experience and satisfaction of the residents, engaging and empowering the nursing staff, and improving healing and/or reducing costs. Small, wireless, and worn at the knee, this muscle pump activator is self‐contained, wearable, and battery‐powered to increase lower‐leg blood circulation (up to 60% of that achieved by walking). It has no wires, weighs just 10 g, and is easy to use. Nurses in four LTC homes identified residents with non‐healing lower leg wounds. Consent was obtained, and on‐site training was delivered. Eleven residents were recruited. Only seven met the inclusion criteria for venous/mixed or diabetic foot ulcers. Of the seven who met the criteria and were adherent with best practices and the muscle pump activator, four healed 100%, and one healed 90%. Two patients with other aetiologies, who were also adherent, healed. All adherent residents had an average weekly decrease in wound size of 9.75% and were extremely happy with the results. Three residents who were non‐adherent had a 9.25% increase in wound size per week. One patient with diabetic foot ulcers developed skin changes at the end of life and passed away. Nursing staff and cognisant residents can easily adjust the pulse of muscle pump activator, and application and removal are simple. Most residents feel engaged with the therapy “because they feel it working”. The LTC corporation feels that it is a great adjunctive solution for many types of lower‐leg wounds (venous, mixed, diabetic, pressure) in addition to best practices in the LTC and Retirement home sectors.

Objectives: This article describes the implementation of the Care for Seniors model of care, an innovative approach to improving care coordination and integration, and provides preliminary evidence of effective use of specialist resources and acute care services. Design: Retrospective. Setting: Primary care; cross-sector. Participants: Older adults living in a rural area in southwestern Ontario, Canada. Measurements: Number of new geriatrician referrals and follow-up visits before and after the launch of the Care for Seniors program, number of Nurse Practitioner visits in a primary care setting, in-home, retirement home and hospital, number of discharges home from hospital and length of hospital stay between. Results: In the 2 years before the launch of the program, the total number of visits to the geriatrician for individuals from this FHT was relatively low, 21 and 15, respectively for 2005–06 and 2006–07, increasing to 73 for the 2011–12 year. Although the absolute number of individuals supported by the NP-Geri has remained relatively the same, the numbers seen in the primary care office or in the senior's clinic has declined over time, and the number of home visits has increased, as have visits in the retirement homes. The percentage of individuals discharged home increased from 19% in 2008–09 to 31% in 2009–10 and 26% in 2011–12 and the average length of stay decreased over time. Conclusions: This model of care represents a promising collaboration between primary care and specialist care for improving care to frail older adults living in rural communities, potentially improving timely access to health care and crisis intervention.

George W. Housner, C F Braun Professor of Engineering, Emeritus, died after a short illness on November 10, 2008, just a few weeks before his 98th birthday. He was in the retirement home in Pasadena where he had lived for several years. For all of us who knew George, this marked the end of an era. Few people have guided and nurtured a field the way George led earthquake engineering over a period of several decades. He had a profound effect on many people and will long be remembered. His impact was so pervasive that he had earned the title of the ‘Father of Earthquake Engineering’. This article records some of my thoughts about this remarkable man.

The incidence of cutaneous squamous cell carcinomas (SCC) has been increasing by about 5% per year of the past 40 years in a population which is growing continuously older and as such presents a growing therapeutic challenge. We report on two elderly female residents of a retirement home with histologically confirmed SCC on the back of the hand. In one case the tumor was completely excised and covered with a graft. In the second case the patient refused all surgical and radiotherapeutic procedures. We sought an adequate therapeutic alternative considering the extent and thickness of the tumor. Topical application of the immune response modifier imiquimod appeared to represent an alternative solution because of its unique antineoplastic mode of action, even though there was no published experience with this approach. She has remained tumor-free for four years, justifying our decision. In both cases, a comparable cosmetic result with full functional capacity of the hands was obtained. Imiquimod 5% cream was approved last year for the treatment of superficial basal cell carcinoma.

In this service-learning, intergenerational exchange, sixth graders sharpen their communication skills by sharing with residents of a retirement home. The students select and review materials to read to the residents by going through several different books and magazines at school. Then, they visit the home regularly to read and discuss stories. At the end of each visit, students converse with residents about their daily lives. They also prepare interview questions to find out about the experiences and historical events that these elderly people remember. The students interview these residents to collect information to write biographies, which they also illustrate and have other students edit. Then they return to the retirement home and deliver the completed biographies. Finally, the students and their teacher reflect on and evaluate the experience.

Two experiments evaluated the effect of commitment on paper recycling. Using an ABA design, Experiment 1 asked 24 individuals in a retirement home to sign a 4-week group commitment pledge to recycle paper. During this intervention, the subjects recycled 47% more paper than they had during baseline. They continued to recycle at this level during a 4-week follow-up period, when the group commitment was removed. Experiment 2 evaluated the relative effectiveness of group commitment, individual commitment, and token reinforcers on paper recycling in a college dormitory. The students in all three experimental conditions recycled from three to five times more paper than those in the control group during the 4-week intervention. However, in the 3-week follow-up period, when the treatments were removed, only the individually committed subjects continued to recycle significantly more paper than the controls.

The Private World of the Hermitage: Lifestyles of the Rich and Old in an Elite Retirement Home. MARY MOORE FREE. Westport, CT: Bergin & Garvey, 1995. x + 168 pp., references, index.

Physical and mental correlates of dependent living were determined in 128 Catholic sisters (nuns), aged 75 to 94 years, who had similar social support systems and lifestyles. The primary a priori hypothesis was that poor manual dexterity would correlate strongly with living in the nursing home. Stepwise discriminant analysis indicated that manual dexterity explained 51% of the variance in the sisters' residential living site (ie, nursing home, retirement home, or living in community). The discriminant analysis equation using manual dexterity predicted living site correctly for 63% of the sisters in the nursing home with a specificity of 99%, a positive predictive value of 96% and a negative predictive value of 84%. The addition of age and mental status to the equation improved the prediction only slightly.