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1.
Trials ; 22(1): 726, 2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34674750

RESUMO

The efficient community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in the current pandemic of coronavirus disease-2019 (COVID-19), which in severe and critical cases results in progressive pulmonary infection, complicated by respiratory failure, with a high prevalence of acute respiratory distress syndrome. Of all age groups, older adults have the greatest risk of severe COVID-19 and the associated complications. Globally, there are many reports of the rapid spread of COVID-19 among residents of skilled nursing facilities, with high associated rates of morbidity and mortality. With over 1.3 million residents in nursing home care in the USA, there is an urgent need for therapeutic strategies to prevent COVID-19 in these populations.Lilly, in collaboration with the National Institute of Allergy and Infectious Diseases, conducted the BLAZE-2 trial to evaluate the efficacy and safety of the monoclonal antibody bamlanivimab (LY3819253) in preventing SARS-CoV-2 infection and COVID-19, defined as symptomatic infection, in skilled nursing and assisted living facilities. It is a phase 3 randomized, double-blind, placebo-controlled trial, where participants were randomized to bamlanivimab (4200 mg) or placebo and then followed up for 24 weeks. Conducting a trial in the midst of a pandemic in these facilities poses several challenges, including a vulnerable elderly population, travel restrictions, supply chain interruptions, and defining the target population. The operational challenges were addressed by the innovative use of mobile research units which are customized, equipped, and staffed to support BLAZE-2 randomization and participant dosing within the skilled nursing and assisted living facilities. Herein, we describe the design of the study, the analytics behind facility selection, and an innovative operational model.


Assuntos
Moradias Assistidas , COVID-19 , Idoso , Ensaios Clínicos como Assunto , Humanos , Profilaxia Pós-Exposição , SARS-CoV-2
2.
PLoS One ; 16(10): e0258701, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34714846

RESUMO

BACKGROUND: Care institutions are recognised to be a high-risk setting for the emergence and spread of infections and antimicrobial-resistant organisms, which stresses the importance of infection prevention and control (IPC). Accurate implementation is crucial for optimal IPC practice. Despite the wide promotion of IPC and research thereof in the hospital and nursing home setting, similar efforts are lacking in disability care settings. Therefore, this study aimed to assess perceived barriers and facilitators to IPC among professionals working at residential care facilities (RCFs) for people with intellectual and developmental disabilities (IDD), as well as to identify professional-reported recommendations to improve IPC. METHODS: This qualitative study involved semi-structured interviews (before COVID-19) with twelve professionals from five Dutch RCFs for people with IDD. An integrated theoretical approach was used to inform data collection and analysis. Thematic analysis using inductive and deductive approaches was conducted. This study followed the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines. RESULTS: Our findings revealed barriers and facilitators at the guideline, client, professional, professional interaction, professional client interaction, client interaction, organisational, community, and societal level. Six main themes covering multiple barriers and facilitators were identified: (1) guidelines' applicability to (work)setting; (2) professionals' cognitions and attitude towards IPC (related to educational background); (3) organisational support and priority; (4) educational system; (5) time availability and staff capacity; and (6) task division and change coaches. The main professional-reported recommendations were the introduction of tailored and practical IPC guidelines, structural IPC education and training among all professionals, and client participation. CONCLUSIONS: To promote IPC, multifaceted and multilevel strategies should be implemented, with a preliminary need for improvements on the guideline, professional, and organisational level. Given the heterogeneous character, i.e., different professionals, clients and care needs, there is a need for a tailored approach to implement IPC and sustain it successfully in disability care. Our findings can inform future IPC practice improvements.


Assuntos
Moradias Assistidas/normas , Controle de Infecções/normas , Dinamarca , Deficiências do Desenvolvimento , Pessoal de Saúde , Humanos , Deficiência Intelectual , Pesquisa Qualitativa , Inquéritos e Questionários
3.
Health Aff (Millwood) ; 40(9): 1377-1385, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34495716

RESUMO

Assisted living provides housing and long-term care services to more than 811,000 older adults in the United States daily and is regulated by the states. This article describes changes in the specificity of state regulations governing the staffing in assisted living settings (that is, requirements for sufficient staffing or staffing ratios or levels) between 2007 and 2018 and the association between these changes and rates of hospitalization among a national sample of assisted living residents, including a subgroup with dementia. We found that increased regulatory specificity for direct care workers (for example, a change from requiring "sufficient" direct care worker staffing to requiring a specific staffing ratio or level) was associated with a 4 percent reduction in the monthly risk for hospitalization among residents in our sample and a 6 percent reduction among the subgroup with dementia. However, an increase in regulatory specificity for licensed practical nurses was associated with a 2.5 percent increase in the monthly risk for hospitalization and a 5 percent increase among the subgroup with dementia. Given that no federal requirements exist for the number of staff members or composition of staff in assisted living, these findings can inform states' policy decisions about staffing requirements for assisted living settings.


Assuntos
Moradias Assistidas , Idoso , Atenção à Saúde , Hospitalização , Humanos , Estados Unidos , Recursos Humanos
4.
NCHS Data Brief ; (404): 1-8, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34570695

RESUMO

Residential care communities provide housing for persons who cannot live independently but generally do not require the skilled care provided by nursing homes. On any given day in 2018, an estimated 918,700 residents lived in residential care communities (1,2). With the aging of the U.S. population, the numbers of residential care community residents will likely increase, becoming a substantial segment of the long-term care population. This report presents national estimates of selected characteristics of residential care community residents in 2018.


Assuntos
Moradias Assistidas , Envelhecimento , Humanos , Assistência de Longa Duração , Instituições Residenciais , Estados Unidos
5.
Int J Qual Stud Health Well-being ; 16(1): 1978724, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34558380

RESUMO

BACKGROUND: With adverse events and injuries recurring in residential aged care facilities (RACFs), older adults' safety in residential age care settings has attracted extensive attention from governments, researchers, and healthcare providers. Risk management is of utmost importance in reducing risks and improving the quality of care for older adults in long-term care. Although previous studies have made great efforts to explore risk management methods and technologies in RACFs, little is known about how managers identify and respond to risks in practice. PURPOSE: This qualitative study aimed to elucidate the perceptions and experiences of managers involved in risk management in RACFs in China. PARTICIPANTS AND METHODS: This study used a phenomenological research design. We conducted semi-structured interviews with 13 managers across 11 RACFs in Changsha City, Hunan Province, China. Data were analysed using Colaizzi's seven steps and NVivo 12 plus software. RESULTS: "Facilitation of an error-free culture" emerged as a central theme of managers' perceptions of risk management. Four sub-themes were revealed, namely "creating an age-friendly physical environment," "paying close attention to frail older adults," "improving the competence of nursing staff," and "building effective management programs." CONCLUSION: Facilitation of an error-free culture was of prime importance in risk management. Managers' experiences can help RACFs to better manage risks, as well as provide new perspectives and approaches for RACFs to improve the quality and outcomes of care. This study developed initiatives for improving resident safety in RACFs and may foster interest in the developing these initiatives.


Assuntos
Moradias Assistidas , Idoso , China , Humanos , Percepção , Pesquisa Qualitativa , Gestão de Riscos
6.
BMC Geriatr ; 21(1): 463, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-34399694

RESUMO

BACKGROUND: Many residents of assisted living facilities live with dementia, but little is known about the characteristics of assisted living facilities that provide specialized care for older adults who live with dementia. In this study, we identify the characteristics of assisted living facilities that offer a dementia care program, compared to those that do not offer such a program. METHODS: We conducted a population-level cross-sectional study on all licensed assisted living facilities in Ontario, Canada in 2018 (n = 738). Facility-level characteristics (e.g., resident and suite capacities, etc.) and the provision of the other 12 provincially regulated care services (e.g., pharmacist and medical services, skin and wound care, etc.) attributed to assisted living facilities were examined. Multivariable Poisson regression with robust standard errors was used to model the characteristics of assisted living facilities associated with the provision of a dementia care program. RESULTS: There were 123 assisted living facilities that offered a dementia care program (16.7% versus 83.3% no dementia care). Nearly half of these facilities had a resident capacity exceeding 140 older adults (44.7% versus 21.6% no dementia care) and more than 115 suites (46.3% versus 20.8% no dementia care). All assisted living facilities that offered a dementia care program also offered nursing services, meals, assistance with bathing and hygiene, and administered medications. After adjustment for facility characteristics and other provincially regulated care services, the prevalence of a dementia care program was nearly three times greater in assisted living facilities that offered assistance with feeding (Prevalence Ratio [PR] 2.91, 95% Confidence Interval [CI] 1.98 to 4.29), and almost twice as great among assisted living facilities that offered medical services (PR 1.78, 95% CI 1.00 to 3.17), compared to those that did not. CONCLUSIONS: A dementia care program was more prevalent in assisted living facilities that housed many older adults, had many suites, and offered at least five of the other 12 regulated care services. Our findings deepen the understanding of specialized care for dementia in assisted living facilities.


Assuntos
Moradias Assistidas , Demência , Idoso , Estudos Transversais , Demência/diagnóstico , Demência/epidemiologia , Demência/terapia , Humanos , Casas de Saúde , Ontário/epidemiologia
7.
Sr Care Pharm ; 36(9): 439-443, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34452653

RESUMO

Medication management for seniors is a foundation for keeping them healthy and independent. A vital aspect of medication management is the selective discontinuation of medications, or deprescribing. While this is a common practice within nursing homes it seems to be less common among those who live in assisted living facilities. Shockingly little exiting literature was found when conducting a literature review concerning deprescribing in assisted living facilities. Therefore, it was determined to set forth this call to action to focus on deprescribing in assisted living facilities hoping that it would be given more attention to keep our seniors healthy and safe.


Assuntos
Moradias Assistidas , Desprescrições , Humanos , Conduta do Tratamento Medicamentoso , Casas de Saúde
9.
J Am Med Dir Assoc ; 22(10): 2115-2120.e6, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34352202

RESUMO

OBJECTIVE: We investigate whether older adults who were newly diagnosed with dementia (severity unspecified) and resided in an assisted living facility that offered a dementia care program had a lower rate of transition to a nursing home, compared to those who resided in an assisted living facility without such a program. DESIGN: Population-based retrospective cohort study. SETTING AND PARTICIPANTS: Linked, person-level health system administrative data on older adults who were newly diagnosed with dementia and resided in an assisted living facility in Ontario, Canada, from 2014 to 2019 (n = 977). METHODS: Access to a dementia care program in an assisted living facility (n = 57) was examined. Multivariable Cox proportional hazards regression with robust standard errors clustered on the assisted living facility was used to model the time to transition to a nursing home from the new dementia diagnosis. RESULTS: There were 11.8 transitions to a nursing home per 100 person-years among older adults who resided in an assisted living facility with a dementia care program, compared with 20.5 transitions to a nursing home per 100 person-years among older adults who resided in an assisted living facility without a dementia care program. After adjustment for relevant characteristics at baseline, older adults who resided in an assisted living facility with a dementia care program had a 40% lower rate of transition to a nursing home (hazard ratio 0.60, 95% confidence interval 0.44, 0.81), compared with those in an assisted living facility without such a program at any point during the follow-up period. CONCLUSIONS AND IMPLICATIONS: The rate of transition to a nursing home was significantly lower among older adults who resided in an assisted living facility that offered a dementia care program. These findings support the expansion of dementia care programs in assisted living facilities.


Assuntos
Moradias Assistidas , Demência , Idoso , Estudos de Coortes , Demência/terapia , Humanos , Casas de Saúde , Ontário , Estudos Retrospectivos
10.
Sensors (Basel) ; 21(13)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34209826

RESUMO

Numerous researchers are working on Ambient Assisted Living systems to enable more comfortable and safer living for senior people in their homes. Due to modern lifestyles and an aging population, this has become a very important issue. According to the available literature, it is obvious that the kitchen is one of the most important and most dangerous rooms in the home. However, there is still evident lack of monitoring systems suitable for specific kitchen activities. In this paper, we propose a monitoring system capable of identifying activities related to the cooking process, and a decision-making system capable of identifying some unwanted and possibly critical conditions. The proposed systems are designed to satisfy the requirements of the modern Ambient Assisted Living systems dedicated to older adults. The proposed monitoring system consists of ultrasound, temperature, and humidity sensors. The acquired results from these sensors are the inputs for the decision-making system, which generate warnings or alarms intended for the senior users and/or formal or informal caregivers. This system is designed to improve home safety related to kitchen activities, as well as to provide information about the lifestyle and daily activities of senior users. Experimental validation of the proposed system confirms its functionality and accurate design approach.


Assuntos
Inteligência Ambiental , Moradias Assistidas , Atividades Cotidianas , Idoso , Envelhecimento , Cuidadores , Humanos , Monitorização Fisiológica
11.
CMAJ Open ; 9(3): E718-E727, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34257090

RESUMO

BACKGROUND: As in other jurisdictions, the demographics of people infected with SARS-CoV-2 changed in Quebec over the course of the first COVID-19 pandemic wave, and affected those living in residential care facilities (RCFs) disproportionately. We evaluated the association between clinical characteristics and outcomes of hospitalized patients with COVID-19, comparing those did or did not live in RCFs. METHODS: We conducted a retrospective case series of all consecutive adults (≥ 18 yr) admitted to the Jewish General Hospital in Montréal with laboratory-confirmed SARS-CoV-2 infection from Mar. 4 to June 30, 2020, with in-hospital follow-up until Aug. 6, 2020. We collected patient demographics, comorbidities and outcomes (i.e., admission to the intensive care unit, mechanical ventilation and death) from medical and laboratory records and compared patients who did or did not live in public and private RCFs. We evaluated factors associated with the risk of in-hospital death with a Cox proportional hazard model. RESULTS: In total, 656 patients were hospitalized between March and June 2020, including 303 patients who lived in RCFs and 353 patients who did not. The mean age was 72.9 (standard deviation 18.3) years (range 21 to 106 yr); 349 (53.2%) were female and 118 (18.0%) were admitted to the intensive care unit. The overall mortality rate was 23.8% (156/656), but was higher among patients living in RCFs (36.6% [111/303]) compared with those not living in RCFs (12.7% [45/353]). Increased risk of death was associated with age 80 years and older (hazard ratio [HR] 2.39, 95% confidence interval [CI] 1.35-4.24), male sex (HR 1.74, 95% CI 1.25-2.41), the presence of 4 or more comorbidities (HR 2.01, 95% CI 1.18-3.42) and living in an RCF (HR 1.62, 95% CI 1.09-2.39). INTERPRETATION: During the first wave of the COVID-19 epidemic in Montréal, more than one-third of RCF residents hospitalized with SARS-CoV-2 infection died during hospitalization. Policies and practices that prevent future outbreaks of SARS-CoV-2 infection in this setting must be implemented to prevent high mortality in this vulnerable population.


Assuntos
Moradias Assistidas/estatística & dados numéricos , COVID-19/mortalidade , Hospitalização/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Moradias Assistidas/tendências , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Estudos de Casos e Controles , Comorbidade , Feminino , Seguimentos , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Modelos de Riscos Proporcionais , Quebeque/epidemiologia , Respiração Artificial/mortalidade , Respiração Artificial/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Populações Vulneráveis/estatística & dados numéricos
12.
Artigo em Inglês | MEDLINE | ID: mdl-34072223

RESUMO

Complex medication regimens are highly prevalent, burdensome for residents and staff, and associated with poor health outcomes in residential aged care facilities (RACFs). The SIMPLER study was a non-blinded, matched-pair, cluster randomized controlled trial in eight Australian RACFs that investigated the one-off application of a structured 5-step implicit process to simplify medication regimens. The aim of this study was to explore the processes underpinning study implementation and uptake of the medication simplification intervention. A mixed methods process evaluation with an explanatory design was undertaken in parallel with the main outcome evaluation of the SIMPLER study and was guided by an established 8-domain framework. The qualitative component included a document analysis and semi-structured interviews with 25 stakeholders (residents, family, research nurses, pharmacists, RACF staff, and a general medical practitioner). Interviews were transcribed verbatim and reflexively thematically content analyzed. Descriptive statistics were used to summarize quantitative data extracted from key research documents. The SIMPLER recruitment rates at the eight RACFs ranged from 18.9% to 48.6% of eligible residents (38.4% overall). Participation decisions were influenced by altruism, opinions of trusted persons, willingness to change a medication regimen, and third-party hesitation regarding potential resident distress. Intervention delivery was generally consistent with the study protocol. Stakeholders perceived regimen simplification was beneficial and low risk if the simplification recommendations were individualized. Implementation of the simplification recommendations varied between the four intervention RACFs, with simplification implemented at 4-month follow-up for between 25% and 86% of residents for whom simplification was possible. Good working relationships between stakeholders and new remunerated models of medication management were perceived facilitators to wider implementation. In conclusion, the one-off implicit medication simplification intervention was feasible and generally delivered according to the protocol to a representative sample of residents. Despite variable implementation, recommendations to simplify complex regimens were valued by stakeholders, who also supported wider implementation of medication simplification in RACFs.


Assuntos
Moradias Assistidas , Preparações Farmacêuticas , Idoso , Austrália , Humanos , Assistência de Longa Duração , Farmacêuticos
13.
J Frailty Aging ; 10(3): 254-258, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105710

RESUMO

BACKGROUND: The relationship between frailty and variables such as housing are the least included in models of frailty and research on frailty or social frailty and relocation is negligible. The decision to relocate is complex and demanding for older adults with a loss of independence but little is known about what makes older adults relocate to congregated housing designated for older adults, let alone in combination with social frailty, and how they navigate this transition. OBJECTIVES: This mixed method descriptive study aims to understand the influence of social frailty for a population of French-speaking semi-independent older adults relocating to a housing continuum community. DESIGN: Semi-structured individual interviews including sociodemographic data and the PRISMA-7 Frailty Scale were conducted with recently relocated older adults. SETTING: A newly opened French-speaking housing continuum community in Eastern Canada that offers luxury apartments for independent older adults, two assisted living facilities for semi-independent older adults along with a long-term care facility. PARTICIPANTS: Twenty-nine older adults with a mean age of 85 years, mostly female, married or widowed and highly educated. MEASUREMENTS: Content analysis of the transcribed recorded interviews and descriptive statistical analyses to examine relationships between the frailty PRISMA-7 scale, answers to additional questions and the sociodemographic data. RESULTS: There was not a significant difference in the scores for socialization before and after relocation nor between prior help and current help; however, there was a significant negative correlation between help and socialization before and after relocation. Three main themes included: imposed influences, push and pull factors and post relocation. CONCLUSIONS: The results indicate that several social factors contributed to relocation and that participants were experiencing social frailty. Participants were at the crossover point of being vulnerable to experiencing additional deficits which would potentially have led to higher frailty had they not relocated.


Assuntos
Moradias Assistidas , Fragilidade , Idoso , Idoso de 80 Anos ou mais , Canadá , Feminino , Humanos , Vida Independente , Masculino , Casas de Saúde
15.
Sensors (Basel) ; 21(10)2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34069727

RESUMO

Over the last decade, there has been considerable and increasing interest in the development of Active and Assisted Living (AAL) systems to support independent living. The demographic change towards an aging population has introduced new challenges to today's society from both an economic and societal standpoint. AAL can provide an arrary of solutions for improving the quality of life of individuals, for allowing people to live healthier and independently for longer, for helping people with disabilities, and for supporting caregivers and medical staff. A vast amount of literature exists on this topic, so this paper aims to provide a survey of the research and skills related to AAL systems. A comprehensive analysis is presented that addresses the main trends towards the development of AAL systems both from technological and methodological points of view and highlights the main issues that are worthy of further investigation.


Assuntos
Inteligência Ambiental , Moradias Assistidas , Envelhecimento Saudável , Idoso , Humanos , Vida Independente , Qualidade de Vida , Tecnologia
16.
JAMA ; 326(1): 46-55, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34081073

RESUMO

Importance: Preventive interventions are needed to protect residents and staff of skilled nursing and assisted living facilities from COVID-19 during outbreaks in their facilities. Bamlanivimab, a neutralizing monoclonal antibody against SARS-CoV-2, may confer rapid protection from SARS-CoV-2 infection and COVID-19. Objective: To determine the effect of bamlanivimab on the incidence of COVID-19 among residents and staff of skilled nursing and assisted living facilities. Design, Setting, and Participants: Randomized, double-blind, single-dose, phase 3 trial that enrolled residents and staff of 74 skilled nursing and assisted living facilities in the United States with at least 1 confirmed SARS-CoV-2 index case. A total of 1175 participants enrolled in the study from August 2 to November 20, 2020. Database lock was triggered on January 13, 2021, when all participants reached study day 57. Interventions: Participants were randomized to receive a single intravenous infusion of bamlanivimab, 4200 mg (n = 588), or placebo (n = 587). Main Outcomes and Measures: The primary outcome was incidence of COVID-19, defined as the detection of SARS-CoV-2 by reverse transcriptase-polymerase chain reaction and mild or worse disease severity within 21 days of detection, within 8 weeks of randomization. Key secondary outcomes included incidence of moderate or worse COVID-19 severity and incidence of SARS-CoV-2 infection. Results: The prevention population comprised a total of 966 participants (666 staff and 300 residents) who were negative at baseline for SARS-CoV-2 infection and serology (mean age, 53.0 [range, 18-104] years; 722 [74.7%] women). Bamlanivimab significantly reduced the incidence of COVID-19 in the prevention population compared with placebo (8.5% vs 15.2%; odds ratio, 0.43 [95% CI, 0.28-0.68]; P < .001; absolute risk difference, -6.6 [95% CI, -10.7 to -2.6] percentage points). Five deaths attributed to COVID-19 were reported by day 57; all occurred in the placebo group. Among 1175 participants who received study product (safety population), the rate of participants with adverse events was 20.1% in the bamlanivimab group and 18.9% in the placebo group. The most common adverse events were urinary tract infection (reported by 12 participants [2%] who received bamlanivimab and 14 [2.4%] who received placebo) and hypertension (reported by 7 participants [1.2%] who received bamlanivimab and 10 [1.7%] who received placebo). Conclusions and Relevance: Among residents and staff in skilled nursing and assisted living facilities, treatment during August-November 2020 with bamlanivimab monotherapy reduced the incidence of COVID-19 infection. Further research is needed to assess preventive efficacy with current patterns of viral strains with combination monoclonal antibody therapy. Trial Registration: ClinicalTrials.gov Identifier: NCT04497987.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Neutralizantes/uso terapêutico , Antivirais/uso terapêutico , COVID-19/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/imunologia , Antivirais/efeitos adversos , Antivirais/imunologia , Moradias Assistidas , COVID-19/epidemiologia , Método Duplo-Cego , Aprovação de Drogas , Feminino , Pessoal de Saúde , Humanos , Imunização Passiva , Incidência , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença , Instituições de Cuidados Especializados de Enfermagem , Adulto Jovem
17.
Geriatr Nurs ; 42(4): 806-815, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34090224

RESUMO

PURPOSE: Pursuing active aging and maintaining the quality of life (QoL) is essential, particularly in older people living in residential care facilities (RCFs). We evaluated physical activity (PA) as an intervention to improve the QoL in this population, trying to hypothesize future perspectives in this field. METHODS: A systematic search was performed on Pubmed. Only randomized control trials or quasi-experimental control group trials were considered. RESULTS: Results showed that a high-frequency PA can be effective in older people, allowing them to improve their functional mobility, autonomy, anxiety level, balance, and social interactions. Moreover, a moderate-intensity PA showed the most interesting results, improving all the QoL-related aspects considered. CONCLUSION: Results highlight the beneficial effects of multidisciplinary intervention strategies in increasing QoL and QoL-related aspects of RCFs older residents, contemplating PA as the main instrument. However, structured PA is necessary to fully understand which protocol could be the most effective.


Assuntos
Moradias Assistidas , Qualidade de Vida , Idoso , Envelhecimento , Exercício Físico , Humanos
18.
BMJ Open ; 11(5): e042937, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33952539

RESUMO

INTRODUCTION: Poor oral health among older people is a global problem impacting on health and well-being. The economic cost to the health system is significant. An ageing population is intensifying the urgency for action. However, poor oral health, particularly for those in residential aged care facilities, continues to be highly resistant to resolution. The overall aims of this realist review are to: (A) explore and synthesise evidence on oral health interventions for older people in residential aged care facilities, (B) produce a causal theory on how contextual factors and mechanisms interact to produce outcomes, and (C) produce guidelines/policies to inform high-quality oral health interventions to improve older people's oral health in residential aged care facilities. METHODS AND ANALYSIS: The review is guided by the RAMESES publication standards for realist synthesis. Participants include older people in residential aged care facilities, the aged care workforce, carers and families. Interventions include oral healthcare, oral health education, policy interventions and oral health promotion. The five-step realist review process of Pawson et al will guide the review: clarification of scope and development of initial framework, systematic searches, study appraisal and data extraction, synthesising evidence, drawing conclusions, and dissemination, implementation and evaluation. Expert input with key stakeholders will occur through a blog. Stakeholders will examine consistencies across studies and an explanatory causal theory will be developed to guide policy and practice. ETHICS AND DISSEMINATION: Formal ethical approval was granted by the La Trobe University Ethics Committee HREC 20144. The developed theory will guide education, practice and policy decisions about interventions and the factors that impact on implementation. Using an integrated knowledge translation approach, traditional research outputs such as international conference presentations and publications will be supplemented with stakeholder forums, infographics, blogs, social media postings, webinars, podcasts and writing for web-based independent outlets. PROSPERO REGISTRATION NUMBER: CRD42021155658.


Assuntos
Moradias Assistidas , Saúde Bucal , Idoso , Atenção à Saúde , Promoção da Saúde , Humanos , Revisões Sistemáticas como Assunto
19.
Stud Health Technol Inform ; 281: 704-708, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34042667

RESUMO

Ambient assisted living (AAL) technologies aim at increasing an individual's safety at home by early recognizing risks or events that might otherwise harm the individual. A clear definition of safety in the context of AAL is still missing and facets of safety still have to be shaped. The objective of this paper is to characterize the facets of AAL-related safety, to identify opportunities and challenges of AAL regarding safety and to identify open research issues in this context. Papers reporting aspects of AAL-related safety were selected in a literature search. Out of 395 citations retrieved, 28 studies were included in the current review. Two main facets of safety were identified: user safety and system safety. System safety concerns an AAL system's reliability, correctness and data quality. User safety reflects impact on physical and mental health of an individual. Privacy, data safety and security issues, sensor quality and integration of sensor data, as well as technical failures of sensors and systems are reported challenges. To conclude, there is a research gap regarding methods and metrics for measuring user and system safety in the context of AAL technologies.


Assuntos
Inteligência Ambiental , Moradias Assistidas , Reprodutibilidade dos Testes , Tecnologia
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