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Background/Objectives: Randomized controlled trials that deliver physical activity interventions have demonstrated benefits for older adults across numerous health outcomes. However, too little attention has been directed to ensuring that such trials are measuring patient-relevant outcomes. To support outcome selection for future trials, the objective of this study was to understand what outcomes related to their physical activity participation older adults find important. Methods: We conducted 12 semistructured interviews with adults aged 65 years and older and analyzed interview transcripts with a reflexive thematic analysis. Results: Older adults desired diverse outcomes from their physical activity participation, ranging from generic (e.g., quality of life) to specific (e.g., leg strength). Relevant outcomes were classified under five themes: physical, clinical, social, psychological, and overarching, each with respective subthemes. Conclusions: The outcomes that older adults found important were plentiful and rooted in a desire to improve their quality of life. Some of the outcome themes have been reported frequently in past trials (e.g., physical), but others have not (e.g., social). Future researchers should be aware of, and responsive to, the priorities of older adults when designing trials and defining outcomes. Significance/Implications: This study will help to improve outcome selection for future trials of physical activity with older adults. In alignment with a patient-oriented research philosophy, this study will also ground future outcome selection in the priorities of older adults. [ABSTRACT FROM AUTHOR]

Research indicates a positive relationship between physical literacy and healthy aging; however, there is no consensus on the components required to become a physically literate adult. The objective of this study was to understand how physical literacy for adults with chronic conditions is characterized from the perspective of healthcare professionals. Physiotherapy leaders and physical literacy researchers within North America were invited to an online consensus panel and presented with questions related to physical literacy and rehabilitation. A nominal group technique was used for idea generation, clarification, and ranking. Confidence and safety with movements, motivation and commitment to physical activity, the ability to self-monitor changes in function, and understanding the benefits of physical activity were key components when defining physical literacy. There is a need to reconceptualize physical literacy to include the rehabilitation needs of adults living with chronic conditions, and to design programs that promote physical literacy to enhance function and mobility. [ABSTRACT FROM AUTHOR]

Unpaid eldercare provided by family comes with costs to caregivers, including the limitations eldercare responsibilities may place on labor force participation and work hours. This study examines the relationship between the frequency of unpaid eldercare and work behavior for previously full-time workers using multivariate regression and 2011–2018 American Time Use Survey data. High-frequency eldercare provision is associated with a decreased probability of being in the labor force for both men and women, and 5.5 fewer weekly hours worked for men ages 25–49, conditional on working full time 2–5 months prior. Policymakers should consider the relationship between work and unpaid caregiving for high-frequency caregivers in addressing growing care demand. [ABSTRACT FROM AUTHOR]

Background and purpose: The number of older people in prisons is increasing across the globe. Many have poor physical and mental health, higher prevalence of head injury, cognitive impairment and dementia than found in community populations. Meeting the complex needs of this vulnerable group has become an increasing concern for prison and prison healthcare services. The aim of this multi method qualitative study was to investigate how men with diagnosed or suspected dementia were identified, assessed, and cared for in Scottish prisons. It also explored the lived experience of individuals being assessed for or diagnosed with dementia within four prisons. The data from twenty nine interviews was thematically analysed and used to collaboratively propose principles for dementia care in prison and present the resultant co-designed care pathway. Results: At the time of data collection almost all the men known to have a dementia diagnosis or suspected dementia had complex health and social care needs, and some were living with advanced dementia. Prison healthcare staff reported taking a 'case by case' approach to their pre- and post-diagnostic care. Meeting these prisoner's needs was complicated by the absence of organisational leads for care of older adults or people with dementia and there was no pathway or model in place to guide staff. Prison healthcare teams often had difficulty accessing specialist community services to support diagnosis. There was a lack of dementia education and knowledge about how to provide pre and post diagnostic dementia care in this setting amongst staff. The findings arising from this research have informed the co-production of two important evidence informed innovations namely a Model of Care and a pre- and post-diagnostic Care Pathway. Conclusion: This research adds insights critical to understanding the adequacy of current approaches to meeting dementia related needs within the prison setting. To our knowledge this paper offers the first co-produced evidence informed pre- and post- diagnostic dementia care pathway and model of care for use in prisons. These could serve as tools for change that could enable prison healthcare staff to deliver the right care, at the right time, by the right people, and provide an opportunity to assess risk and plan care for the future. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion The rise in the elderly population all over the world has led to an increase in the health care needs of elderly individuals. Thus, health care professionals need programs to help them develop positive attitudes toward the elderly during their education process. This study aims to explore the effect of interventions that encourage health care students to develop positive attitudes toward the elderly.In this research utilizing the meta‐analysis method, searches were conducted across eight databases. Following the screening process, a total of 14 101 studies were retrieved, of which 13 were ultimately included in the meta‐analysis.Following the meta‐analysis, the effect size of interventions for positive attitude development toward the elderly was found to be statistically significant at 0.422 (95% confidence interval, 0.013–0.830; P = 0.043).Thirteen studies in which the effect of interventions for positive attitude development toward the elderly was examined revealed that the effect was moderately in favor of the experimental group. Although there are a large number of studies in the literature that aim to develop positive attitudes toward the elderly, well‐designed studies with high methodological quality are needed to obtain high level evidence. Geriatr Gerontol Int ••; ••: ••–•• Geriatr Gerontol Int 2024; ••: ••–••. [ABSTRACT FROM AUTHOR]

ABSTRACT Local policy documents play a key role in the provision of social services in decentralised welfare systems. Previous Swedish research shows great municipal variation in local policies for delegation, which determines social workers' legal rights to make decisions about the welfare service given to older people. In this paper, we examine the association between local conditions and the variation of restrictiveness in local policies on delegation for elder care services, by combining data on political rule and economic, demographic, and geographic characteristics of all Swedish municipalities (n = 290), with data on delegation policy. Based on logistic regression models, the results indicate that population density, political rule and average income are correlated with the probability of restrictiveness in delegation. Our findings highlight the importance of understanding local conditions while allocating the responsibility for the provision of welfare in decentralised states with varying local prerequisites. They further highlight the need for studies investigating the consequences of varying local political policies on the outcome of the elder care services provided to older adults. [ABSTRACT FROM AUTHOR]

Shared site intergenerational care programs (SSICPs) integrate care services for old and young generations in co-located contexts. A common form combines residential aged care and childcare services within a single site that is home to older adults and contains a childcare center. At present, SSICPs are under-researched and under-developed. Consequently, the aim of this scoping review is to review evidence on this type of SSICP, informing their future development. Nine articles met the inclusion criteria, and were analyzed with narrative synthesis and tabulation. Findings reveal benefits plus practices and principles underlying the establishment of SSICPs. While more research is needed to confirm outcomes and best practice, and examine possibilities beyond developed countries, this review demonstrates the potential of SSICPs as a viable model of care for older people and young children, and provides guidelines toward their development and implementation. [ABSTRACT FROM AUTHOR]

This article explores the intersection of healthcare accessibility and digitalisation from a rights perspective. Drawing from two illustrative cases presented to a filariasis management clinic in Puducherry, where the authors are affiliated, the article argues that despite the multiple benefits that digital health poses, there are individuals and sections of society that experience marginalisation in healthcare owing to digitalisation. Collating the data generated through the observations of the authors and the narratives of the patients, the article illustrates that such marginalisation can originate even from a relatively simple ICT adaptation like text message-based appointments, inducing health inequities. The impact of such digital marginalisation disproportionately affects vulnerable sections like older adults and the rural population in an intersectional pattern where disadvantages compound to produce larger health inequities for the affected. The study advocates for bridging the digital divide through efforts including digital literacy–when possible–and alternative solutions like dedicated helpdesks, training healthcare staff and involving NGOs and voluntary organisations to ensure health equity for the digitally marginalised. [ABSTRACT FROM AUTHOR]

Approximately one in three older adults (aged 65 years and over) experience pain, negatively impacting their quality of life. Opioid analgesics are commonly prescribed to manage pain; however, balancing the benefits and harms of these high-risk analgesics can be challenging for both healthcare professionals and patients. This is particularly true for older adults, as factors such as polypharmacy, age-related physiological changes and cognitive decline may impact upon opioid safety and efficacy. Deprescribing is the patient-centred process of reducing or discontinuing a medication that is no longer appropriate, or where the risks of continuation are deemed to outweigh the anticipated benefits. Opioid deprescribing has been proposed as a mechanism to reduce individual and societal opioid-related harm; however, to date, research has predominantly focused on the general adult population, rather than older adults. This current opinion aims to summarise the existing opioid deprescribing literature, discussing its applicability for older adults. Drawing on a non-systematic review of the literature, it identifies unique challenges and considerations for this population, highlights international initiatives to enhance opioid deprescribing in clinical practice and proposes future directions to advance the field. [ABSTRACT FROM AUTHOR]

Understanding patients' degree of frailty is crucial for tailoring clinical care for older adults based on their physiologic reserve and health needs ("frailty‐guided clinical care"). Two prerequisites for frailty‐guided clinical care are: (1) access to frailty information at the point of care and (2) evidence to inform decisions based on frailty information. Recent advancements include web‐based frailty assessment tools and their electronic health records integration for time‐efficient, standardized assessments in clinical practice. Additionally, database frailty scores from administrative claims and electronic health records data enable scalable assessments and evaluation of the effectiveness and safety of medical interventions across different frailty levels using real‐world data. Given limited evidence from clinical trials, real‐world database studies can complement trial results and help treatment decisions for individuals with frailty. This article, based on the Thomas and Catherine Yoshikawa Award lecture I gave at the American Geriatrics Society Annual Meeting in Long Beach, California, on May 5, 2023, outlines our group's contributions: (1) developing and integrating a frailty index calculator (Senior Health Calculator) into the electronic health records at an academic medical center; (2) developing a claims‐based frailty index for Medicare claims; (3) applying this index to evaluate the effect of medical interventions for patients with and without frailty; and (4) efforts to disseminate frailty assessment tools through the launch of the eFrailty website and the forthcoming addition of the claims‐based frailty index to the Centers for Medicare and Medicaid Services Chronic Conditions Data Warehouse. This article concludes with future directions for frailty‐guided clinical care. [ABSTRACT FROM AUTHOR]

Since their inception in 1975, the Department of Veterans Affairs Geriatric Research, Education, and Clinical Centers (GRECCs) have served as incubators of innovation in geriatrics. Their contributions to the VA mission were last reviewed in 2012. Herein, we describe the continuing impact of GRECCs in research, clinical, and educational areas, focusing on the period between 2018 and 2022. GRECC research spans the continuum from bench to bedside, with a growing research portfolio notable for highly influential publications. GRECC education connects healthcare professions trainees and practicing clinicians, as well as Veterans and their caregivers, to engaging learning experiences. Clinical advancements, including age‐friendly care, span the continuum of care and leverage technology to link disparate geographical sites. GRECCs are uniquely positioned to serve older adults given their alignment with the largest integrated health system in the United States and their integration with academic health centers. As such, the GRECCs honor Veterans as they age by building VA capacity to care for the increasing number of aging Veterans seeking care from VA. GRECC advancements also benefit non‐VA healthcare systems, their academic affiliates, and non‐Veteran older adults. GRECCs make invaluable contributions to advancing geriatric and gerontological science, training healthcare professionals, and developing innovative models of geriatric care. [ABSTRACT FROM AUTHOR]

Introduction: The intersection of ageism and racism is underexplored in geriatric emergency medicine (GEM) research. Methods: We performed a scoping review of research published between January 2016 and December 2021. We included original emergency department‐based research focused on falls, delirium/dementia, medication safety, and elder abuse. We excluded manuscripts that did not include (1) original research data pertaining to the four core topics, (2) older adults, (3) subjects from the United States, and (4) for which full text publication could not be obtained. The primary objective was to qualitatively describe reporting about older adults' social identities in GEM research. Secondary objectives were to describe (1) the extent of inclusion of minoritized older adults in GEM research, (2) GEM research about health equity, and (3) feasible approaches to improve the status quo of GEM research reporting. Results: After duplicates were removed, 3277 citations remained and 883 full‐text articles were reviewed, of which 222 met inclusion criteria. Four findings emerged. First, race and ethnicity reporting was inconsistent. Second, research rarely provided a rationale for an age threshold used to define geriatric patients. Third, GEM research more commonly reported sex than gender. Fourth, research commonly excluded older adults with cognitive impairment and speakers of non‐English primary languages. Conclusion: Meaningful assessment of GEM research inclusivity is limited by inconsistent reporting of sociodemographic characteristics, specifically race and ethnicity. Reporting of sociodemographic characteristics should be standardized across different study designs. Strategies are needed to include in GEM research older adults with cognitive impairment and non‐English primary languages. [ABSTRACT FROM AUTHOR]

The article discusses the specialty of geriatric medicine that extends well beyond single medical conditions and calls for interdisciplinary team care. Topics covered include medical students' low interest in the specialty and maintenance of specialty certification, and healthcare advances in the field as of 2024. Also noted are recommendations for renewed interest in the specialty like practitioners' need to lay claim to their clinical domain, and the improvement of fellowship training.

Objectives Guided by Andersen's behavioral model, the objectives of this study were to (a) examine the associations between individual factors and the intended utilization of home-based long-term care (LTC) services among older adults in China and (b) explore the influence of community support, if any, on these associations. Methods Using a multistage random sampling approach, we recruited 1,064 older adults in Chengdu, China. Hierarchical regression was employed to investigate the direct effects of individual predictors and community support on the intended use of home-based LTC services. The moderating effect of community support was examined using the Hayes Process. Results Two predisposing (i.e. being old and unmarried), 4 enabling (i.e. living alone, having fewer children, and receiving less family and peer support), and 6 need factors (i.e. having more chronic illnesses; decreased performance in instrumental activities of daily living; higher levels of depression, anxiety, loneliness; and a lower self-image of aging), and low community support were significantly associated with increased intended utilization of home-based LTC. In addition, community support moderated the effects of family support (B  = −0.20, p  < .001), peer support (B  = −0.20, p  < .001), self-image of aging (B  = −0.39, p  < .001), depression (B  = −0.34, p  < .001), and loneliness (B  = −0.48, p  <  .001) on the intended utilization of home-based LTC services. Discussion Policy-makers and practitioners should consider delivering tailored services for older adults and involve the community in the context of enhancing home-based LTC services. [ABSTRACT FROM AUTHOR]

Introduction: Elderly people experience a high level of oral diseases, and such conditions were found to be more prevalent among those living in residential aged care facilities (RACFs). Objectives: This study explored the barriers to providing oral health (OH) care for residents living in private residential aged care facilities (RACF) in Malaysia, from the perspective of the supervisors. Methodology: This was a qualitative study, that involved face-to-face interviews with supervisors in seven private RACFs in Selangor, Malaysia. Interviews were conducted using a semi-structured open-ended questionnaire, audio-recorded for analysis, transcribed verbatim, and subjected to thematic analysis. Results: All seven supervisors agreed on a lack of any structured protocol available to residents or workers to promote OH care for residents. They reported that RACF staff received no formal training in providing OH care for residents, and noted various barriers to the provision of routine OH care, categorised into three main themes: (1) residents' factors (e.g. physical limitations, limited family involvement, uncooperative behaviour), (2) caregivers' factors (e.g. lack of knowledge on the part of caregivers, incompetent caregivers and insufficient comprehensive management in RACFs) and (3) environmental factors (e.g. less involvement from government, difficulty in accessing dental clinics, refusal of dentists to manage patients with complex medical conditions, and poor public awareness). Conclusions: The study concluded with the need for the establishment of an OH training program for RACF staff and a protocol for daily and professional OH care for the residents of private RACFs in Malaysia. [ABSTRACT FROM AUTHOR]

The study investigates temporal aspects of home care in Sweden, as experienced and interpreted by older care users. Data consists of 34 interviews with 36 care users and 15 participant observations during home visits by care staff. By focusing on care users' recalibration of time and events, the analysis identifies a form of interpreted experience – here termed 'home care time' – that comprises two governing sublogics – care users' understanding of themselves as part of the home care organisation, and care users' empathetic understanding for care staff – where each sublogic evolved from several approaches where care users expressed time empathy, tried to increase time efficiency, or adapted to other care users. Some care users described attempts to take control and influence temporal aspects. Such attempts resulted in adjustments to services at the individual care user's request, but they were also associated with the risk of conflict between care users and care workers. The study addresses the gap in the literature, which mostly studies and theorises care from a care provider perspective. The logic of home care time identified in the study can explain why older people may say they are satisfied with services though poorly performed due to time shortages. This explanation is a corrective to stereotypes that portray older care users as docile and grateful. [ABSTRACT FROM AUTHOR]

This paper examines the tensions and struggles over elder care that are happening in South Africa between family caregivers, care workers and the state. These struggles are experienced and expressed at the familial and community level but are best understood by examining how the state has de-funded facilities in favour of 'ageing in place' without any additional investment in community and home-based care support. The findings reveal that stresses on unpaid and paid carers are expressed in terms of individual failings and interpersonal conflict rather than through a socio-political contextual lens. These findings contribute to how a familialist care regime impacts the everyday personal relationships between paid and unpaid carers of older persons. [ABSTRACT FROM AUTHOR]

India is aging. The growth of India's older population has increased our concerns about their well-being. While it is critical to explore the diverse needs and aging experience of older Indians, their voices are largely missing in the aging literature. In this context, data was collected from 63 community-dwelling and OAH residing older men and women of Delhi NCR to understand their aging experience, views about old age and perceived need for government intervention in old age care and support. Reflexive thematic analysis of their aging experience and perception of old age generated five themes and six sub-themes: The aging body encompassing three sub-themes "the older we become the more diseases we have", "the ointment called positive thinking", "women's quest for self-care"; Psychological gains and social losses; Affiliation, distraction and anticipation; The aging parent and the adult child comprising three sub-themes "filial relations—quality and quantity", "children these days and their mobile phones", "our daughter shows us more love and care"; and A time for religious and spiritual devotion. Lastly, the analysis of their perceived need for government support in old age care generated five sub-themes – Political cynicism, I was a private employee but am I not a part of this country? Government or Private Hospitals: A no-win situation, Everyday life and Reforms in OAHs. The present findings highlight the multidimensional and multidirectional experience of aging and the diverse needs of older persons in the Indian context. [ABSTRACT FROM AUTHOR]

Problematic integration theory is a theory in communication that deals with the processing of messages by humans. It is helpful to study challenges and their solutions in the health communication context to develop effective relationships, treat patients, and, ultimately, ensure the well-being of society. A scoping review was conducted. Three databases were searched following the PRISMA‐ScR statement without a time frame. Independent screening of titles, abstracts, and full texts was performed, and the studies selected based on the inclusion and exclusion criteria were assessed. The required information was then extracted from the studies and entered into Excel software. A total of 43 studies related to PI theory were identified in the databases. The results indicated that PI theory is used to interpret feelings, beliefs, challenges, concerns, and problematic dilemmas in five thematic categories: elderly care, cancer care, infertility, pregnancy, and childbirth care, illness care, and sexual care. Each of the papers also offers distinctive and valuable considerations for interventions such as communication strategies, coping mechanisms, uncertainty and certainty management, information management, education, training, support groups, and campaigns to improve decision-making and meet the challenges of health communication. [ABSTRACT FROM AUTHOR]

An online qualitative survey explored perceived training, readiness, and needs of recent SW graduates serving older adults. Over half (N = 14) held a master's in social work, with 70% having taken an introductory aging course. Nearly halfcompleted other aging-specific coursework, and 80% did fieldwork with older adults. Participants indicated moderate proficiency in assessing issues like lossestransitions (46.7%), and physical health (53.3%), and advanced expertise in cognitive assessments (60.0%) and caregiver stress management (53.3%). Training deficiencies were noted in disaster readiness, telehealth, and resource coordination. Findings underscore the need for educationfor early-career social workers, ensuring their effective support to older adults. [ABSTRACT FROM AUTHOR]

Preventable hospital admissions in elderly home care residents are a major socioeconomic burden, whilst early detection of deterioration may improve outcomes. Our goal was to develop and validate a machine learning-based algorithm to predict hospitalization risk among home care users. Our primary outcome was hospitalization. An existing risk score (1-5) was assessed for its discriminatory capacity over time. We subsequently developed a new machine learning model using carer concerns, service user demographics, and other home care data between January and July 2021. We randomly selected 150 service user records for validation, which were evaluated by both the model and 10 clinicians (9 doctors and 1 nurse) to compare prediction time and accuracy to human experts. Comparison between model and human was via area under the receiver operating characteristic curve (AUC). A score of 5 conferred an 8x higher likelihood of hospitalization in the subsequent 7 days (15.4% vs 1.8%, p <.05), compared to a score of 1. The new model and risk score increased performance, detecting 182 hospitalizations/month (3.7x chance). The AUC for the model was significantly higher than for clinicians (0.87 vs 0.41-0.57, respectively; p <.05). The model took <1 minute, while clinicians typically took over 40 minutes. A risk prediction model using carer concerns and other home care data features detects 3.7x more hospitalizations than chance. The model is faster and more accurate than human clinicians, enabling low-cost scale-up. This study supports linking the model to a triage and intervention service to reduce preventable hospitalizations in the home care sector. [ABSTRACT FROM AUTHOR]

In Japan, little is known about the approaches to medical care for older patients with multimorbidity used by physicians either at patients' homes or in hospitals. A questionnaire survey was conducted to understand the current approaches to older patients with multimorbidity. The questionnaire was sent to 3300 people, including 1650 geriatric specialists and 1650 primary care specialists, were enrolled. A four-point Likert-type scale was used to score the following items: diseases that cause difficulties in treatment (diseases), patient backgrounds that cause difficulties in treatment (backgrounds), important clinical factors, and important clinical strategies. We used the Tukey–Kramer test to examine the differences between scores across 3 groups: physicians providing only home care (the "home" group), physicians providing only inpatient care (the "hospital" group), and physicians providing both home care and inpatient care (the "home and hospital" group). Out of 836 valid responses, those from 587 physicians were included in the analysis. The overall score for diseases was significantly higher in the "hospital" group than in either the "home" or "home and hospital" groups. The overall score for important clinical strategies was significantly higher in the "home and hospital" group than in the "hospital" group. In conclusion, physicians' approaches to treating older people with multimorbidity may vary by practice setting, and particularly whether they provide care only to patients at home or in hospital or to both. To improve the quality of transition of care between hospital and home, a support system that considers differences in physician practice should be developed. [ABSTRACT FROM AUTHOR]

Our society, in general, and health care, in particular, faces notable challenges due to the emergence of innovative digital technologies. The use of socially assistive robots in aged care is a particular digital application that provokes ethical reflection. The answers we give to the ethical questions associated with socially assistive robots are framed by ontological and anthropological considerations of what constitutes human beings and how the meaning of being human relates to how these robots are conceived. Religious beliefs and secular worldviews, each of which may participate fully in pluralist societies, have an important responsibility in this foundational debate, as anthropological theories can be inspired by religious and secular viewpoints. This article identifies seven anthropological considerations grounded in the synthesis of biblical scriptures, Roman Catholic documents, and recent research literature. We highlight the inspirational quality of these anthropological considerations when dealing with ethical issues regarding the development and use of socially assistive robots in aged care. With this contribution, we aim to foster a global and inclusive dialogue on digitalization in aged care that deeply challenges our basic understanding of what constitutes a human being and how this notion relates to machine artefacts. [ABSTRACT FROM AUTHOR]

Aim(s): To evaluate the literature to inform and propose a conceptual definition for dementia friendly in the context of hospitalization. Methods: The Walker & Avant method for concept analysis was utilized for this review. Data Sources (Include Search Dates): Initial search conducted June 2022. Repeated search conducted in February 2023. Databases for the literature search include Scopus, PubMed, CINAHL, PsycINFO, and AGELINE. Results: Five attributes of the concept of dementia friendly in the context of hospitalization were identified including: staff knowledge/education, environmental modification, person‐centred care, nursing care delivery and inclusion of family caregivers. Based on these attributes a conceptual definition is proposed. Conclusion: A clarified definition for dementia friendly in the context of hospitalization will aid in understanding the concept, provide guidance for hospitals seeking to implement dementia‐friendly interventions and benefit researchers aiming to study the impact of such programs. Reporting Method: n/a. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim: To examine changes in the use of glucose‐lowering medicine (GLM) 12 months before and 12 months after long‐term care facility (LTCF) entry among people with diabetes. Materials and Methods: A national retrospective cohort study was conducted using linked health and aged care data from the Registry of Senior Australians National Historical Cohort. Residents of LTCFs with diabetes aged 65 years or older from 2015 to 2019 were included. Prevalence of GLM use and the number of defined daily doses (DDDs) dispensed per 1000 resident‐days were estimated quarterly (91‐day) using Poisson regression models, or negative binomial regression when overdispersion was present. Results: Among the 50 993 residents studied (median age 84 years), the prevalence of GLM use was 58.4% (95% confidence interval [CI] 58.0%‐58.8%) in the 9‐12 months pre‐LTCF entry and 56.3% (95% CI 55.9%‐56.8%) in the 9‐12 months post‐entry. The number of DDDs/1000 resident‐days increased from 1015.2 (95% CI 1002.3‐1028.1) to 1253.8 (95% CI 1168.4‐1339.3) during the same period. GLM use in the 3 months pre‐entry was 56.8% (95% CI 56.4%‐57.2%) compared with 61.7% (95% CI 61.3%‐62.1%) in the 3 months post‐entry, with the increased use driven mainly by insulin. No marked changes in the number of GLMs dispensed or GLM type were observed at 9‐12 months post‐entry compared with 3 months pre‐entry. Among 22 792 individuals dispensed a GLM in the 3 months prior to LTCF entry, 50.2% continued the same GLM at 9‐12 months post‐entry. Conclusions: GLM use peaked in the first 3 months following LTCF entry, driven mainly by insulin, hence, residents may benefit from close monitoring of diabetes treatment during this period. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic revealed that when formal care services closed down, informal care burden was unequally transferred to women. Women across the world became part of "caregiver pools". Using textual archive material collected by the Finnish Literature Society, we analyse the transformation of informal elder care practices in Finland. We adopt a care mobility and care process perspective to analyse how informal elder care was transformed due to social distancing measures that restricted ageing individuals and their family members' local and translocal mobilities. We find that over 70-year-olds had to adapt their daily mobilities according to risk assessment. Caregiving provided by mostly female family members was replaced by digital care at a distance, which reinforced existing inequalities in care. We argue that the pandemic simultaneously brought about both a time–space compression and what we call a time–space expansion that affected the everyday practices and mobilities of care. [ABSTRACT FROM AUTHOR]

Introduction: Older adults are at high risk of adverse health outcomes in the post–emergency department (ED) discharge period. Prior work has shown that discharged older adults have variable understanding of their discharge instructions which may contribute to these outcomes. To identify discharge comprehension gaps amenable to future interventions, we utilize meta‐analysis to determine patient comprehension across five domains of discharge instructions: diagnosis, medications, self‐care, routine follow‐up, and return precautions. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, two reviewers sourced evidence from databases including Medline (PubMed), EMBASE, Web of Science, CINAHL, and Google Scholar (for gray literature). Publications or preprints appearing before April 2024 were included if they focused on geriatric ED discharge instructions and reported a proportion of patients with comprehension of at least one of five predefined discharge components. Meta‐analysis of eligible studies for each component was executed using random‐effects modeling to describe the proportion of geriatric ED cases understanding the discharge instructions; where appropriate we calculated pooled estimates, reported as percentages with 95% confidence interval (CI). Results: Of initial records returned (N = 2898), exclusions based on title or abstract assessment left 51 studies for full‐text review; of these, seven constituted the study set. Acceptable heterogeneity and absence of indication of publication bias supported pooled estimates for proportions comprehending instructions on medications (41%, 95% CI 31%–50%, I2 = 43%), self‐care (81%, 95% CI 76%–85%, I2 = 43%), and routine follow‐up (76%, 95% CI 72%–79%, I2 = 25%). Key findings included marked heterogeneity with respect to comprehending two discharge parameters: diagnosis (I2 = 73%) and return precautions (I2 = 95%). Conclusions: Older patients discharged from the ED had greater comprehension of self‐care and follow‐up instructions than about their medications. These findings suggest that medication instructions may be a priority domain for future interventions. [ABSTRACT FROM AUTHOR]

Older adults with cancer heterogeneously experience health care, treatment, and symptoms. Geriatric assessment (GA) offers a comprehensive evaluation of an older individual's health status and can predict cancer‐related outcomes in individuals with solid tumors and those with hematologic malignancies. In the last decade, randomized controlled trials have demonstrated the benefits of GA and GA management (GAM), which uses GA information to provide tailored intervention strategies to address GA impairments (e.g., implementing physical therapy for impaired physical function). Multiple phase 3 clinical trials in older adults with solid tumors and hematologic malignancies have demonstrated that GAM improves treatment completion, quality of life, communication, and advance care planning while reducing treatment‐related toxicity, falls, and polypharmacy. Nonetheless, implementation and uptake of GAM remain challenging. Various strategies have been proposed, including the use of GA screening tools, to identify patients most likely to benefit from GAM, the systematic engagement of the oncology workforce in the delivery of GAM, and the integration of technologies like telemedicine and mobile health to enhance the availability of GA and GAM interventions. Health inequities in minoritized groups persist, and systematic GA implementation has the potential to capture social determinants of health that are relevant to equitable care. Caregivers play an important role in cancer care and experience burden themselves. GA can guide dyadic supportive care interventions, ultimately helping both patients and caregivers achieve optimal health. [ABSTRACT FROM AUTHOR]

Purpose: The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden. Design/methodology/approach: Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061). Findings: The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results. Originality/value: The instrument measures both leadership and management performance and can be used to continually measure managers' performances as perceived by staff to identify areas for development. [ABSTRACT FROM AUTHOR]

The article discusses the need for a philosophical shift in the Australian residential aged care sector to better cater to the physical, social, and psychological needs of older people. It proposes reframing aged care as communities within social and ecological communities to move away from consumerist approaches. By recognizing residents as part of interconnected communities, the sector can address critical challenges identified by the Royal Commission and promote social and environmental justice. The article emphasizes the importance of relationships in shaping personhood and advocates for a holistic approach to care that considers the broader community and ecological impact. [Extracted from the article]

Objectives: To determine whether adherence to hip fracture clinical care quality indicators influences mortality among people who undergo surgery after hip fracture in New South Wales, both overall and by individual indicator. Study design: Retrospective population‐based study; analysis of linked Australian and New Zealand Hip Fracture Registry (ANZHFR), hospital admissions, residential aged care, and deaths data. Setting, participants: People aged 50 years or older with hip fractures who underwent surgery in 21 New South Wales hospitals participating in the ANZHFR, 1 January 2015 – 31 December 2018. Main outcome measures: Thirty‐day (primary outcome), 120‐day, and 365‐day mortality (secondary outcomes) by clinical care indicator adherence level (low: none to three of six indicators achieved; moderate: four indicators achieved; high: five or six indicators achieved) and by individual indicator. Results: Registry data were available for 9236 hip fractures in 9058 people aged 50 years or older during 2015–2018; the mean age of patients was 82.8 years (standard deviation, 9.3 years), 5510 patients were women (69.4%). Complete data regarding adherence to clinical care indicators were available for 7951 fractures (86.1%); adherence to these indicators was high for 5135 (64.6%), moderate for 2249 (28.3%), and low for 567 fractures (7.1%). After adjustment for age, sex, comorbidity, admission year, pre‐admission walking ability, and residential status, 30‐day mortality risk was lower for high (adjusted relative risk [aRR], 0.40; 95% confidence interval [CI], 0.30–0.52) and moderate indicator adherence hip fractures (aRR, 0.61; 95% CI, 0.46–0.82) than for low indicator adherence hip fractures, as was 365‐day mortality (high adherence: aRR, 0.59 [95% CI, 0.51–0.68]; moderate adherence: aRR, 0.74 [95% CI, 0.63–0.86]). Orthogeriatric care (365 days: aRR, 0.78; 95% CI, 0.61–0.98) and offering mobilisation by the day after surgery (365 days: aRR, 0.74; 95% CI, 0.67–0.83) were associated with lower mortality risk at each time point. Conclusions: Clinical care for two‐thirds of hip fractures attained a high level of adherence to the six quality care indicators, and short and longer term mortality was lower among people who received such care than among those who received low adherence care. [ABSTRACT FROM AUTHOR]

Objective: Elder Mistreatment (EM) occurs in approximately 10% of older adults and is associated with trauma-related outcomes including depression, anxiety, posttraumatic stress disorder, and early mortality. Low screening and older adult self-reporting, especially within emergency departments, represent missed opportunities for identify and mitigate future EM occurrences and consequences. To date, no studies have obtained EM survivors' perspectives on EM screening and response practices in emergency departments. Methods: Semi-structured interviews with 19 EM survivors of those with Adult Protective Services validated EM were completed in older adults' homes. The Elder Mistreatment Emergency Department Screening and Response Tool (EM-SART) was used to guide the interview questions. All interviews were recorded, transcribed, and analyzed using qualitative thematic analyses. Results: The participants were mostly female (63%) and white (58%) with an average age of 74 years. Physical abuse accounted for 67% of the EM incidents. Three themes emerged indicating the survivor preference for (1) building rapport and approaching the older adult with compassion and care, (2) setting the context before asking the EM questions, and (3) allowing mutuality, collaborative work, and shared decision-making during the response. Conclusions: Older adults are agreeable and willing to self-report and actively engage in the EM screening and response practices in the emergency department if trauma-informed care principles are utilized. [ABSTRACT FROM AUTHOR]

BACKGROUND: Additional evidence is required to address the unintended consequences of medication use in older people and the required caregiver support. To inform priorities for future research efforts, different stakeholder perspectives are needed, including those of older people, caregivers, clinicians, and researchers. OBJECTIVE: To develop a co-designed medicationrelated research agenda. METHODS: A 12-member Advisory Council, half of which were older people and caregivers, designed the research. An 11-question survey to identify priorities for medication-related patient-centered outcomes research (PCOR) topics was administered to members of the Elder Care Medicine Network (ECMN) (ie, older people, caregivers, clinicians, and researchers). Respondents were categorized into two groups with hierarchical assignment to the clinician/research group over the older adult/caregiver group. Chi-square tests compared priority areas for medication-related PCOR between the two groups. RESULTS: There were 53 responses (48% response rate) from the ECMN, with 39.6% (n = 21) from the clinician/researcher group and 60.4% (n = 32) from the older adult/caregiver group. The priority areas from both groups included safe ways to simplify medicines (62.2%), communicating with pharmacists and prescribers about medications (58.5%), and information about safe supplements with prescription medications (52.8%). Statistically significant differences existed between the two groups in the proportions choosing the priority areas. CONCLUSION: Co-design of a survey to identify priority areas for PCOR demonstrated successful engagement of older people and caregivers as research partners. While older people and caregivers may have differing perspectives on the importance of specific medication-related PCOR topics, simplifying medication regimen and health care communications were germane to both groups. [ABSTRACT FROM AUTHOR]

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The Montessori method applied in nursing homes is a person-centered approach targeting the enhancement of autonomy, well-being, and quality of life for older adults with dementia. Despite its potential in the aging field, its operationalization remains unclear in the context of institutionalization. This study aims to outline the method's components and adoption factors using a behavior change intervention framework among professionals from a French institution demonstrating a high level of method application. We employed a qualitative descriptive approach based on thematic analysis. Nine professionals from the same institution underwent a semi-structured individual interview within the facility. The findings were modeled using the Behavior Change Intervention Ontology. We obtained a final framework defining the intervention, mechanisms of action, exposure, contextual factors, and behavioral outcomes. The method is based on values, principles, and techniques such as facilitation, choice, meaningful activities, environmental adjustments, and specific tools. Applied continuously to residents, families, and professionals, its implementation is influenced by several contextual factors leading to practice changes at various levels. This study constitutes both a theoretical and practical contribution, providing a better definition of the method and the key factors influencing its appropriation. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionsClinical implicationThis study aimed to assess the knowledge, attitude, and practice of the healthcare professionals and paid caregivers toward non-pharmacological interventions (NPIs) for managing behavioural and psychological symptoms of dementia (BPSD) in Australian residential aged care homes (RACHs).A cross-sectional, online survey was completed by RACH staff and physicians over the period 6 March-31 August 2023. Descriptive statistics were used to present the results.Ninety-six respondents participated (41.7% aged 35–54 years, 80.2% female, 38.5% nurses). While 50–65% of the respondents were extremely familiar with 15 of NPIs, only 22% believed there was a sufficient funding for their implementation, and 6% felt there were sufficient human resources. Although 66% of the respondents viewed NPIs as more useful than medications, only 46% expected consistent positive outcomes from NPIs. The most used NPIs were redirection, behaviour management, and validation therapy.The study highlights that barrier such as inadequate funding, limited human resources, skepticism about NPIs’ effectiveness, unfamiliarity with certain NPIs, and unfavourable attitude toward NPIs are likely to slow NPI adoption for BPSD management.To improve practice, it is essential to address these barriers through targeted education, and training, increased funding, and enhancement of the workforce. [ABSTRACT FROM AUTHOR]

The demand for home-based eldercare, especially for those with dementia, has been growing as societies age; in this context, the acute shortage of local care labor has resulted in the use of migrant workers in many countries. Taiwan, Singapore, and Austria, all emphasizing the family’s responsibility for eldercare, have long histories of recruiting migrant workers for home-based eldercare. However, cases of mistreatment of migrant caregivers and care recipients have aroused public concern regarding migrant workers’ care capabilities and working conditions. Migrant caregivers have also reported that their lack of care skills and sufficient rest hamper their work with care recipients who have dementia. This commentary provides a critical review of the laws and policies pertaining to live-in migrant care workers’ care capabilities and working conditions; the effects of such legal frameworks; and recent changes in Taiwan, Singapore, and Austria. This article enhances our cross-country understanding of the advantages and disadvantages of using foreign labor for eldercare in private homes. Governments should enact legislation that supports live-in migrant care workers’ care capabilities and welfare, thereby also improving the well-being of care recipients and their families. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Data Sources Methods Results Conclusion Impact Patient or Public Contribution To systematically review the potential of smart home technology to enhance the independence of older adults and reduce their dependence on care. Additionally, it sought to examine the positive impacts of such technology on their golden years.A systematic review based on Preferred Reporting Items for Systematic Review and Meta‐Analyses (PRISMA).The search was conducted on 8 April 2024. Peer‐reviewed studies in PubMed, Embase, Web of Science, IEEE Xplore, Scopus, The Cochrane Library, CINAHL, CNKI, WANFANG DATA and VIP from 1 January 2000 to 8 April 2024 were searched.The methodological quality assessment used the Mixed Methods Appraisal Tool (MMAT). Positive findings relevant to this study were extracted from the literature and analysed using thematic synthesis.After meticulously examining 3404 studies, we identified 21 relevant sources for in‐depth analysis, including qualitative studies (n = 10), experimental studies (n = 9) and mixed method studies (n = 2). These sources were grouped into five core themes based on the pivotal role of smart home technologies in enabling ageing in place: daily monitoring, assisted living activities, life reminders, functional improvement and emotional companionship. The study found that smart home technology offers numerous benefits to the lives of older adults, including increased independence, psychological support, improved cognitive functioning, enhanced self‐management, increased mobility, support for caregivers, promoted social engagement and enhanced quality of life.Smart home technology can enhance the independence of older adults' lives, reduce their dependence on care, alleviate the burden on caregivers and promote home‐based elderly care.This systematic review contributes to understanding the capability of smart home technology to promote elderly care at home and help better utilise smart home technology to benefit older adults. Older adults and their caregivers should be encouraged to adopt this technology to improve older adults' quality of life.No patient or public contribution. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResultConclusionTo evaluate current oral care practices in an acute aged care hospital setting, and staff perceptions of the barriers and enablers to delivery of evidence-based oral care practices.A mixed method study comprised of retrospective file audit and cross-sectional survey was conducted within a single acute aged care unit. Medical records of patients aged ≥ 65 years admitted over a 6 month period were retrospectively audited. A clinician survey was used to explore barriers to and enablers of the delivery of oral care practices using the Capability, Opportunity, Motivation, Behaviour (COM-B) questionnaire. Result were analysed using descriptive statistics.Patient file audits (n = 206) found 13.6% (n = 28) of patients had oral care completed, despite 23% (n = 47) of patients being recommended by a speech language pathologist to receive oral care. Staff survey respondents (n = 31) reported they do not have the physical or social opportunities to provide oral care (i.e. adequate resources, time, and social support), however, they were motivated and reported they have the required knowledge and skills to provide oral care.There is a need for implementation strategies to enable an interprofessional response to improve the delivery of evidence-based oral care practices and optimise patient outcomes. [ABSTRACT FROM AUTHOR]

AbstractChina’s urbanization has relocated many rural families, but it remains unclear if such changes undermine patriarchy. This study draws on survey and interview data in northwestern China to examine what prevailing principles families draw on in dividing the newly acquired family wealth (1) between parents and children, (2) between elder and younger children, and (3) between sons and daughters. These family decisions are not triggered by life course changes but are induced by a sudden increase in family wealth, which may differ from what usually happens in rural families. Quantitative comparison and qualitative case analysis suggest the accelerated downstream transfers from parents and the mixed desires to prioritize sons’ housing needs, care for each child’s entitlement, compensate less privileged children, and secure parents’ elderly care. The persisting values and rising desires, as reflected by multiple principles of altruism, exchange, entitlement, son preference, and need, contributed to the persisting gender effect and the ambiguous generation and parity effects—parents and elder children did not have apparent advantages in family property structures when rural families were relocated or enclosed into urban areas. [ABSTRACT FROM AUTHOR]

Background: Drug-related problems (DRPs) significantly threaten the safety of the elderly. In order to improve pharmacists' ability to minimize these events, novel educational interventions that consider the current challenges in clinical practice are crucial. Objectives: The primary objective is to assess the impact of two unique educational interventions on pharmacists' ability to identify DRPs. Method: A total of 127 community pharmacies in the United Arab Emirates (UAE) were recruited and randomly allocated to one of three arms using a 1:1:1 allocation ratio. While a series of clinical case scenarios (N = 24) related to elderly care were established and validated and sent to pharmacists in Active Group A over a 3-month period, lengthy research articles focused on medication safety in elderly were emailed to pharmacists in Active Group B. The control group pharmacist received no intervention. Then, pharmacists self-reported the number, categories, and severity of DRPs and pharmacist recommendations. Results: The incidence of DRPs identified by pharmacists was 10.8% in Active Group A, 2.0% in the Control Group (p = 0.011), and 3.8% in Active Group B (p = 0.014). A significant difference was observed in the proportion of DRP types between Active Group A and the Control Group. The most common DRPs in Active Group A were avoidable medication (14.7%) and untreated disease (9.2%). Pharmacists in Active Group A (37.2%) and Active Group B (32.3%) most commonly intervened by recommending the cessation of medication, while the most common intervention in the Control Group was recommending a decrease in dose (29.8%). The mean cost reduction per patient was highest in Active Group A (31.3 ±11.8 $), followed by Active Group B (20.8 ±8.6 $) and the Control Group (19.6 ±9.5 $). The mean time needed to resolve a DRP was shortest in Active Group A (7.3 ±3.5 minutes), followed by Active Group B (9.8 ±4.2 minutes) and the Control Group (9.8 ±5.7 minutes). Conclusion: Using WhatsApp to deliver clinical scenarios was effective in improving pharmacists' ability to identify and address DRPs in elderly patients, resulting in faster resolution and higher cost savings. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the associations and mediating pathways between grip strength, cognitive function, and depression in middle-aged and elderly individuals in China. Methods: Utilizing data from the 2011 China Health and Retirement Longitudinal Study (CHARLS), we employed logistic regression and mediation analysis to examine the relationships and mediating factors between grip strength, cognitive function, and depression, while adjusting for potential confounders. Results: The study included 6,841 participants, of whom 1,734 (25.35%) exhibited symptoms of depression. Our findings indicate that weak grip strength is significantly associated with an increased risk of depression (OR: 1.57, 95% CI: 1.32-1.87) among the middle-aged and elderly population. Conversely, good cognitive function was found to be protective against depression (OR: 0.94, 95% CI: 0.93-0.95). Grip strength indirectly affected depression through cognitive function, accounting for 9.4% of the total effect (β = -0.008, 95% CI [-0.013, -0.004]). This mediating effect was 23.8% in men (β = -0.013, 95% CI [-0.020, -0.007]); and 23.2% in those aged 60 years and over (β = -0.015, 95% CI [-0.022, -0.009]). Conclusion: This study highlights that weak grip strength increases risk of depressive symptoms, and adequate cognitive function can mitigate the association between weak grip strength and an increased risk of depression among middle-aged and elderly individuals in China. Psychological care for elder adults with weak grip strength and poor cognitive function should be strengthened. [ABSTRACT FROM AUTHOR]

Background: Falls remain a persistent problem in residential aged care (RAC) facilities. Fall screening and assessment tools such as the Peninsula Health Falls Risk Assessment Tool (PHFRAT) are widely used to inform falls risk and guide fall prevention interventions. However, it is unclear how it is used in practice and whether clinicians believe it supports resident care. This study aimed to measure the extent of use of PHFRAT to understand clinicians' perceptions of its value and usefulness. Methods: This mixed method study involved an analysis of PHFRAT assessment from 25 RAC facilities in New South Wales, Australia, and interviews with seven RAC staff about how PHFRAT information is used in practice. In the quantitative component, descriptive statistics were applied to PHFRAT data to summarise how RAC staff use the PHFRAT including the completeness and content of the three parts. In the qualitative component, thematic analysis techniques were applied to interview data. Results: The sample included 215 RAC residents with 703 PHFRATs, of which 617 documented fall prevention interventions. Among these 617 PHFRATs, 593 (96.1%) included strategies related to staff assistance and 283 (45.9%) recorded strategies related to device provision. While nearly all residents (96.74%) received at least one PHFRAT assessment over the study period, many PHFRAT assessments were incomplete (part 1: 11.5% of information missing; part 2: 10.8%; part 3: 17.1%). There were few variations in fall interventions prescribed to individual residents by their fall risk level. Interviews with RAC staff indicated that PHFRAT assessments are the responsibility of registered nurses with limited input from other staff or residents. While the structured process was viewed positively in guiding risk assessment and intervention assessment, a lack of input from others prevented strategies from being tailored to residents' specific needs and preferences. A shortage of resources, lack of communication, and limited staff education were identified as the main barriers to PHFRAT guideline implementation. Conclusion: The PHFRAT provides a useful structure for clinicians to assess falls risk factors and plan falls prevention strategies. In the future, increased multidisciplinary input into fall prevention strategy development may improve the comprehensiveness of fall prevention plans. [ABSTRACT FROM AUTHOR]

Many people manage the dual roles of employment and providing unpaid care for an older relative. Although this is increasingly common, carers frequently observe that their caring role is undervalued. This lack of recognition and the adverse consequences that flow from it are of increasing interest to policymakers, advocacy bodies, and employers who have advanced legislative, policy, and workplace accreditation initiatives to enhance recognition of caring. However, the design and impact of these initiatives are constrained by the scarcity of research on carer recognition, its predictors, and its outcomes. Drawing on data from the Australian National Carer Survey, we utilise path analysis to test a conceptual model outlining how life experiences shape carer recognition and subsequent personal outcomes. Our findings provide support for the mediating role of carer recognition linking care-related disruptions in multiple domains (aged care services, employment, family) with carer outcomes (social connectedness, personal well-being, psychological distress, personal time alongside caring). Employees who experienced less disruption in aged care services, employment, and family domains reported higher carer recognition and better outcomes than employees with more disruptive experiences in each domain. The findings suggest new points of intervention to enhance carer perceptions of recognition, and in turn, carer outcomes. [ABSTRACT FROM AUTHOR]

With the acceleration of global population aging, the elderly have an increasing demand for home care and nursing institutions, and the significance of health prevention and management of the elderly has become increasingly prominent. In this context, we propose a biometric recognition method for multi-modal biomedical signals. This article focuses on three key signals that can be picked up by wearable devices: ECG, PPG, and breath (RESP). The RESP signal is introduced into the existing two-mode signal identification for multi-mode identification. Firstly, the features of the signal in the time–frequency domain are extracted. To represent deep features in a low-dimensional feature space and expedite authentication tasks, PCA and LDA are employed for dimensionality reduction. MCCA is used for feature fusion, and SVM is used for identification. The accuracy and performance of the system were evaluated using both public data sets and self-collected data sets, with an accuracy of more than 99.5%. The experimental data fully show that this method significantly improves the accuracy of identity recognition. In the future, combined with the signal monitoring function of wearable devices, it can quickly identify individual elderly people with abnormal conditions, provide safer and more efficient medical services for the elderly, and relieve the pressure on medical resources. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Design Sample Results Conclusions The aging Mediterranean Basin population presents complex challenges for healthcare systems, which require innovative care approaches. The study aimed to critically assess 19 socio‐healthcare practices in the Mediterranean Basin that target the elderly population by analyzing their theoretical foundations, integration of care services, ethical considerations, gender‐specific approaches, and use of technology.An integrative literature review was conducted using a structured methodology.Diverse sources across multiple languages were searched, with the inclusion criteria focusing on the alignment of socio‐healthcare practices with the components of the nursing metaparadigm, the incorporation of transversal values, and relevance to the elderly population.The socio‐healthcare practices exhibited common themes, such as person‐centered care, interdisciplinary collaboration, and incorporation of technology for coordinated care delivery. Ethical principles of autonomy, dignity, and respect were central, with some socio‐healthcare practices addressing gender‐specific care needs. Evidence‐based findings emphasized holistic care, integration, ethics, and innovation in elderly socio‐healthcare.New eldercare frameworks should integrate these aspects, which offer a comprehensive approach to addressing the complex needs of elderly patients. Managers should design systems prioritizing patient well‐being, whereas policymakers should develop equitable and high‐quality care policies that collectively improve the well‐being of the elderly population in the Mediterranean Basin. [ABSTRACT FROM AUTHOR]

Research on animals in residential aged care facilities (RACFs) mainly focuses on the residents with little apparent concern for animal welfare. In the context of documented human welfare breaches in the sector the question arises - how do Australian RACF approach animal welfare. To understand animals’ lived experiences in this context experienced dog-trainers with RACF employment history were interviewed. These experts were recruited using snowball sampling, with nine participating in semi-structured interviews about their experience of visiting and live-in animals in Australian RACFs. While initial inductive coding produced six themes (residents, animals, handlers, staff, facility and policy) pervasive animal welfare issues were noted. The outcomes of a subsequent, deductive, recoding using a welfare framework are reported here. Overall, with a focus on residents, and in a context of inadequate staffing, training and oversight, the interviews demonstrate systemic potential for compromised animal welfare with examples of dogs being frightened and one accidentally poisoned. These examples and the need to develop legislation and guidelines to guide safe, ethical, animal contact in RACFs are discussed. [ABSTRACT FROM AUTHOR]

Background: Older adults with chronic diseases often experience higher rates of Activities of Daily Living (ADL) disability, with research primarily examining the transition between states of ADL disability and non-disability. The current study aims to analyze the patterns and factors of mutual transitions between multiple different ADL disability states in older adults with chronic diseases. Methods: This longitudinal study utilized data from the Shanghai Elderly Care Unified Needs Assessment (SECUNA) spanning 2014 to 2017, with 2014 being the baseline. The study included older adults aged 60 years and older with chronic diseases. Using the Markov model, individuals were classified into three states: no ADL disability, mild ADL disability, and severe ADL disability. Transition patterns were analyzed by calculating the frequency, intensity, and probability of transition, and the influencing factors of six transition scenarios were evaluated. Results: Older adults with mild ADL disability were more likely to experience improvement (transition intensity: 0.4731) rather than deterioration (transition intensity: 0.2226) in their ADL disability states. However, those with severe ADL disability faced challenges in improving their states (transition intensities: 0.0068 and 0.1204). Among the six ADL disability transition scenarios, place of residence was associated with four scenarios, age and economic sources were associated with three scenarios, sex was associated with two scenarios, and other factors were associated with one scenario. Conclusions: The transition patterns and factors differ among individuals with varying ADL disability states. It is essential for relevant agencies to implement tailored preventive healthcare strategies to effectively manage the health status of older adults with chronic diseases. [ABSTRACT FROM AUTHOR]