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Loneliness - a subjective, emotional state of feeling social isolation and being cut off from others. It comes and goes when life situation changes. In the case of chronic loneliness, it is experienced no matter what the circumstances. Loneliness functions in the temporal (time) dimension: it can be continuous, but it can also occur temporarily. The feeling of loneliness occurs in situations where the emotional bond is broken or in the case of isolation. The aim of this article is to address the problem of seniors' loneliness which is caused by the limitations of the Covid-19 pandemic. The participants of the study are seniors living in Poland and Slovakia. Research conducted in Poland, with two elderly women over 70, living in a small fishing village in the north of the country, shows that they experience unpleasant states of loneliness despite having adequate relationships with other people. As observations show, the increase in loneliness is caused by conditions that require the observance of precautionary measures related to the pandemic and restrictions on socializing and conducting classes in senior clubs. The above factors result in shallowing interpersonal interactions; weakening interpersonal relations; contribute to more superficial contacts mainly by telephone. Seniors who are in care at the Retirement Home and Nursing Home in Slovakia also admit to feeling lonely, though not directly. From the conversation, however, it can be concluded that this condition does not result directly from pandemic limitations, but rather from too little contact with loved ones. The presence of other residents and staff, contact with people, meals, activities and conversations significantly fill the time during the day. The study was aimed at checking the facts of loneliness faced by seniors living in Slovakia and Poland as well as providing information about their views on their situation. The aim of the study is also to indicate the direction that will be helpful in combating and preventing such a pejorative phenomenon as loneliness. The research was conducted in the form of an interview. In order for the quality of the interviews to be as high as possible, the respondents were selected from various backgrounds. In Poland, there were two single women, aged over 70, living in a tiny fishing village; in Slovakia they were clients of the Retirement Home and the Nursing Home in Rimavska Sobota. The authors of the texts on the situation in Poland and Slovakia would like to add that the respondents waited with interest for contact from the authors of the publication; were happy that they could speak; that there were people who were interested in their problems. The researchers tried to comprehensively present the analysis of the obtained data, situations and statements of the respondents and, using the bricollage technique, to interpret it in detail. The most important issues raised in the interviews were additionally summarized in the conclusions.

International audience; Objective The objectives of this study were to describe poisonings occurring in older or disabled patients residing in structured living facilities, identify risk factors, and propose preventive measures. Method This was a prospective and observational study, covering all cases of poisoning occurring in structured living facilities in the Brittany region of France. All calls were received at the Grand Ouest Poison Control Centre (PCC) of Angers and were recorded from 1 February 2019 to 31 January 2020. The clinical severity of the poisonings was assessed using the Poisoning Severity Score (PSS). Clinical severity was compared by univariate and multivariate analyses using the following dependent variables: PSS score < 2 and PSS >= 2. Results This study included 158 residents with a median age of 83 years (5-116 years old). The average number of residents supervised by a member of the supervisory staff was 11 (+/-10.7). The substance ingested was a personal hygiene product or a cleaning product in 48% and 25% of cases, respectively. The most frequently ingested product was a bar of soap (n = 20). All moderate to severe cases (4.6%, n = 8 including one death) occurred in residents with dementia living in nursing homes for elderly patients, and 9% of residents required hospital treatment. In more than 50% of cases (n = 83), the product was provided by the facility and in 23% (n = 40), it was brought in by the family. Ingestion of a bar of soap or a product brought in by the family was significantly associated with higher poisoning severity (PSS >= 2). After adjustment for age, sex and the number of residents per supervisor, the severity of poisoning was significantly greater after ingestion of a bar of soap (OR = 12.33, CI95 [2.12, 71.63], p = 0.005). Conclusion Older adults residing in medical facilities who have a history of dementia and/or cognitive impairment are more at risk of non-medicinal product poisoning. Clinical severity and the hospitalisation rate were greater when bar soap was ingested.

Many medical errors occur because people are in charge of patients or elderly medications by handling large amounts of medications every day. This work consists of designing and establishing a pillbox prototype intended to address this shortcoming in medical areas. It can be used separately from the medication itself and other advanced features provided with this device by the hospital or retirement home. This medication pack aims to take most medications or vitamin supplements or stimulants that deal with over-salting or over-the-counter patients. The proposed smart pillbox contains a program that enables medical caregivers or clients to determine the pill size and timing of pills and service routine each day. In this research work, the Augmented Data Recognition (ADR) algorithm is also used to monitor humans' health conditions. Initially, the UCI dataset is used for training and validation of the proposed ADR algorithm. The heart rate, blood pressure and temperature of the patient have carried during the testing phase via the Internet of Things (IoT) setup. The testing phase estimates any abnormalities in the health status based on the information obtained by the sensor collected by the population structure. Statistical analysis is based on data obtained from a cumulative cloud from IoT devices to estimate percentage accuracy.

BACKGROUND: The epidemiology of SARS-CoV-2 infection in retirement homes (also known as assisted living facilities) is largely unknown. We examined the association between home-and community-level characteristics and the risk of outbreaks of SARS-CoV-2 infection in retirement homes since the beginning of the first wave of the COVID-19 pandemic. METHODS: We conducted a population-based, retrospective cohort study of licensed retirement homes in Ontario, Canada, from Mar. 1 to Dec. 18, 2020. Our primary outcome was an outbreak of SARS-CoV-2 infection (≥ 1 resident or staff case confirmed by validated nucleic acid amplification assay). We used time-dependent proportional hazards methods to model the associations between retirement home- and community-level characteristics and outbreaks of SARS-CoV-2 infection. RESULTS: Our cohort included all 770 licensed retirement homes in Ontario, which housed 56 491 residents. There were 273 (35.5%) retirement homes with 1 or more outbreaks of SARS-CoV-2 infection, involving 1944 (3.5%) residents and 1101 staff (3.0%). Cases of SARS-CoV-2 infection were distributed unevenly across retirement homes, with 2487 (81.7%) resident and staff cases occurring in 77 (10%) homes. The adjusted hazard of an outbreak of SARS-CoV-2 infection in a retirement home was positively associated with homes that had a large resident capacity, were co-located with a long-term care facility, were part of larger chains, offered many services onsite, saw increases in regional incidence of SARS-CoV-2 infection, and were located in a region with a higher community-level ethnic concentration. INTERPRETATION: Readily identifiable characteristics of retirement homes are independently associated with outbreaks of SARS-CoV-2 infection and can support risk identification and priority for vaccination.

Introduction: Cognitive abilities are defined as the awareness of immediate discovering, rediscovering, and recognizing information in various forms, understanding, and comprehension. Objective: To examine the cognitive impairment rate and its effect on the functional status of elderly persons, retirement home beneficiaries. Method: The research has been designed as a cross-sectional study, including 110 elderly persons. Research instruments comprised a general questionnaire, Katz index of independence in activity of daily living, Lawton instrumental activities of everyday life, and Mini-mental state examination. The statistical test used was the ch2 test, while Pearson's correlation analysis was used for correlation analysis. Results: Out of the total number of subjects, 60% had an impaired cognitive status. When it comes to functional status, assistance was necessary for 79.2% of the subjects. Statistically significant weak positive correlation existed between the subjects' cognitive status and their functional abilities (r = 0.331; p

Summary Background and aims Elderly orthopaedic patients are potentially at a high nutritional risk. The reasons for this are numerous as i.e. reduced appetite, sensation of satiety after eating small amounts of food, multi-medication or immobility. This is in contrast to the increased energy and protein recommendations for geriatric orthopaedic patients. Methods Oral intake during hospitalization of more than 1000 geriatric orthopaedic patients aged over 80, with or without fracture, was recorded, calculated and then compared to energy and protein requirements by clinical dietitians according to international guidelines. Results 330 patients were included in the sample of which 76.7% were female (n = 253) and 23.3% male (n = 77). The mean age was 87.4 (+/−4.7) years. Most patients (204 = 61.8%) had lived at home prior to hospital admission. 72 patients (21.8%) lived in a retirement home, 54 (16.4%) lived in a nursing home. 98.5% of the included patients were unable to cover their energy needs and 99% were unable to achieve their protein needs. Only five patients (1.5%) were able to achieve their energy needs and one single patient (0.3%) achieved his recommended protein intake. Conclusion Orthogeriatric patients are at high risk of malnutrition. Very few of these patients were able to cover their estimated energy and protein needs through dietary intake. This suggests that there is a high need of dietetic interventions in this multimorbid elderly patient group. The aim of the nutritional therapy and its interventions should be its continuity, especially after hospital discharge so that long-term optimization of the nutritional status can occur. Future research should further investigate if current recommendations are applicable and the best way to achieve a better nutritional status in this population risk group.

We report a therapy cat in a nursing home in Germany infected with severe acute respiratory syndrome coronavirus 2 during a cluster outbreak in the home residents. Although we confirmed prolonged presence of virus RNA in the asymptomatic cat, genome sequencing showed no further role of the cat in human infections on site.

Background: Elderly were facing heavy burden of sequel of long-term physical illness, as a result the ultimate effect was on quality of life.There is a need to highlight their medical and psychosocial problems and bring up strategies for improvement in their quality of life.Methods: A community based cross sectional study was conducted among 100 elderly people, aged 60 and above, residing in a retirement home, present in the field practice area of RHTC, Anandhapuram, Visakhapatnam district, Andhra Pradesh, from October 2019 to December 2019.Data was collected by using thestandard WHO BREF questionnairefor quality of life assessment and Katz index of ADL score for activity of daily living assessment.Majority of study population were females (53%) and majority was in the age group of 60-69 years (65%). Social support and relationship domain and environmental domain found with high mean quality of life scores (55.87+ 13.12 and 54.24 +10.12 respectively). 89% of the study population was found with full functional activity and only 1% with severe impairment.Conclusion: Economical independence, social security and support by the family, regular health checkups and health seeking behaviour, legal security and special schemes for elderly will improve their quality of life and helps them to live longer and happier.

Existential or spiritual concerns are especially important for older people and those faced with their fragility and mortality. In most cases, the elderly have to deal with their worries and needs alone, as several perceive low interest in their concerns. This chapter describes which spiritual needs were of relevance for the elderly living in retirement homes, assisted living homes or nursing homes, and what may trigger these. Findings from studies among the elderly from Germany, Poland and Italy are discussed. There were similarities in specific unmet spiritual needs, and significant differences that refer particularly to Religious needs and Existential needs. The underlying causes are probably multifactorial and involve cultural and religious differences, on the one hand, and negative mood states, feelings of loneliness and perceived daily life affections (and thus low self-care abilities and independence), on the other hands. The loss of connectedness and involvement were identified as crucial, and thus support concepts could start with these topics. These should be suited to facilitating the elderly’s social participation and inclusion, on the one hand, and their independence and generative giving abilities, on the other hand, which would help to maintain feelings of meaningfulness and psychosocial and spiritual well-being.

In an 80-bed fee-based retirement home with nursing care, the dispatched-pharmacist has provided prescription recommendations to visiting physicians based on pathogen identification using Gram staining as part of an antimicrobial stewardship program. Thus, we evaluated the effects of pharmacist-supported antimicrobial stewardship. We calculated the total number of all antimicrobials and macrolides, fluoroquinolones, and cephalosporins prescriptions per 100 residents per month at the retirement home from January 2013 to December 2017. Using log-transformed monthly resident numbers with an offset before and after the intervention, we performed Poisson regression analyses that adjusted for monthly mean age. Interrupted time series analyses (ITSA) were conducted to examine the changes in the incidence rate ratios for the baseline and slope before and after the intervention. The total number of all antimicrobial prescriptions per 100 residents per month from 2013 to 2017 was 14.10, 18.51, 10.59, 5.41, and 3.90, respectively. Although there was a significant pre-intervention increase in the total number of all antimicrobial prescriptions, the intervention was followed by a significant decrease. There was also a significant reduction in the slope. ITSA of the changes in the prescription of macrolides and fluoroquinolones showed that there were significant pre-intervention increase and followed by a significant post-intervention decrease in the slope. There was no significant change in cephalosporin prescriptions by the intervention. Our study shows that pharmacist-supported AS can reduce antimicrobial prescriptions in a retirement home. Nevertheless, further studies are needed to collect and analyse more data on similar interventions.

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.

Background: Sport stacking has been beneficial in improving reaction time, as well as hand-eye-co-ordination; predominantly in children. Sport stacking intervention studies, although limited, have shown improvements in motor and cognitive functioning in both children and adults, post-intervention. Similar intervention studies on geriatrics are limited. Aim: The aim of this study was to determine the effects of a sport stacking physical activity intervention on the motor and cognitive functioning of geriatrics. Methods: An intact, convenient sample of 58 geriatrics from a retirement home in KwaZulu-Natal, South Africa was selected to participate in this study. All participants performed selected motor and cognitive functioning tests, pre- and post-intervention. Twenty eight participants were exposed to an eight-week intervention while the control group (30 individuals) continued with activities as usual. Results: The intervention group showed improvements in their mean reaction time and plate tapping (hand-eye co-ordination) times. Overall, there were no changes in the balance test results pre- and post-intervention. There were no significant results from the memory and quality of life tests. Conclusions: A sport stacking activity intervention has the potential to improve motor functioning in geriatrics, and its clinical application is recommended.

Introduction: Social participation is considered as a means of improving one’s quality of life, thus the study aimed at assessing the association between the quality of life and social participation in the elderly. Methods: This cross-sectional study was conducted in 2016. The study population was selected from among the residents of a retirement home (an elderly residential home) in one of the Northwestern provinces of Iran, and the required data was collected via three questionnaires related to the demographic data, the specific quality of life for the elderly (LEIPAD), and the extent of social participation. Data was analyzed using mean, standard deviation, Spearman correlation coefficient, Mann-Whitney, Chi-square and Kruskal-Wallis test in SPSS software. Results: The social participation level of the population under study was estimated as being appropriate (mean score: 3.81±0.32); whereas, the respondents' quality of life was estimated as being relatively inappropriate (mean score: 2.78±0.41). The "art, sport and leisure activities" subscale showed a significant relationship with the subscales related to the total quality of life and those of "Physical Performance" (r=0.128, p=0.46), "depression and anxiety"(r=0.114, p=0.051), "sexual performance"(r=0.213, p=0.21), and "life satisfaction"(r=0.272, p=0.11); furthermore, there was a significant relationship between total social participation and "life satisfaction" and the subscales related to "depression and anxiety"(r=0.263, p=0.12). Conclusions: It seems that activities that involve the art, sport and leisure subscale of social participation can result in quality of life improvement for the elderly.

We examine recipients of publicly funded ongoing care in a single Ontario jurisdiction who reside in three different settings: long-stay home care patients in private homes and apartments, other patients in retirement homes and residents of long-term care homes, using interRAI assessment instruments. Among home care patients, those in retirement homes have higher proportions of dementia and moderate cognitive impairment, less supportive informal care systems as well as more personal care and nursing services above those provided by the public home care system, more frequent but shorter home support visits and lower than expected public home care expenditures. These lower expenditures may be because of efficiency of care delivery or by retirement homes providing some services otherwise provided by the public home care system. Although persons in each setting are mostly older adults with high degrees of frailty and medical complexity, long-term care home residents show distinctly higher needs. We estimate that 40% of retirement home residents are long-stay home care patients, and they comprise about one in six of this Community Care Access Centre's long-stay patients.

Using a robot designed for senior citizens in a retirement home setting, an experiment (N=51) was conducted to investigate whether variations in the role (companion vs. assistant) and social demeanor (playful vs. serious) of a robot influence senior citizens’ perceptions of the robot's social attractiveness, intelligence, anxiety, and eeriness. Results show that assistant robots are perceived as more socially attractive and intelligent when their demeanor is playful rather than serious. In addition, companion robots are evaluated as less anxious and less eerie when their personality is serious rather than playful. Finally, companion robots with a serious demeanor have a positive indirect effect on robot use intentions via heightened perceptions of intelligence and social attractiveness, while assistant robots with a playful demeanor have a positive indirect effect on intentions via lower perceptions of anxiety. The implications of our findings for human-robot interaction and the design of socially assistive robotics are discussed.

Long-stay home care clients mostly reside in private homes or retirement homes, and the type of residence may influence risk factors for long-term care placement. This multi-state analytic study uses RAI-Home Care and administrative data from the Hamilton Niagara Haldimand Brant Local Health Integration Network to model conceptualized states of risk at baseline through a 13-month follow-up period. Modifiable risk factors in these states were client loneliness or depressive symptoms, and caregiver distress. A higher adjusted likelihood of being discharged deceased was found for the lowest-risk clients in retirement homes. Adjusting for client, service, and caregiver characteristics, retirement home residency was associated with higher likelihood of placement in a long-term care home; reduced caregiver distress; and increased client loneliness/depression. As an alternative to private home settings as the location for aging in place among these long-stay home care clients, retirement home residency represents some trade-offs between client and informal caregiver.

Le Floc’h Y. L’animal médiateur dans la santé de l’homme. In: Bulletin de l'Académie Vétérinaire de France tome 172, 2019. pp. 42-44.

With this contribution we want to give insights into the development of a drinking gadget which is useable by the elderly and dementia patients with the goal to create an automated drinking protocol. Through the literature and available smart cups, we deduced important strategies for the design of a drinking aid. Our natural solution is integrated into the daily workflow, hence enables the caregivers to react to the needs of the elderly without additional burden. Therefore, we identified some key requirements for both user groups. Furthermore, we integrated aspects of expandability with software, a vision of rich interaction between user/gadget and focused on the convenience during the daily usage to reach the elderly and caregivers alike.

We investigate the combination of a drinking gadget with Serious Games, designed to entice elderly/dementia patients to drink more water - with potential benefit for both, the elderlies and their caregivers. We present several strategies that are essential towards developing a Combined Evaluation Process needed to determine user acceptance. We report on a pilot study conducted in a retirement home with dementia patients. The goal was to gain first insights regarding the acceptance of such a technology from the viewpoint of the elderly and their caregivers.

Abstract. Social relationships are crucial for older adults’ well-being. Past research demonstrated that video-communication technology could reduce social isolation. However, most commercial telecommunication systems have interfaces that are too complex to be operated by older adults without assistance. In this paper, we present a system that exploits the tangible affordances of a physical window to provide a natural interface for an always-on video-communication system. In addition, we present a case study focused on the system accessibility and user acceptance with 8 older adults living in a retirement home. We also describe the preliminary findings based on an observation study and on a semistructured interview. Finally, we discuss the possible improvements and impact this system might have on older adults’ life.

Dementia significantly impairs cognitive and behavioral functioning of the person, and in recent years there has been a significant increase in the number of patients suffering from dementia. In Croatia, such patients are often placed in retirement homes, non-specialized institutions for the elderly and infirm, often without adequately educated employees. Attitudes toward dementia seem to be an important factor for adequate care of people with dementia, but there was no previous research on this topic in Croatia. The Dementia Attitudes Scale (DAS) developed by O’Connor and McFadden (2010), is a useful tool in research of attitudes toward dementia. The aim of the study was to translate the scale into the Croatian language and validate it on a Croatian sample. Participants were employees and retirement home users, other health care workers and the general population. Validation conducted on samples that were in everyday contact with dementia patients showed consistent factors (social comfort and dementia knowledge) as in the original scale, so the conclusion was that the questionnaire could be used in that population. Still, overall results that included the general sample showed different factors when compared to the original scale, since the Croatian version did not show standard factors, but rather positive and negative attitudes factors. Results could be seen as highly suggestive and emphasize the need to distinguish and separate research on attitudes toward dementia in different populations.

Background/Aim. The World Health Organization (WHO) identified four broad domains as being universally relevant to the quality of life, namely physical, and psychological health, social relationships, and environment. The aim of this study was to assess the relationship between sociodemographic characteristics and quality of life of old people. Methods. The World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) was used to assess quality of life on a random sample of 200 people aged 60 years and over who lived in the Retirement Home in Novi Sad. Items within the questionnaire were organized into four domains: physical, psychological, social relationships and environment. Results. The majority of the participants were women (69.8%). The mean age was 79.2 years (SD = 6.6 years). Most of them were widowed (73.4%). More than two thirds of participants (68.8%) reported that they were ill at that moment and almost half of them (48.8%) had cardiovascular, 18.5% musculoskeletal, 9.6% endocrine and 5.9% neurological disease. In the social relations domain scores were lower in males (t = 2.4; p = 0.017). Scores of other domains did not differ significantly with regard to the age, educational level and the marital status of the participants. Participants who reported the presence of a disease had significantly lower mean scores of physical, psychological and environment domain. Conclusion. The presence of disease is a relevant factor for quality of life, whereas age, education and marital status do not reflect on physical health, psychological and environmental domain of quality of life.

There has been increasing interest in the application of virtual reality (VR) to occupational therapy and rehabilitation fields. This work presents a VR-based city adventure framework designed for occupational therapy. Its concept is based on taking the user to travel around a virtual city, where the motion is powered by the execution of some type of physical exercise, namely cycling in the current example. This framework is extensible and may integrate different goals focused on improving/maintaining motor and cognitive skills necessary for daily activities, mainly through upper and lower limb exercises and mental challenges. This led to the development of an immersive system, which was tested with an elderly sample (15 participants) in a day center and at a retirement home. Usability, satisfaction, performance and side effects were evaluated to understand future applicability and work directions.

Aim The purpose of this formative study was to explore current knowledge and attitudes towards physical activity, as well as perceived barriers, facilitators and opportunities for physical activity participation among older adults living in the community. The findings have subsequently informed the design, delivery and recruitment strategies of a local community physical activity intervention programme which forms part of Sport England’s national Get Healthy, Get Active initiative. Background There is a growing public health concern regarding the amount of time spent in sedentary and physical activity behaviours within the older adult population. Methods Between March and June 2016, 34 participants took part in one of six focus groups as part of a descriptive formative study. A homogenous purposive sample of 28 community dwelling white, British older adults (six male), aged 65–90 years (M=78, SD=7 years) participated in one of five focus group sessions. An additional convenience pragmatic sub-sample of six participants (three male), aged 65–90 years (M=75, SD=4 years), recruited from an assisted living retirement home participated in a sixth focus group. Questions for focus groups were structured around the PRECEDE stage of the PRECEDE–PROCEDE model of health programme design, implementation and evaluation. Questions addressed knowledge, attitudes and beliefs towards physical activity, as well as views on barriers and opportunities for physical activity participation. All data were transcribed verbatim. Thematic analysis was then conducted with outcomes represented as pen profiles. Findings Consistent views regarding both the potential physical and psychosocial benefits of physical activity were noted regardless of living status. The themes of, opportunities and awareness for physical activity participation, cost, transport, location and season/weather varied between participants living in an assisted living retirement home and community dwelling older adults. Further comparative research on the physical activity requirements of older adults living in assisted living versus community settings are warranted.

The current health system in Ontario is not designed to meet the needs of frail older adults. This is particularly true for older adults hospitalized due to exacerbation of chronic illness or medical crisis. This article describes the Subacute Care Unit for the Frail Elderly (SAFE) program, one which is designed to serve frail older patients who are at risk of deconditioning or disability associated with prolonged hospitalization but who may safely return home or to a retirement home following up to 4 weeks of subacute care in a restorative environment. The program centres on an intense restorative and integrated care delivery model. The patient population is medically complex, requiring medical supervision and regular adjustment to the care plan to optimize medical status. Individuals are no longer acutely ill and are considered stable or stabilizing. Care and services are designed to improve outcomes for hospitalized frail older adults by proactively addressing the conditions that contribute to alternate level of care before the deconditioning associated with prolonged hospitalization is experienced.

Objective Depression affect not only older people’ self-care ability and quality of life, but also increase the burden of their families and caregivers as well as health care resources. With consideration of the adverse effects of antidepressant medications and high medical costs of treating depression, it is important to use non-pharmacological interventions for managing depressive symptoms of older people. This study aimed to evaluate the effects of familiar music with alpha binaural beats on blood pressure, heart rate variability, and depression level of older people with depressive symptoms and to assess its feasibility for older people. Methods This study used a one-group pre-test and post-test design. Thirty-five older people residing in a retirement home participated in the study. Each participant listened to 30-minute familiar music with alpha binaural beats via a headphone individually while lying on the chair or bed in the afternoon in a private room. The music compact disk were Taiwanese old songs from the 1950-1970s which was familiar to most of the Taiwanese older people. Results The study results indicated that the participants after listening to 30-minute familiar music with embedded binaural beats of alpha frequencies at 10 Hz had shown immediate effects by a significant reduction on their heart rate, systolic blood pressure, and LF norm of heart rate variability (HRV), and a significant increase on HF norm of HRV indicating that the participants were in a relaxing state after listening to the music. Depression level was significantly decreased after listening to 30-minute familiar music with alpha binaural beats in the afternoon daily for five days. Conclusions Familiar music listening with alpha binaural beats can be a noninvasive and suitable intervention to promote relaxation and alleviate negative emotion in older people with depressive symptoms in long-term care settings.

Background Socially assistive robotics (SAR) has been a major field of investigation during the last decade and, as it develops, the groups the technology can be applied to and all ways in which these can be assisted are rapidly increasing. Objective The main objective is to design and develop a complete robotic agent, so that it performs physical and mental activities for elderly people to maintain their healthy life habits and, as a final result, improve their quality of life. Methods LEGO Mindstorms NXT® robot's unique capacity for adaptability and engaging its users to develop coaching activities and assistive rehabilitation for the elderly. Such activities will aim to enhance healthy habits and provide training in physical and mental rehabilitation. The robot is attached to an iPod Touch that acts as its interface. Results The robot has been tested by a voluntary group of residents, also from that retirement home. Results in the variables of the questionnaire show scores above 4 points out of 5 for all the categories. Conclusions Based on the tests, an easy to use Robot is prepared to deliver basic coaching for physical activities as proposed by the client, the staff of La Misericordia, who confirmed their satisfaction regarding this aspect.

The article discusses education of older people for combating their loneliness, the reasons for it, and its consequences. The current theoretical findings were the reason for the empirical study of the research problem by the authors. In the empirical part, some aspects of the life of older people regarding their residences were compared: among older people living with their relatives, alone, with a partner, or in a retirement home, with special regard to the reasons/causes for residence, and the feeling of loneliness and contacts with relatives. The obtained empirical results showed that older people living alone or in a retirement home are in a worse position compared to those living with relatives or with a partner. The most at risk are older people living alone.

Background and Introduction: Telemedicine, the process of providing healthcare remotely using communication devices, has the potential to be useful for the geriatric population when specifically designed for this age group. This study explored the design of four video telemedicine systems currently available and outlined issues with these systems that impact usability among the geriatric population. Based on the results, design suggestions were developed to improve telemedicine systems for this population.Using a between-subjects experimental design, the study considered four telemedicine systems used in Medical University of South Carolina. The study was conducted at a local retirement home. The participant pool consisted of 40 adults, 60 years or older. The dependent measures used were the mean times for telemedicine session initiation and video session, mean number of errors, post-test satisfaction ratings, the NASA-Task Load Index (NASA-TLX) workload measures, and the IBM-Computer Systems Usability Questionnaire measures.Statistical significance was found among the telemedicine systems' initiation times. The analysis of the qualitative data revealed several issues, including lengthy e-mail content, icon placement, and chat box design, which affect the usability of these systems for the geriatric population.Human factor-based design modifications, including short, precise e-mail content, appropriately placed icons, and the inclusion of instructions, are recommended to address the issues found in the qualitative study.

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.

A descriptive study was carried out with nursing students at Akdeniz University School of Health in 2011 at a university school in the Mediterranean region in Turkey. A total of 285 student nurses were in this research. Personal information forms developed by the researcher and the Ageism Attitude Scale were used as the data tools. The students mean obtained Ageism Attitude Scale score was 68.27±6.28. Significant difference was found between ageism attitude scale scores of students and class, gender, selection status of the nursing profession willingly, being satisfied that the parties are applying state of the profession, 65 years and over the life of a family member requesting status of a retirement home and after graduating from the section where the elderly work status request (p

Starting in 2008. ongoing project 'The Socio-economic status and health needs of Veterans and Disabled Veterans,' on the territory of Serbia. The aim of the project is to collect data and understanding of the current state of the health and social needs of veterans and invalids of NOR and the war of the nineties of the last century. Based on this plan the appropriate steps to help war veterans and invalids. Data were collected from 9,850 veterans and disabled veterans in 45 cities and municipalities, and in some cities covered by the survey are the descendants of former combatants, supporters - members of veterans' organizations. For data collection, we used a special questionnaire. We analyzed data on 7,940 respondents members of veterans' organizations from 40 cities and municipalities, whose processing is completed by the end of the 2013th year. About one quarter of respondents (24%) were females. Three-quarters (76%) of veterans and invalids are older than 80, and 57.3% by 85 years. Out of 7,891 positive responses, 3,480 (44.1%) rated their health is as satisfactory, 3,540 (44.9%) as poor and 871 (9.9%) as very poor. The majority of respondents who answered this question (42.1%) live in multimember families of, 1,360 (21.7%) lived alone, and 2,274 (32.6%) in two-member households. Of 7,940 respondents, 2,204 (27.7%) expressed the need for support services in the home, and 1,220 (15.4%) for placement in a retirement home. It is necessary agreement, planning and implementation of activities, adequate for the found facts and the current needs of veterans and disabled veterans and their descendants.

Uvod: Bolečina v lumbalnem predelu predstavlja pogosto zdravstveno težavo med zdravstvenim osebjem. Z raziskavo smo želeli ugotoviti, kako pogosto se bolečine v križu pojavljajo pri zdravstvenem osebju, in sicer v povezavi z izbranimi dejavniki tveganja. Metode: Raziskava temelji na neeksperimentalni kvantitativni metodi empiričnega raziskovanja. Uporabili smo vprašalnik zaprtega tipa o bolečini v križu, ki ga je izpolnilo 89 zdravstvenih delavcev v Splošni bolnišnici Jesenice in domu upokojencev na področju Gorenjske. Za ugotavljanje statistično značilnih razlik med skupinami smo uporabili test χ2 in enofaktorsko analizo variance. Rezultati: Bolečina v križu se pri 40,4 % zdravstvenega osebja pojavlja večkrat na mesec, najpogosteje pri bolničarjih (p = 0,001) in zaposlenih na negovalnem oddelku (p = 0,006). Povprečno traja manj kot en teden (43,8 %). Dejavnik, ki je z njo najbolj povezan, je dvigovanje in prenašanje bremen (x = 4,5). Glede izobraževanj s področja bolečine v križu in pravilnega dvigovanja bremen obstajajo statistično značilne razlike med poklicnimi skupinami (p < 0,010). Diskusija in zaključek: Z bolečino so najbolj povezani dejavniki, ki nastanejo zaradi neposrednega fizičnega dela s pacientom. Potrebna so nadaljnja raziskovanja na reprezentativnih vzorcih, treba bi bilo izvesti tudi izobraževanja za zaposlene in uvesti nove pripomočke, ki bi jih zdravstveno osebje uporabljalo pri svojem delu s pacientom.

Beginning dementia is a major cause for leaving the familiar home environment and moving into a retirement home. This means loss of independence for the individuals and leads to growing expenses for the health-care system. While many solutions for ambient assisted living (AAL) provide support for monitoring and enabling dementia patients to stay longer in the home environment, the actual use of AAL solutions lags behind expectation. A major challenge is to satisfy the information needs of different stakeholders in the dementia care process while paying attention to the privacy concerns at the same time. In this chapter, a concept is introduced to autonomously process and analyze collected data in the home environment. The concept is part of the “SAKI” project which is funded by the Federal German Government. By using data mining and artificial intelligence, the tremendous amount of data can be analyzed in-home and only sent outside when defined critical situations are detected. Therefore, existing AAL solutions are combined to detect significant patterns where external help or information is required. Three types of actors in the field of dementia care can profit from this development: The patient himself is provided with real-time feedback of his cognitive and behavioral performance. Family members are provided with summarized and abstracted information to monitor the patient’s well-being and their level of autonomy. Professional caregivers are provided with detailed information on daily activities and medical information, which can be integrated in the caregiver’s information technology system.

We observed a dog visitation program in a geriatric retirement home in Japan, to obtain quantitative data on the human–dog interactions. Seven volunteer handlers and seven adult pet dogs were divided into two groups. Each group visited the home on one of two activity days each month for 18 months. The program was conducted in a consistent way and the features of it did not change during the course of the study. Five to 12 senior residents, among a total of 31 (9 men and 22 women, 16 with normal/mild and 15 with moderate/severe disabilities in activities of daily living: ADL), voluntarily participated in each activity day. We focused on each dog as a target, using a focal animal sampling method, and monitored the seating arrangements of the residents. We found that both the residents and dog handlers contributed to the interaction. Affiliative physical contact was predominantly used as an interaction tool. Neither sex, ADL level, nor the rate of adjacent vacant seats affected the frequency of each ...

Introduction When GPs are afflicted by burnout, patients' demands are perceived to create a relational imbalance. It can be supposed that in this situation, GPs will react by distancing themselves from the patient. Effectively, various studies suggest that health professionals who are suffering from burnout adapt withdrawal strategies towards their patients: less implication, etc. In the present study, we make the assumption that when the GP is suffering from burnout, the withdrawal will be even more important with a noncompliant patient. Method Two hundred and seventy GPs responded to the case of an 84 year-old female patient who lives alone and falls regularly. After having broken the neck of the thigh bone, she leaves the hospital and remains dependent for the next months. The patient is presented in two ways: compliant vs. non compliant. The GPs were asked to indicate the degree to which they would choose each of the solutions that were proposed. These solutions vary according to their degree of implication. Information on the participants' level of burnout was also gathered. Results When the patient is compliant, the implicating solutions (home assistance and home care) are chosen equally as much by the participants, whatever their level of emotional exhaustion. But when the patient is noncompliant, these solutions are always chosen as much by the participants with a low level of emotional exhaustion, but are significantly less chosen by those with a high level of emotional exhaustion. The opposite is found for withdrawal solutions (independent living residence, medium term hospital stay, retirement home). When the patient is compliant, the choice of these solutions does not vary in function of the level of exhaustion. However, when the patient is noncompliant, these solutions attract the GPs significantly more if they are exhausted (but not if they are slightly exhausted).

Background Due to demographic ageing and increasing life expectancy, a growing demand for long-term nursing home care can be expected. Stays in nursing homes appear to be more socially determined than hospital stays. We therefore looked at the impact of socio-demographic and health care variables on the length of the last nursing home stay. Methods Nationwide individual data from nursing homes and hospitals in Switzerland were linked with census and mortality records. Gender-specific negative binomial regression models were used to analyze N = 35,739 individuals with an admission age of at least 65 years and deceased in 2007 or 2008 in a nursing home. Results Preceding death, men spent on average 790 days and women 1250 days in the respective nursing home. Adjusted for preceding hospitalizations, care level, cause of death and multimorbidity, a low educational level, living alone or being tenant as well as a low care level at the admission time increased the risk for longer terminal stays. Conversely, a high educational level, being homeowner, being married as well as a high care level at the admission time decreased the risk for longer stays. Discussion The length of the last nursing home stay before death was not only dependent on health-related factors alone, but also substantially depended on socio-demographic determinants such as educational level, homeownership or marital status. The support of elderly people at the admission time of a presumably following nursing home stay should be improved and better evaluated in order to reduce unnecessary and undesired long terminal nursing home stays. Conclusions Health policy should aim at diminishing the role of situational, non-health-related factors in order to empower people to spend the last years before death according to individual needs and preferences.

Bad health combined witii deteriorating physical functions force many elderly people to move to a retirement home. The primary focus of this study was to investigate the resident's experience of safety and security. From a sample of 57 residents, 12 persons volunteered to participate in the interview. Data were analyzed with qualitative content analysis. The standard and design of the participant's previous home made mobility difficult and this affected their sense of security. This motivated them to move into an environment where they felt more secure. The environment at the retirement home was predominantly described as secure and safe. The finding shows that the participants felt that safety and security were more important than independence.

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.

OBJECTIVE To compare a limited array of chewing-stimulated saliva features (salivary flow, pH and buffer capacity) in a sample of elderly Mexicans with clinical, sociodemographic and socio-economic variables. SUBJECTS AND METHODS A cross-sectional study was carried out in 139 adults, 60 years old and older, from two retirement homes and a senior day care centre in the city of Pachuca, Mexico. Sociodemographic, socio-economic and behavioural variables were collected through a questionnaire. A trained and standardized examiner obtained the oral clinical variables. Chewing-stimulated saliva (paraffin method) was collected and the salivary flow rate, pH and buffer capacity were measured. The analysis was performed using non-parametric tests in Stata 9.0. RESULTS Mean age was 79.1 ± 9.8 years. Most of the subjects included were women (69.1%). Mean chewing-stimulated salivary flow was 0.75 ± 0.80 mL/minute, and the pH and buffer capacity were 7.88 ± 0.83 and 4.20 ± 1.24, respectively. Mean chewing-stimulated salivary flow varied (p < 0.05) across type of retirement home, tooth brushing frequency, number of missing teeth and use of dental prostheses. pH varied across the type of retirement home (p < 0.05) and marginally by age (p = 0.087); buffer capacity (p < 0.05) varied across type of retirement home, tobacco consumption and the number of missing teeth. CONCLUSIONS These exploratory data add to the body of knowledge with regard to chewing-stimulated salivary features (salivary flow rate, pH and buffer capacity) and outline the variability of those features across selected sociodemographic, socio-economic and behavioural variables in a group of Mexican elders.

Virtual reality (VR) has been shown to function well as an assistive technology to physical therapy for elderly users. Elderly users are a unique user group in this field, due to their characteristics and demands. They are also a user group that can definitely benefit from VR technology, which is unfortunately a perspective that seems elude the VR community. This study explores how augmenting a manuped exercise (chair-based exercise bike), using an interactive screen-based virtual environment (VE), can change the exercise experience for retirement home residents. It is the first study in a series of studies, initiating an investigation into how to use VR to augment conventional exercise experiences, specifically for the retirement home resident audience. In a larger scope, the ambition is longterm to use VR technology to increase motivation with retirement home residents, to uphold a regular exercise routine. The results showed that a majority of subjects reported to support the VE augmentation and preferred the VE based exercise experience to the conventional exercise. This supports VR as an assisting technology for physical therapy, and suggests the potentiality VE augmented exercises, tailored for retirement home residents.

Balance confidence is an important indicator of functional mobility and independence in older adults. Preliminary psychometric evidence for the Activities-specific Balance Confidence (ABC) Scale is promising, with a series of four studies adding information on the discriminative and evaluative properties of this tool.The original validation sample was reinterviewed one year later. In the second study, the ABC was administered to 475 older adults ranging from home care clients to highly functioning individuals in community exercise programs. The third study compared 31 residents of retirement homes given a 10-week balance control exercise program and fall education with 32 residents who received only fall education. The fourth study examined balance confidence preoperatively and postoperatively for 27 patients undergoing hip or knee replacement.ABC scores remained stable over 12 months in higher functioning elders, but deteriorated in retirement home residents over 26 weeks. Ten weeks of balance training significantly improved balance confidence, as did hip or knee replacement with standard physical therapy. ABC scores lower than 50 indicated a low level of physical functioning characteristic of home care clients. ABC scores above 50 and lower than 80 indicated a moderate level of functioning characteristic of elders in retirement homes and persons with chronic health conditions. ABC scores above 80 are indicative of highly functioning, usually physically active older adults, and are achievable through exercise and rehabilitative therapies. CONCLUSIONS. Balance confidence is amenable to change and able to distinguish between elders at various levels of functional mobility. These results provide comparative benchmarks for researchers and clinicians working with different groups of older adults.

We describe an outbreak of pneumonia due to Streptococcus pneumoniae in a French retirement home. Eleven residents developed pneumonia. Eight patients had positive results of urinary antigen tests. There were no further cases after the implementation of control measures, which involved isolation of and receipt of antibiotic therapy by symptomatic residents. No risk factors for transmission of S. pneumoniae were identified in this population.

The purpose of this study was to discover the care expressions, practices, and patterns of elderly Anglo- and African American elders. The domain of inquiry was the cultural care of elderly residents within the environmental context of a long-term care institution. The ethnonursing qualitative research method was used to conduct the study which was conceptualized within Leininger's theory of culture care diversity and universality. Four major themes were discovered: (a) Residents expressed and lived generic care to maintain their preadmission lifeways; (b) The nursing staff provided aspects of professional care to support satisfying lifeways for residents; (c) Institutional care patterns and expressions were viewed as a continuing life experience but with major differences between the apartment section and nursing home units; and (d) An institutional culture of the retirement home was discovered which reflected unique lifeways and shared care and health expressions and practices. These themes substantiated the culture care theory and revealed new modes of care for the elderly in an institutional setting.

SUMMARY Objective. To investigate predictors of change in the sense of competence of primary caregivers and continuity in home care for dementia patients. Design. A prospective longitudinal study with a follow-up period of 10 months. Setting. Dementia patients living in the community selected by Dutch general practitioners. Subjects. Pairs of demented patients and their primary caregiversONa 138U. Main outcome measures. Sense of competence: a 27-item scaleOaa 0:79U based on issues derived from the family crisis model and the Burden Interview. Continuity in home care is determined by the number of patient’s admissions to a nursing or retirement home. Results. Regression analysis revealed that a change in the caregiver’s sense of competence was independently predicted by characteristics of the patient, the primary caregiver and the professional social network. A decreased sense of competence was associated with a longer duration of dementia and the patient’s more agitated behaviour, the caregiver’s higher initial sense of competence and being a female caregiver sharing a household with the demented patient. A positive influence on the change in the sense of competence was found when these females received a professional intervention consisting of support for the caregiver. Reporting to be a Catholic or a Protestant compared with not being religiously involved positively influenced the change in sense of competence. Logistic regression analysis identified that continuity in home care was predicted by characteristics of the demented patient and the professional social network of the patient. Predictors of continuation of home care were: lower severity of dementia, patient’s higher ADL impairment, the intervention and involvement of regular home help. Institutionalization was more likely when the patient’s behaviour was more apathetic and a district nurse was involved in the care. Conclusions. Caregiver characteristics influenced the change in sense of competence but did not influence the risk for institutionalization. Findings suggest that health professionals should pay attention to the negative consequences of agitated behaviour and to the most vulnerable group, females sharing a household with the demented patient. #1997 by John Wiley & Sons, Ltd.

Mealtime satisfaction is an important component of quality of life (QOL) in residential care, yet there currently is no self-administered tool described in the literature. The purpose of this study is to investigate internal and test–retest reliability, and construct validity of a mealtime satisfaction questionnaire (MSQ) designed for residential care, more specifically retirement homes. A 15-item MSQ was developed and eligible participants from four retirement homes (n = 749) were invited to participate. The participation rate was 24% and the median age was 88 years for respondents. The internal consistency of the MSQ was high (Cronbach Alpha = 0.83) and the test–retest reliability was also high (Intraclass coefficient = 0.91, P