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Carder, Paula, Kali Thomas, Lindsey Smith, David Reed, Philip Sloane i Sheryl Zimmerman. "ASSISTED LIVING ADMINISTRATORS’ UNDERSTANDING OF REGULATORY REQUIREMENTS IN SEVEN STATES". Innovation in Aging 7, Supplement_1 (1.12.2023): 66–67. http://dx.doi.org/10.1093/geroni/igad104.0214.
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Abstract Each state requires assisted living (AL) residences to employ an administrator whose job responsibilities include oversight of resident care, managing staff, and regulatory compliance. This study surveyed administrators of 151 AL residences in 7 states. These AL residences reflect 28 license types (e.g., based on level of care, dementia care services). Administrators were asked whether there were any regulations, policies or procedures that required their AL to do any of 11 health-related activities (e.g., staff able to check vital signs, advance directive on file, reporting change in condition to resident’s healthcare provider). Using health services regulatory analysis, we documented the applicable regulations for each of the 151 AL residences, then assessed whether administrator responses were congruent with the licensed requirements. Almost all (95%) administrators of AL residences governed by a licensure requirement regarding change in condition reported this policy in their residence. In contrast, less than half (48%) of administrators who work in an AL in our sample that state law requires to keep an advance directive on file for residents reported that they did not have a policy to do so. Over one-third (37%) of administrators who work in an AL required to have a policy of non-pharmaceutical treatment for residents with dementia said that they did not have this policy in place. Some administrators reported the presence of policies in the absence of state requirements, suggesting that these AL residences exceed minimum requirements. These results vary by AL license type both within and across states.
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Caspi, Eilon. "Aggressive behaviors between residents with dementia in an assisted living residence". Dementia 14, nr 4 (3.09.2013): 528–46. http://dx.doi.org/10.1177/1471301213502588.
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Plys, Evan. "REASONS FOR RELOCATING TO ASSISTED LIVING: THE PUSH, THE PULL, AND DECISIONAL CONTROL". Innovation in Aging 3, Supplement_1 (listopad 2019): S638. http://dx.doi.org/10.1093/geroni/igz038.2375.
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Abstract Using the push-pull framework, this study describes reasons for relocation and self-reported decisional control in the move to assisted living (AL). A sample of 202 residents of 21 ALs responded to a semi-structured questionnaire regarding their relocation. Participants most commonly relocated from a private local residence (n = 80, 40%), hospital/rehab facility (n = 27, 13%), or private long-distance residence (n = 24, 12%). The most frequently reported pull reasons to relocate to an AL were: “security and safety” (n = 46), “closer to family or friends” (n = 43), and “appearance of the facility” (n = 40). The most frequently reported push reasons to relocate from a previous residence were: “health problems” (n = 94), “others planned the move” (n = 87), and “fear of an accident” (n = 53). On average, participants who moved from other ALs reported the most decisional control in the move (M = 3.94, SD = 1.47), while participants from hospitals/rehab facilities reported the lowest control (M = 2.48, SD = 1.42). On average, participants who relocated from other ALs reported the most pull factors (M = 2.67, SD = 1.15), while participants from independent living communities reported the most push factors (M = 2.53, SD = 1.46). Results suggest that current residents commonly cite safety as both a push and pull reason for relocating to their AL. In addition, reasons for relocation and decisional control varied based on previous residence, which may be useful for identifying AL residents at risk for relocation stress.
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Beuschel, Emily, Jeanneane Wood-Nartker, Katie Macgillivray i Stephanie Tripp. "Assisted Living Facility Layout: A Comparison between Residence Types". International Journal of Aging and Society 2, nr 4 (2013): 89–101. http://dx.doi.org/10.18848/2160-1909/cgp/v02i04/35225.
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Caspi, Eilon. "Wayfinding difficulties among elders with dementia in an assisted living residence". Dementia 13, nr 4 (22.05.2014): 429–50. http://dx.doi.org/10.1177/1471301214535134.
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ElHady, Nancy E., Stephan Jonas, Julien Provost i Veit Senner. "Sensor Failure Detection in Ambient Assisted Living Using Association Rule Mining". Sensors 20, nr 23 (26.11.2020): 6760. http://dx.doi.org/10.3390/s20236760.
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Ambient Assisted Living (AAL) is becoming crucial to help governments face the consequences of the emerging ageing population. It aims to motivate independent living of older adults at their place of residence by monitoring their activities in an unobtrusive way. However, challenges are still faced to develop a practical AAL system. One of those challenges is detecting failures in non-intrusive sensors in the presence of the non-deterministic human behaviour. This paper proposes sensor failure detection and isolation system in the AAL environments equipped with event-driven, ambient binary sensors. Association Rule mining is used to extract fault-free correlations between sensors during the nominal behaviour of the resident. Pruning is then applied to obtain a non-redundant set of rules that captures the strongest correlations between sensors. The pruned rules are then monitored in real-time to update the health status of each sensor according to the satisfaction and/or unsatisfaction of rules. A sensor is flagged as faulty when its health status falls below a certain threshold. The results show that detection and isolation of sensors using the proposed method could be achieved using unlabelled datasets and without prior knowledge of the sensors’ topology.
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Peterson, Lindsay J., Kathryn Hyer, David Dosa, Joseph June, Debra J. Dobbs i Kali S. Thomas. "EVACUATING OR SHELTERING IN PLACE DURING A DISASTER: HOW ASSISTED LIVING ADMINISTRATORS MAKE THE DECISION". Innovation in Aging 3, Supplement_1 (listopad 2019): S699. http://dx.doi.org/10.1093/geroni/igz038.2572.
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Abstract The decision to evacuate or shelter in place during a natural disaster such as a hurricane is complicated and poses risks to long-term care residents. While research has documented the difficulty of the evacuation decision for nursing home administrators, little is known about how assisted living residence (ALR) administrators make this decision. This is a concern given the physical and cognitive impairment level of many ALR residents, the increasing number of ALRs in the U.S., and the frequency of natural disasters. The purpose of this paper was to explore the factors that influenced whether assisted living administrators evacuated their ALRs for Hurricane Irma, a large hurricane that made landfall on Florida’s Southwest coast in September, 2017. This qualitative study used semi-structured interviews and focus groups with ALR owners or administrative staff (N=60) with questions including how they prepared for Hurricane Irma, their experiences during the hurricane, including whether they evacuated or sheltered in place, and lessons learned. The sample includes small (< 25 beds) and large ALRs in the multiple Florida counties affected by the hurricane. A content analysis approach was used. Atlas.ti version 7 was used for initial and axial coding. Prevalent themes included “emergency management planning”, “logistics”, “pressure”, “storm characteristics,” and “staffing”. The results of this study have implications for long-term care policy and training, potentially leading to changes in how ALR leaders prepare for and respond to disasters to improve the safety of residents.
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Baldwin, Ann, Barbara Rector i Ann Alden. "Physiological and Behavioral Benefits for People and Horses during Guided Interactions at an Assisted Living Residence". Behavioral Sciences 11, nr 10 (23.09.2021): 129. http://dx.doi.org/10.3390/bs11100129.
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Assisted living is a fast-growing living option for seniors who require residence-based activities for maintaining mental and physical health. Guided equine interactions may benefit seniors, so an on-site equine program was started at Hacienda at the River senior living community. For research purposes, twenty-four residents and associates, aged fifty-five or over, consented to physiological measurements before, during and after four guided sessions of stroking one of three horses for 10 min over 4–6 weeks. Heart rate variability (HRV) was measured simultaneously in humans and horses during interactions. We hypothesized that human heart rate (HR) and HRV would increase during stroking and HRV power would shift toward the very low frequency (VLF) range common in horses, indicative of healthy function. During stroking, human HR increased (p < 0.05) but HRV (SDRR) and %VLF of HRV power did not change. Diastolic blood pressure (DBP), an exploratory measure, significantly increased after stroking, consistent with arousal. Two horses showed no significant changes in HR or HRV, but one relaxed. Sixteen horse–human pairs demonstrated synchronized HRV peak frequencies during sessions, suggestive of social connection. Participants used more positive than negative words describing their experience during exit interviews (p < 0.05). These data show that horses animate seniors without causing emotional stress and provide opportunities for social bonding.
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Smith, Christen. "The Assisted Living Residence: A Vision for the Futureby Stephen M. Golant and Joan Hyde". Activities, Adaptation & Aging 33, nr 2 (12.06.2009): 127–29. http://dx.doi.org/10.1080/01924780902947710.
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Hayes, Susan, Nicole Rosendaal, Xiao (Joyce) Wang, Kali Thomas i Emma Belanger. "RETENTION OF DUALLY ELIGIBLE BENEFICIARIES IN ASSISTED LIVING AT THE END OF LIFE". Innovation in Aging 6, Supplement_1 (1.11.2022): 421–22. http://dx.doi.org/10.1093/geroni/igac059.1656.
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Abstract To examine to what extent dually eligible beneficiaries (duals) residing in assisted living remain there toward the end of life, we conducted a prospective cohort study of 98,944 Medicare beneficiaries present at validated AL ZIP codes in January 2017, and who died during a two-year follow-up. The outcome was AL residence in the last 30 days of life. We compared decedents who were not duals (80,156 decedents), with those newly dually eligible in 2017-2018 (3,722 decedents), and those already dually eligible in 2016 (15,066 decedents). Only 36.7% of new dual decedents resided in AL in the last 30 days of life, compared to 66.2% among those dually eligible in 2016, and 84.5% of those without Medicaid. While 29 states retained over half of all decedents in AL until death, only 8 states retained a majority of dually eligible decedents.
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Spillman, Brenda C. "The Assisted Living Residence: A Vision for the Futureby Stephen M. Golant and Joan Hyde (Eds.)". Journal of Aging & Social Policy 22, nr 1 (31.12.2009): 89–93. http://dx.doi.org/10.1080/08959420903385643.
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Carder, P. C. ""Learning About Your Residents": How Assisted Living Residence Medication Aides Decide to Administer Pro Re Nata Medications to Persons With Dementia". Gerontologist 52, nr 1 (7.09.2011): 46–55. http://dx.doi.org/10.1093/geront/gnr099.
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Dorner, Thomas Ernst, Andreas Kauba i Veronika Schauer. "Care for and with people with severe disabilities. Results of a survey of residents in assisted living communities in Austria". International Journal of Integrated Care 23, S1 (28.12.2023): 360. http://dx.doi.org/10.5334/ijic.icic23472.
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Background: Communication barriers, along with attitudinal, physical and financial barriers are among the strongest hurdles in the comprehensive care of people with disabilities. Especially due to communication barriers and patronising attitudes, care is often designed for people with disabilities and not with them. The Integration Team of Haus der Barmherzigkeit (HABIT) in Vienna and Lower Austria offers high-quality care to people with severe and multiple disabilities and high nursing support needs. Most of the residents are dependent on a wheelchair, often communicate non-verbally only, are often affected by epileptic seizures and sometimes require enteral nutrition. For adult people HABIT runs 15 shared flats for 10 to 12 inhabitants for fully or semi-supervised living, and two residential communities for 16 children and young people. Furthermore, there are 4 basic day centres for 182 places. Additionally, HABIT offers mobile support for children, young people and young adults. It was the aim of this residents survey to systematically examine quality of life, satisfaction, and the care needs of the residents of the living communities of HABIT.
Methods: The survey was conducted by nine trained HABIT employees. A total of 42 residents in 14 different HABIT housing units were interviewed. The survey was conducted in personal interviews with a structured questionnaire, partly with visualised answer scales.
Results: The questions most frequently answered positively were those about feeling comfortable in the place of residence, security in the shared apartment (each 86% positive answers), and whether one could do what one would like to do (81% positive answers). The questions most frequently answered negatively were (1) often being in pain (45%), (2) being often annoyed by caregivers (33%), (3) noise pollution, (4) caregivers not knocking on the door before entering, and (5) not being able to sleep at night (24% each).
Learnings and next steps: Especially the points with high dissatisfaction were discussed in an interdisciplinary team and measures against them were fixed: (1) Employees are to be sensitised to the recognition of pain. How pain is individually expressed verbally and non-verbally is now documented for each resident. (2) Anger about caregivers should be taken seriously by noticing it, reacting to it, and verbalising the feeling of the person concerned. It is now known and documented for each resident how anger and dissatisfaction manifest themselves so that this can also be recognized by each caregiver. (3) Measures against excessive volume include paying attention to whether employees are speaking too loudly, reflecting on the volume with which music is being played, checking whether loudness of a resident could be a sign of displeasure or overwhelm and represents other needs of the inhabitant, and considering soundproofing. (4) Regarding knocking, it was agreed that the resident's room would not be entered immediately after knocking, but that a few seconds would be allowed before entering the room, even if no reaction is expected. This also applies to open doors. (5) Staff will pay more attention to when residents want to go to bed and wake up.
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Wilhelm, Sebastian, Jakob Kasbauer, Dietmar Jakob, Benedikt Elser i Diane Ahrens. "Exploiting Smart Meter Water Consumption Measurements for Human Activity Event Recognition". Journal of Sensor and Actuator Networks 12, nr 3 (6.06.2023): 46. http://dx.doi.org/10.3390/jsan12030046.
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Human activity event recognition (HAER) within a residence is a topic of significant interest in the field of ambient assisted living (AAL). Commonly, various sensors are installed within a residence to enable the monitoring of people. This work presents a new approach for HAER within a residence by (re-)using measurements from commercial smart water meters. Our approach is based on the assumption that changes in water flow within a residence, specifically the transition from no flow to flow above a certain threshold, indicate human activity. Using a separate, labeled evaluation data set from three households that was collected under controlled/laboratory-like conditions, we assess the performance of our HAER method. Our results showed that the approach has a high precision (0.86) and recall (1.00). Within this work, we further recorded a new open data set of water consumption data in 17 German households with a median sample rate of 0.083¯ Hz to demonstrate that water flow data are sufficient to detect activity events within a regular daily routine. Overall, this article demonstrates that smart water meter data can be effectively used for HAER within a residence.
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Cornell, Portia Y., Momotazur Rahman, Wenhan Zhang i Kali Thomas. "DOES MEMORY CARE MATTER? EXAMINING THE EFFECT OF DEMENTIA-LICENSED CARE ON RESIDENTS’ OUTCOMES". Innovation in Aging 3, Supplement_1 (listopad 2019): S545—S546. http://dx.doi.org/10.1093/geroni/igz038.2008.
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Abstract The objective of this study is to estimate the effect of receiving care in a dementia-care licensed (DCL) assisted living community, versus a standard AL, on outcomes of residents with ADRD. In four states that issue a license for specialized dementia care (AL, CO, MS, and NY), we identify a cohort of 5,720 Medicare fee-for-services beneficiaries with ADRD who moved to an AL in 2014. To control for unobserved factors that contribute to a patient’s selection of AL type, we use the difference in the log-distances from an individual’s home address to the nearest DCL and standard AL as an instrumental variable. We will report the effect of residence in a DCL AL on mortality, inpatient hospital days, emergency department utilization, and hospice use, showing how the use the distance instrument offers differing estimates from unadjusted or multiple-regression methods.
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Lohman, Matthew, Nicholas Resciniti, Morgan Fuller i Joshua Sellner. "Timeline of COVID-19 Incidence and Mortality among Residents and Staff of South Carolina Long-term Care Facilities". Innovation in Aging 5, Supplement_1 (1.12.2021): 728. http://dx.doi.org/10.1093/geroni/igab046.2713.
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Abstract The COVID-19 pandemic has disproportionately impacted older adults living in long-term care facilities (LTCFs), but little research has described parallel infection rates and mortality among LTCF residents and staff in relation to state-level mitigation measures. This study used comprehensive COVID-19 tracking data from the South Carolina Department of Health and Environmental Control (SCDHEC), including case report information on demographics, symptoms, comorbidities, and employment. We included all confirmed or probable COVID-19 cases and deaths among adult SC residents reported between 3/15/2020 and 1/2/2021. Residence or employment in LTCF, including nursing homes, assisted living, or skilled nursing facilities, were confirmed by SCDHEC. Cox proportional hazards models were used to compare mortality between residents/staff and counterparts in the community. Overall, 54,514 cases of COVID-19 were identified among older adults in SC. Of these, 13.5% (n = 7,366) resided in a LTCF. LTCF residents with COVID-19 were more likely to be hospitalized compared to older adults in the community and 74% more likely to die (HR= 1.74, 95% CI: 1.59-1.90), after controlling for age, gender, race, and chronic health conditions. LTCF staff had greater infection rates but lower risk of mortality (HR=0.58; 95% CI: 0.39-0.88) compared to the general population. Differences in COVID-19 incidence and mortality between residents/staff and the community decreased after statewide mitigation policies. This study indicates that LTCF residents are at increased risk of COVID infection and mortality, even accounting for pre-existing health conditions. LTCF settings are key sites for prioritizing prevention, vaccination, and training plans to prepare for future pandemics.
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Deviana, Deviana, i Dimas Iqbal Nurrahman. "SPACE DESIGN STUDY OF ELDERLY BEHAVIOR; CASE STUDY OF THE PURI KEBAJIKAN NURSING HOME, BATAM". Journal of Architectural Research and Education 5, nr 1 (1.03.2023): 103–20. http://dx.doi.org/10.17509/jare.v5i1.52451.
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Along with the changing years, the elderly population in Batam City has increased rapidly. However, facilities such as nursing homes for the elderly are still minorly found in Batam City. Regarding quality, nursing homes in Batam City also have not fully met the standards of design that should be both in terms of quality, facilities, and needs for the elderly. The Elderly being the prime residents in a nursing home, of course, need to pay attention to their needs in living in that place, especially the relationship between the behavior of the elderly and the nursing home that provides a reciprocal relationship in the life of the elderly or known as behavioral architecture. Therefore, through this research, it is expected to find out the situation related to nursing homes in Batam City by paying attention to the psychological side and comfort of the needs of the elderly. This study uses a combined method of qualitative research and quantitative research (mixed methods). Researchers conducted direct observations and interviews at one of the assisted living in Batam City in addition to literature studies in completing the data collection process. Through this research, it can be concluded that the Puri Kebajikan nursing home has not fully implemented the appropriate design requirements and the application of behavioral architecture to the elderly in nursing homes. It expected to be an increase in the application of facilities at the Puri Kebajikan nursing home as a comfortable residence for the elderly according to their needs.
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Belanger, Emmanuelle, Nicole Rosendaal, Xiao (Joyce) Wang, Joan M. Teno, David M. Dosa, Pedro L. Gozalo, Paula Carder i Kali S. Thomas. "Association Between State Regulations Supportive of Third-party Services and Likelihood of Assisted Living Residents in the US Dying in Place". JAMA Health Forum 3, nr 10 (7.10.2022): e223432. http://dx.doi.org/10.1001/jamahealthforum.2022.3432.
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ImportanceOlder adults are increasingly residing in assisted living residences during their last year of life. The regulations guiding these residential care settings differ between and within the states in the US, resulting in diverse policies that may support residents who wish to die in place.ObjectiveTo examine the association between state regulations and the likelihood of assisted living residents dying in place. The study hypothesis was that regulations supporting third-party services, such as hospice, increase the likelihood of assisted living residents dying in place.Design, Setting, and ParticipantsThis retrospective cohort study combined data about assisted living residences in the US from state registries with an inventory of state regulations and administrative claims data. The study participants comprised 168 526 decedents who were Medicare beneficiaries, resided in 8315 large, assisted living residences (with ≥25 beds) across 301 hospital referral regions during the last 12 months of their lives, and died between 2017 and 2019. Descriptive analyses were performed at the state level, and 3-level multilevel models were estimated to examine the association between supportive third-party regulations and dying in place in assisted living residences. The data were analyzed from September 2021 to August 2022.ExposuresSupportive (vs “silent,” ie, not explicitly mentioned in regulatory texts) state regulations regarding hospice care, private care aides, and home health services, as applicable to licensed/registered assisted living residences across the US.Main Outcomes and MeasuresPresence in assisted living residences on the date of death.ResultsThe median (IQR) age of the 168 526 decedents included in the study was 90 (84-94) years. Of these, 110 143 (65.4%) were female and 158 491 (94.0%) were non-Hispanic White. Substantial variation in the percentage of assisted living residents dying in place was evident across states, from 18.0% (New York) to 73.7% (Utah). Supportive hospice and home health regulations were associated with a higher odds of residents dying in place (adjusted odds ratio [AOR], 1.38; 95% CI, 1.24-1.54; P &lt; .001; and AOR, 1.21; 95% CI, 1.10-1.34; P &lt; .001, respectively). In addition, hospice regulations remained significant in fully adjusted models (AOR, 1.46; 95% CI, 1.25-1.71).Conclusions and RelevanceThe findings of this cohort study suggest that a higher percentage of assisted living residents died in place in US states with regulations supportive of third-party services. In addition, assisted living residents in licensed settings with regulations supportive of hospice regulations were especially likely to die in place.
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Wister, Andrew. "Stephen M. Golant and Joan Hyde (Eds). The Assisted Living Residence: A Vision for the Future. Baltimore, MD: Johns Hopkins University Press, 2008." Canadian Journal on Aging / La Revue canadienne du vieillissement 29, nr 2 (czerwiec 2010): 295–96. http://dx.doi.org/10.1017/s071498081000019x.
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Gimm, Gilbert, Syeda Chowdhury i Nicholas Castle. "Resident Aggression and Abuse in Assisted Living". Journal of Applied Gerontology 37, nr 8 (27.07.2016): 947–64. http://dx.doi.org/10.1177/0733464816661947.
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This article estimates the prevalence and identifies risk factors of resident aggression and abuse in assisted living facilities. We conducted multivariate analyses of resident-level data from an analytic sample of 6,848 older Americans in the 2010 National Survey of Residential Care Facilities. Nationwide, 7.6% of assisted living residents engaged in physical aggression or abuse toward other residents or staff in the past month, 9.5% of residents had exhibited verbal aggression or abuse, and 2.0% of resident engaged in sexual aggression or abuse toward other residents or staff. Dementia and severe mental illness were significant risk factors for all three types of resident aggression and abuse. Resident aggression and abuse in assisted living facilities is prevalent and warrants greater attention from policy makers, researchers, and long-term care providers. Future research is needed to support training and prevention efforts to mitigate this risk.
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Sun, Carolyn, i Caitlin Burke. "Assessing the Potential of Technology to Describe Resident and Staff Interactions in Assisted Living Facilities". Journal of Gerontological Nursing 50, nr 7 (lipiec 2024): 7–11. http://dx.doi.org/10.3928/00989134-20240618-02.
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Purpose: Falls are a significant financial burden and health hazard for residents in assisted living facilities (ALFs). However, limited capacity to observe residents has hindered understanding of resident–staff interactions within rooms. The current study aimed to describe nurse–resident interactions using data from a remote technology combining computer vision and staff location tracking. Method: Eighty-three staff working at an urban ALF with 215 residents were trained at the initiation of the study. Remote surveillance devices were installed in 32 residences and staff and resident interactions were tracked over 170 days. Results: Staff visited residents an average of 20.7 times per day for short durations (mean = 1.08 minutes). Urgent alert response times averaged 3.0 minutes, with faster response times through the mobile application (mean = 2.7 minutes) compared to in-person (mean = 3.3 minutes) response. Conclusion: By better understanding staff activity patterns in ALFs, this study has the potential to improve fall prevention and care for residents in ALFs. [ Journal of Gerontological Nursing, 50 (7), 7–11.]
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Resnick, Barbara. "THE ASSISTED LIVING SETTING: CLINICAL CARE AND OUTCOMES". Innovation in Aging 3, Supplement_1 (listopad 2019): S235—S236. http://dx.doi.org/10.1093/geroni/igz038.877.
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Abstract Although the description of assisted living (AL) varies by state this term generally refers to residences that provide housing and supportive services, 24-hour supervision, and at least two meals a day to meet the individual needs of residents. Approximately 37% of residents in AL need help with three or more activities of daily living (ADLs), 42% have some cognitive impairment and 39% need skilled nursing services. Approximately 15 to 50% of older adults living in AL communities experience a fall over a 6 to 24 month period. The cause of these falls involves multiple factors at the resident and facility level. In addition to a high rate of falls there is a high rate of polypharmacy, using the polypharmacy definition of taking five or more medications daily. Polypharmacy results in negative outcomes such as falls and hospitalizations among AL residents. Along with high rates of falls and polypharmacy there is also a high incidence of pain among AL residents and concerns that some pain goes unreported and untreated. Pain, polypharmacy and falls can all influence life satisfaction along with other factors such as the environment itself. The purpose of this symposium is to describe the incidence and factors that influence falls, polypharmacy, pain and pain management and the impact of these care concerns, among others, on life satisfaction drawn from 508 residents from 54 nursing homes participating in the first two cohorts of the study testing the implementation of Function Focused Care for Assisted Living (FFC-AL-EIT).
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Raczkiewicz, V., A. Neumann i B. Buchberger. "Influence of assisted outpatient living in people with intellectual disabilities on individual quality of life and resilience – design of a doctoral thesis". European Psychiatry 65, S1 (czerwiec 2022): S609. http://dx.doi.org/10.1192/j.eurpsy.2022.1560.
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Introduction The research field of disability and mental health is politically and socially relevant, because the psychological well-being of people with intellectual disabilities has often been trivialized in therapy and legislation. Since the pursuit of mental health is coming into focus due to removal of stigma and emerging awareness, people with disabilities must have equal opportunities to choose their place of residence and get suitable psychosocial support. Objectives Our aim is to investigate the influence of assisted outpatient treatment (AOT) on the quality of life and resilience of people with intellectual disabilities who are living self-determined. Methods A participatory mixed-methods design is chosen as it enables the greatest possible standardization and allows a high flexibility. The project will be divided into three parts: A systematic literature search to gain knowledge about the field and to estimate the sample size, a pre-post-comparison of the WHOQOL-BREF to evaluate AOT in terms of self-perceived quality of life and a focus-group of handicapped people to reflect the study results with attention on resilience. Results To foster the doctoral thesis, several questions can be discussed: 1) How is the relation of disability and mental health to be described? 2) What might be the pros and cons of self-determined living? 3) Which steps need to be taken to implement AOT more often? Conclusions The topic is relevant in the public health sector and the results could help to sensitize professionals and the general society regarding to participation in everyday life. The recommendations developed may serve to implement comparable forms of housing. Disclosure No significant relationships.
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Pillemer, Karl, Jeanne A. Teresi, Mildred Ramirez, Joseph Eimicke, Stephanie Silver, Gabriel Boratgis, Rhoda Meador i in. "Estimated Prevalence of Resident-to-Resident Aggression in Assisted Living". JAMA Network Open 7, nr 5 (3.05.2024): e249668. http://dx.doi.org/10.1001/jamanetworkopen.2024.9668.
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ImportanceResident-to-resident aggression in assisted living facilities can result in physical and psychological harm, but its prevalence is unknown.ObjectiveTo estimate the prevalence of resident-to-resident aggression, including physical, verbal, and sexual, among residents in assisted living facilities.Design, Setting, and ParticipantsThis study used cross-sectional, observational data from a clinical trial, in which residents of assisted living facilities were monitored for events over a 1-month period. All residents of 14 large facilities randomly selected from 2 geographic locations (N = 1067), except those receiving hospice care (n = 11), were invited to participate; 93 died or moved prior to enrollment. There were 33 family and resident refusals; 930 residents were enrolled. Data were collected between May 30, 2018, and August 11, 2022.Main Outcomes and MeasuresThe data are from a clinical trial testing the effectiveness of an intervention to reduce resident-to-resident aggression. In addition, the study was designed to assess prevalence using the Time 1 (baseline) data, using a probability sample of facilities to allow for this analysis. Resident-to-resident aggression was identified using a mixed-method, case-finding strategy involving 6 sources: (1) cognitively capable resident reports regarding 22 possible events, (2) direct care staff report, (3) staff member reports collected from event-reporting forms, (4) research assistant observation of events in real time, (5) facility accident or incident reports, and (6) resident records.ResultsThe prevalence of resident-to-resident aggression among the 930 participants (mean [SD] age, 88.0 [7.2] years; 738 women [79.4%]) during the past month was estimated to be 15.2% (141 of 930 residents; 95% CI, 12.1%-18.8%). The most common forms of aggression included verbal (11.2% [104 of 930 residents; 95% CI, 8.8%-14.2%]), physical (41 of 930 residents; 4.4% [95% CI, 3.1%-6.3%]), sexual (0.8% [7 of 930 residents; 95% CI, 0.4%-1.6%]), and other (70 of 930 residents; 7.5% [95% CI, 5.5%-10.2%]). These categories are not mutually exclusive as residents could be involved with more than 1 type of aggressive behavior.Conclusions and RelevanceIn this cross-sectional, observational prevalence study, resident-to-resident aggression in assisted living facilities was highly prevalent. Verbal aggression was the most common form, and physical aggression also occurred frequently. The effects of resident-to-resident aggression can be both morbid and mortal; therefore, intervention research is needed to prevent it and to treat it when it occurs.
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Zhang, Yimeng, Shari Margolese, Mark H. Yudin, Janet M. Raboud, Christina Diong, Trevor A. Hart, Heather M. Shapiro, Cliff Librach, Matt Gysler i Mona R. Loutfy. "Desires, Need, Perceptions, and Knowledge of Assisted Reproductive Technologies of HIV-Positive Women of Reproductive Age in Ontario, Canada". ISRN Obstetrics and Gynecology 2012 (16.08.2012): 1–11. http://dx.doi.org/10.5402/2012/853503.
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The purpose of this cross-sectional study is to assess the desire, need, perceptions, and knowledge of assisted reproductive technologies (ARTs) for women living with HIV (WLWHIV) and determine correlates of ART knowledge desire. WLWHIV of reproductive age were surveyed using the survey instrument “The HIV Pregnancy Planning Questionnaire” at HIV/AIDS service organizations across Ontario, Canada. Of our cohort of 500 WLWHIV, median age was 38, 88% were previously pregnant, 78% desired more information regarding ART, 59% were open to the idea of receiving ART, 39% felt they could access a sperm bank, and 17% had difficulties conceiving (self-reported). Age, African ethnicity, and residence in an urban center were correlated with desire for more ART information. Of participants, 50% wanted to speak to an obstetrician/gynecologist regarding pregnancy planning, and 74% regarded physicians as a main source of fertility service information. While the majority of participants in our cohort desire access to ART information, most do not perceive these services as readily accessible. Healthcare practitioners were viewed as main sources of information regarding fertility services and need to provide accurate information regarding access. Fertility service professionals need to be aware of the increasing demand for ART among WLWHIV.
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Hua, Cassandra. "Trends in Acuity of Residents in Assisted Living". Innovation in Aging 5, Supplement_1 (1.12.2021): 526. http://dx.doi.org/10.1093/geroni/igab046.2030.
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Abstract Assisted living serves as a substitute for nursing home residents with low care needs, especially in markets with a high proportion of dually eligible Medicare beneficiaries. This study examines trends in the acuity of residents in assisted living communities over time in comparison to nursing homes to characterize how substitution has affected the resident compositions of both settings. We also examine how trends in acuity are shaped by dual eligibility. Using Medicare claims data, we identify cross-sectional samples of beneficiaries in each setting from 2007-2017. The proportion of residents in assisted living with high care needs has increased 18% in assisted living communities compared to 8.7% in nursing homes. Acuity levels are higher among dually eligible assisted living residents compared to assisted living residents who are not dually eligible. Policy makers and administrators should examine whether assisted living is prepared to provide care for an increasingly acute population.
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Beeber, Anna, Ruth Anderson i Lindsay Schwartz. "A Stakeholder-Based Study Improving Resident and Family Engagement in the Safety of Assisted Living". Innovation in Aging 5, Supplement_1 (1.12.2021): 343. http://dx.doi.org/10.1093/geroni/igab046.1330.
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Abstract Assisted living (AL), is a long-term care service that provides housing and care for over 800,000 older adults in 30,000 residences. AL culture and operations have been transforming to enhance resident personhood and increase autonomy, however, these practices are balanced with the need to minimize safety issues (e.g., medication errors, infections, falls, and in cases of dementia, elopement and injuries). In this stakeholder-based study, we are translating existing strategies for improving patient safety to AL residences and developing an evidence-based tool for implementing these engagement strategies in AL. This symposium presents the methods and findings from a federally-funded mixed methods study including qualitative interviews with 105 AL residents, staff and family caregivers, and a series of focus groups with an AL stakeholder group to develop a toolkit to improve resident and family engagement in AL safety. The first paper outlines our methodological approach, including our efforts to work with stakeholders throughout the research process. The second paper reports findings from a scoping review of existing tools to support resident and family engagement in the safety of AL. The third paper presents the findings from our interviews with AL residents, families and staff exploring their safety priorities, and how they differ across stakeholder groups. The fourth paper presents the findings from our qualitative interviews exploring the challenges and promising practice to resident and family engagement in AL safety during the COVID-19 pandemic. All four presentations in this symposium illustrate important issues for future practice, policy, and research.
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Rincon, Jaime A., Angelo Costa, Paulo Novais, Vicente Julian i Carlos Carrascosa. "Using Emotions in Intelligent Virtual Environments: The EJaCalIVE Framework". Wireless Communications and Mobile Computing 2017 (2017): 1–9. http://dx.doi.org/10.1155/2017/9321463.
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Nowadays, there is a need to provide new applications which allow the definition and implementation of safe environments that attends to the user needs and increases their wellbeing. In this sense, this paper introduces the EJaCalIVE framework which allows the creation of emotional virtual environments that incorporate agents, eHealth related devices, human actors, and emotions projecting them virtually and managing the interaction between all the elements. In this way, the proposed framework allows the design and programming of intelligent virtual environments, as well as the simulation and detection of human emotions which can be used for the improvement of the decision-making processes of the developed entities. The paper also shows a case study that enforces the need of this framework in common environments like nursing homes or assisted living facilities. Concretely, the case study proposes the simulation of a residence for the elderly. The main goal is to have an emotion-based simulation to train an assistance robot avoiding the complexity involved in working with the real elders. The main advantage of the proposed framework is to provide a safe environment, that is, an environment where users are able to interact safely with the system.
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Park, Nan Sook, Sheryl Zimmerman, Kathleen Kinslow, Hae Jung Shin i Lucinda Lee Roff. "Social Engagement in Assisted Living and Implications for Practice". Journal of Applied Gerontology 31, nr 2 (15.10.2010): 215–38. http://dx.doi.org/10.1177/0733464810384480.
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While it is known that social engagement is important for the well-being of older people, its role among residents in assisted living (AL) residences has not been well explored. The purposes of this study were to explore the experiences of social engagement among AL residents and explain its components and processes as unique to this setting. Qualitative data were collected via semistructured, in-depth interviews with 29 residents in four AL residences in a Southern state. Salient themes were derived using the grounded theory approach. Findings revealed the complexity of social engagement and were organized around five themes related to characteristics of desired social relationships, the perspective of time and loss, barriers to and resources for social engagement, and strategies to develop or modify relationships. AL providers could make concerted efforts to develop practices to provide residents with more social and emotional resources and help them engage in meaningful social interactions.
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Thomas, Kali S., i Lindsay Schwartz. "INTEREST GROUP SESSION—ASSISTED LIVING: DEMENTIA IN ASSISTED LIVING: STATE VARIABILITY IN REGULATIONS, OVERSIGHT, AND RESIDENT OUTCOMES". Innovation in Aging 3, Supplement_1 (listopad 2019): S545. http://dx.doi.org/10.1093/geroni/igz038.2005.
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Abstract Approximately one million individuals, an estimated 40% with a diagnosis of Alzheimer’s disease-related dementias (ADRD), reside in assisted living (AL); yet, little is known about their experience or the quality of care provided in AL. Unlike other forms of long-term care (LTC), the licensing, operating, and enforcement requirements for AL falls to the states, which vary dramatically in their regulatory approaches. The overall objective of this symposium is to examine states’ AL regulatory environments and understand if and how the health outcomes of AL residents with ADRD are impacted by states’ regulatory decisions. Presenters will highlight the state variability in the regulation, oversight, resident composition, and outcomes of AL residents with ADRD. The first presentation will describe states’ different regulatory requirements for staffing and admission/discharge criteria as it relates to residents with ADRD and how those have changed over the last decade. The second presentation will report results from a national survey of state agents regarding their oversight and enforcement activities in AL. The third presentation will characterize differences in the resident composition and healthcare utilization among residents with ADRD across states. The fourth presenter will report on the effect of residing in an AL licensed to provide specialized dementia care versus a standard-licensed AL on ADRD residents’ outcomes. The discussant will contextualize findings as they relate to the current state of the AL industry. Results will ultimately inform policy-makers, organizational leaders, and clinicians as they seek the most effective ways to ensure optimal outcomes vulnerable residents with ADRD.
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Pavlova, S. V., i A. M. Salogub. "The main approaches to assessing the quality and effectiveness of measures for assisting persons with disabilities". Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) 14, nr 2 (17.05.2024): 170–80. http://dx.doi.org/10.20340/vmi-rvz.2024.2.ozoz.1.
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Introduction. Currently, there is a fairly high demand from society for changing approaches to the life of people with disabilities, improving the level and quality of their lives. There is an increase in the number of people with disabilities who need to be assisted when receiving services for assisted living, assisted work and social employment of disabled people in the Russian Federation. The article considers the main methodological approaches to assessing the quality and effectiveness of support measures in the provision of services for assisted living, assisted work and social employment of persons with disabilities.Aim. The study of indicators of the quality and effectiveness of support measures for the formation of unified approaches in various departments of the support system of the Russian Federation aimed at improving the level of assistance and support to the population.Materials and methods. Normative legal and methodological documentation, special literature, information systems of federal executive authorities of the subjects of the Russian Federation. Applied general scientific methods (content analysis, analytical, system-structured, comparative) and methodological methods of systematization, comparison, generalization, interpretation, as well as special methods — formal legal, comparative legal.Results. The main approaches to assessing the quality and effectiveness of support measures may include: availability of receiving support events; compliance with goals and objectives; the economic component (the necessary costs for conducting support activities); competence and professionalism of specialists; satisfaction of recipients (improving the quality of life of recipients). To assess the quality and effectiveness of support measures, the following criteria are highlighted: improving the quality of life of assisted persons, including their physical, psychological and social well-being, improving social adaptation and inclusion of escorted persons in society; the communicative effectiveness of the work of the specialists of the support system, both in a group and individually with each assisted one; сost-effectiveness of support activities, optimization of resource use and reduction of costs for the provision of the support process; аssessment of the satisfaction of the assisted ones and their families with the assistance and support provided; the effectiveness of interdepartmental interaction, co-operation and co-ordination of work between various services and organizations in the support system; assessment of the achievement of targets and tasks in the support system. The score is determined for each criterion separately based on the amount of points received. If the amount is below 55% of the maximum possible, the rating is "unsatisfactory", if from 56 to 85% – "good", above 85% – "excellent". Thus, the introduction of methods for evaluating the effectiveness and quality of support measures will make them more accessible and useful for all categories of the population in need of the Russian Federation.Discussion. One of the key indicators of the quality and effectiveness of the support system's activities is the availability of support activities for all those in need. It is necessary to ensure equal access to quality support in obtaining social services for all categories of people in need, regardless of their place of residence, family income and other factors. Another important indicator is the effectiveness of the work of the specialists providing support. Training and advanced training of specialists, as well as modern methods of working with assisted ones and their families, will help to increase the effectiveness of assisting activities when receiving social services and improve the results of assistance, in general. Effective implementation of methods and technologies for assessing the quality, accessibility and effectiveness of the support system requires a systematic approach and co-ordination of efforts at various levels, interdepartmental interaction, regulation of legal relations in the support system in the Russian Federation.Conclusion. The main indicators of the quality and effectiveness of support contribute to providing feedback from both the assisted ones and those in need of support activities, as well as from the specialists of the support system and management structures. This will allow considering the opinions and needs of all participants in the support process, which contributes to the development of a sustainable and adaptive system.
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Przydacz, Mikolaj, Marcin Chlosta, Adrian Andrzej Chrobak, Pawel Rajwa, Przemyslaw Dudek, Tomasz Wiatr, Katarzyna Gronostaj i in. "Sexual activity in a large representative cohort of polish men: Frequency, number of partners, correlates, and quality of life". PLOS ONE 19, nr 1 (19.01.2024): e0296449. http://dx.doi.org/10.1371/journal.pone.0296449.
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Introduction Sexual activity of men has been evaluated at the population-level in different regions of the world. However, reliable data are lacking for Eastern Europe. Therefore, the aim of this study was to analyze the frequency of sexual activity and the number of sexual partners in a large representative cohort of Polish men. Methods We performed a cross-sectional investigation with computer-assisted web interviews. Participants were stratified by age (≥18 years) and place of residence. The most recent population census was used to produce a population-representative sample of respondents. Men’s sexual activity was then correlated with multiple variables. Results We enrolled 3001 men, representative for age and place of residence, including adequate proportions of respondents from urban and rural areas. Most Polish men were sexually active, predominantly having had sex at least weekly with one partner. Almost 18% of respondents declined sexual intercourse and/or sexual partner in the prior year. The highest sexual activity was observed for men 35-44-years-old (for sex frequency) and 18-24-years-old (for partner number), living in medium-sized cities, employed, and married (for sex frequency) or divorced (for partner number). Erectile dysfunction negatively affected the frequency of sexual activity and lowered the number of sexual partners, although premature ejaculation did not have any effect. Frequency of sexual activity and number of sexual partners correlated well with psychological distress, quality of sex life, and overall life quality. Whereas lifestyle habits including smoking and alcohol intake decreased the likelihood of sexual activity, all analyzed comorbidities did not affect sex life. Conclusions This study of men’s sexual activity was the first population-representative and nationwide investigation performed in Poland. Most Polish men were sexually active and sexual activity correlated with multiple variables including sociodemographic factors, erectile functioning, mental distress, overall and sex-specific quality of life, and lifestyle habits.
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Burnes, David, David Hancock, John Eckenrode, Mark Lachs i Karl Pillemer. "Incidence and Risk Factors of Elder Mistreatment in the Community: A Longitudinal Population-Based Study". Innovation in Aging 5, Supplement_1 (1.12.2021): 87–88. http://dx.doi.org/10.1093/geroni/igab046.335.
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Abstract Prior population-based elder mistreatment (EM) risk factor research has focused on problem prevalence using cross-sectional designs, which cannot make causal inferences between proposed risk factors and EM or discern existing cases from new cases entering the population. This study sought to estimate the incidence of EM and identify risk factors for new cases. It is a ten-year prospective, population-based cohort study with data collected between 2009 (Wave 1) and 2019 (Wave 2). Based on Wave 1 random, stratified sampling to recruit English/Spanish-speaking, cognitively intact, community-dwelling older adults (age ≥ 60) across New York State, this study conducted computer assisted telephone interviews (CATI) with 628 respondents participating in both Wave 1 and Wave 2 interviews (response rate=60.7%). Ten-year EM incidence was regressed on factors related to physical vulnerability, living arrangement, and socio-cultural characteristics using logistic regression. Ten-year incidence rates included overall EM (11.4%), financial abuse (8.5%), emotional abuse (4.1%), physical abuse (2.3%), and neglect (1.0%). Poor self-rated health at Wave 1 significantly predicted increased risk of new Wave 2 overall EM (odds ratio [OR]=2.8), emotional abuse (OR=3.67), physical abuse (OR=4.21), and financial abuse (OR=2.8). Black older adults were at significantly heightened risk of overall EM (OR=2.61), specifically financial abuse (OR=2.8). Change from co-residence (Wave 1) toward living alone (Wave 2) significantly predicted financial abuse (OR=2.74). Healthcare visits represent important opportunities to detect at-risk older adults. Race is highlighted as an important social determinant for EM requiring urgent attention. This study represents the first longitudinal, population-based EM incidence study.
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Lee, John Tayu, Barbara McPake, Likke Prawidya Putri, Kanya Anindya, Diah Ayu Puspandari i Tiara Marthias. "The effect of health insurance and socioeconomic status on women’s choice in birth attendant and place of delivery across regions in Indonesia: a multinomial logit analysis". BMJ Global Health 8, nr 1 (styczeń 2023): e007758. http://dx.doi.org/10.1136/bmjgh-2021-007758.
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BackgroundEvidence suggests that women gave birth in diverse types of health facilities and were assisted by various types of health providers. This study examines how these choices are influenced by the Indonesia national health insurance programme (Jaminan Kesehatan Nasional (JKN)), which aimed to provide equitable access to health services, including maternal health.MethodsUsing multinomial logit regression models, we examined patterns and determinants of women’s choice for childbirth, focusing on health insurance coverage, geographical location and socioeconomic disparities. We used the 2018 nationally representative household survey dataset consisting of 41 460 women (15–49 years) with a recent live birth.ResultsJKN coverage was associated with increased use of higher-level health providers and facilities and reduced the likelihood of deliveries at primary health facilities and attendance by midwives/nurses. Women with JKN coverage were 13.1% and 17.0% (p<0.05) more likely to be attended by OBGYN/general practitioner (GP) and to deliver at hospitals, respectively, compared with uninsured women. We found notable synergistic effects of insurance status, place of residence and economic status on women’s choice of type of birth attendant and place of delivery. Insured women living in Java–Bali and in the richest wealth quintile were 6.4 times more likely to be attended by OBGYN/GP and 4.2 times more likely to deliver at a hospital compared with those without health insurance, living in Eastern Indonesia, and in the poorest income quantile.ConclusionThere are large variations in the choice of birth attendant and place of delivery by population groups in Indonesia. Evaluation of health systems reform initiatives, including the JKN programme and the primary healthcare strengthening, is essential to determine their impact on disparities in maternal health services.
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Plys, Evan, i Rachel Johnson-Koenke. "Perceived Social Standing in Assisted Living Communities: A Mixed-Methods Study of Social Hierarchies Among Residents". Research on Aging 43, nr 1 (10.06.2020): 47–57. http://dx.doi.org/10.1177/0164027520932823.
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The purpose of this mixed-methods study was to measure perceived social standing within an assisted living (PSS-AL), and to identify individual determinants and empirical correlates of this construct. The sample consisted of 200 residents of 21 assisted livings (ALs). A self-anchoring ladder measured PSS-AL ( M = 6.95, SD = 2.04) and an open-ended follow-up question assessed individual determinants of PSS-AL ratings. In a multiple regression, mental health ( β = .27, p = .001), intimate staff-resident relationships ( β = .22, p = .024), and extraversion ( β = .27, p < .001) were significant predictors of PSS-AL. Qualitative findings revealed that inter-personal factors, prosocial behaviors, and health were key determinants of PSS-AL. Results highlight the social demands of AL and associated implications for residents with varying social abilities, skills, and interests. Findings also suggest that staff-resident relationships may shape and-or reinforce resident social hierarchies. The authors discuss implications for research and practice.
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David, Daniel, Abraham Brody, Tina Sadarangani, Bei Wu i Tara Cortez. "Identifying Palliative Care Needs in Assisted Living". Innovation in Aging 4, Supplement_1 (1.12.2020): 788. http://dx.doi.org/10.1093/geroni/igaa057.2854.
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Abstract Many residents of Assisted Living (AL) confront serious illness and therefore might benefit from greater access to Palliative Care Services to improve quality of life. We surveyed resident records and AL nursing staff to identify patients in need of Palliative Care. Preliminary findings showed that nurses predicted 23% would not be alive and 49% would no longer live in AL. A majority of residents were over the age of 90, yet 30% did not have a reported code status. These findings suggest that a substantial portion of AL residents may have unmet needs with respect to palliative care. Future interventions are needed to support advance care planning conversations and make palliative care more accessible to this population.
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Prizer, Lindsay, Sheryl Zimmerman, Christopher Wretman, John Preisser, Kali Thomas i Philip Sloane. "Which Assisted Living Communities Provide Hospice?" Innovation in Aging 4, Supplement_1 (1.12.2020): 677. http://dx.doi.org/10.1093/geroni/igaa057.2355.
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Abstract Assisted living (AL) communities have become a common site for end-of-life and hospice care. However, AL is highly variable, meaning that hospice use is likely to be variable as well. This study explored the association between AL community characteristics and their residents’ use of hospice. A stratified random sample of 250 AL communities in seven states was recruited. Community-level data were obtained from interviews with AL administrators, and resident-level case-mix data were abstracted from charts. Survey-weighted regressions examined the relationship between community characteristics and hospice use. Having residents on hospice was associated with being for-profit (86% vs. 51%), larger (48 vs. 31 beds), newer (16 vs. 37 years), having weekly primary care provider visits (44% vs. 26%), having more residents with dementia (50% vs. 35%) and fewer on Medicaid (4% vs. 11%), and having more lenient discharge policies. Data suggest there may be some disparity in hospice provision in AL.
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Morgan, Jennifer C., Candace L. Kemp, Christina Barmon, Andrea Fitzroy i Mary M. Ball. "Limiting and Promoting Resident Self-Care in Assisted Living". Journals of Gerontology: Series B 76, nr 8 (20.01.2021): 1664–72. http://dx.doi.org/10.1093/geronb/gbab016.
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Abstract Objectives Assisted living (AL) residents often manage multiple chronic conditions, functional and/or cognitive decline along with their individual needs and preferences for a full life. Although residents participate in their own care, little is known about their self-care activities and how to support them. This analysis focuses on residents’ self-care and theorizing the dynamic, socially embedded process of negotiating self-care. Methods We analyze data from a grounded theory study informed by the Convoys of Care model. Participants included 50 focal residents and 169 paid and unpaid convoy members in eight AL homes; each resident convoy was followed up for 2 years. Data collection included participant observation, interviews, and resident record review. Results To the extent possible, most AL residents were involved in self-care related to activities of daily living, health promotion, and social, emotional, and mental well-being. Residents and care partners engaged in a dynamic process of limiting and promoting self-care activities. Multiple factors influenced self-care, including residents’ past self-care behaviors, caregiver fear and availability, and the availability of services and supports. Discussion Strategies for promoting self-care must involve residents and care partners and include convoy education in collaborative goal-setting, prioritizing care that supports the goals, and putting resources in place to support goal achievement.
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Payandeh, Shahram, i Jim Park. "Passive Observer of Activities for Aging in Place Using a Network of RGB-D Sensors". International Journal of Telemedicine and Applications 2020 (23.10.2020): 1–15. http://dx.doi.org/10.1155/2020/8867926.
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Aging in place is a notion which supports the independent living of older adults at their own place of residence for as long as possible. To support this alternative living which can be in contrast to various other types of assisted living options, modes of monitoring technology need to be explored and studied in order to determine a balance between the preservation of privacy and adequacy of sensed information for better estimation and visualization of movements and activities. In this paper, we explore such monitoring paradigm on how a network of RGB-D sensors can be utilized for this purpose. This type of sensor offers both visual and depth sensing modalities from the scene where the information can be fused and coded for better protection of privacy. For this purpose, we introduce the novel notion of passive observer. This observer is only triggered by detecting the absence of movements of older adults in the scene. This is accomplished by classifying and localizing objects in the monitoring scene from both before and after the detection of movements. A deep learning tool is utilized for visual classification of known objects in the physical scene followed by virtual reality reconstructing of the scene where the shape and location of objects are recreated. Such reconstruction can be used as a visual summary in order to identify objects which were handled by an older adult in-between observation. The simplified virtual scene can be used, for example, by caregivers or monitoring personnel in order to assist in detecting any anomalies. This virtual visualization can offer a high level of privacy protection without having any direct visual access to the monitoring scene. In addition, using the scene graph representation, an automatic decision-making tool is proposed where spatial relationships between the objects can be used to estimate the expected activities. The results of this paper are demonstrated through two case studies.
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Thomas, Kali, i Lindsay Schwartz. "COVID-19 in Assisted Living: Evidence on Policies, Provider Experiences, and Resident Mortality". Innovation in Aging 5, Supplement_1 (1.12.2021): 56–57. http://dx.doi.org/10.1093/geroni/igab046.216.
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Abstract The devastating effects of Coronavirus disease 2019 (COVID-19) among older adults residing in long-term care settings has been well documented. Assisted living settings in the U.S. have 811,000 residents; most are 80 years or older, and many have one or more chronic illnesses, making them highly susceptible to poor outcomes if exposed to COVID-19. This symposium highlights five studies that focus on various levels of COVID-19 response in assisted living: national organizations, states, assisted living operators and healthcare providers, and residents. The first study compares the sometimes conflicting guidance provided by national long-term care industry-related organizations and recommends assisted living-specific actions for the future. The second study describes the state regulatory response to COVID-19 in assisted living, identifying the themes and implications for the function of the care networks of assisted living residents. The third study presents findings from interviews with key stakeholders, including policymakers and industry leaders, that reflect on the challenges responding to changing recommendations and policies. The fourth study reports results from a survey with administrators and medical and mental health care providers who treat their residents that illustrates the care practices that were implemented in response to COVID-19 in assisted living. The fifth presentation documents the national excess assisted living resident mortality that was attributable to COVID-19. This symposium culminates with a leading assisted living industry expert reflecting on providers’ experiences and posing areas to consider when preparing for and responding to future pandemic events in assisted living settings.
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Kole, Noviana. "ASRAMA SEBAGAI TEMPAT KEHIDUPAN DAN PEMBINAAN SISWA-SISWI SEKOLAH MISI INTERDENOMINASI". Inculco Journal of Christian Education 2, nr 2 (20.06.2022): 151–65. http://dx.doi.org/10.59404/ijce.v2i2.69.
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Abstrak: Apa yang dipikirkan di benak kita tentang kata “tinggal diasrama”, mungkin kita berpikir bahwa asrama adalah bangunan tempat tinggal dimana kita harus mengikuti berbagai tata tertib yang ditetapkan. Tinggal diasrama pasti ada aturan dan tata tertib yang akan kita ikuti, sebagai penghuni asrama harus memiliki disiplin besar ataupun kewajiban untuk bisa melakukan segala kegiatan yang biasanya dibantu oleh keluarga sekarang harus melakukannya sendiri. Dari pembahasan ini akan timbul beberapa pertanyaan: 1. Apakah asrama itu? 2. Bagaimana fungsi asrama bagi mahasiswa? Jawaban : Asrama adalah bangunan tempat tinggal bagi kelompok orang untuk sementara waktu, terdiri atas sejumlah kamar, dan dipimpin oleh seorang kepala asrama. Fungsi bagi mahasiswa sebagai sarana untuk tempat tinggal bagi mahasiswa selama menempuh studinya, sebagai sarana untuk mempererat hubungan sosial antar sesama, sebagai sarana membentuk pribadi mahasiswa sehingga dapat mandiri, disiplin dan bertanggung jawab Abstract: What we think about the word “live in a dormitory”, maybe we think that a dormitory is a residential building where we have to follow various rules and regulations. Living in a dormitory, there must be rules and regulations that we will follow, as residents of a dormitory, we must have great discipline or an obligation to be able to carry out all activities that are usually assisted by the family, now we have to do it ourselves. From this discussion, several questions will arise: 1. What is a hostel? 2. How does the dormitory function for students? Answer: A dormitory is a temporary residence for a group of people, consisting of a number of rooms, and led by a dormitory head. The function for students is as a place to live for students during their studies, as a means to strengthen social relations between others, as a means to shape students' personalities so that they can be independent, disciplined and responsible.
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Thomas, Kali, Paula Carder, Lindsey Smith i Sheryl Zimmerman. "A VISION FOR THE FUTURE OF ASSISTED LIVING RESEARCH: LEVERAGING ADMINISTRATIVE DATA TO STUDY QUALITY". Innovation in Aging 6, Supplement_1 (1.11.2022): 281–82. http://dx.doi.org/10.1093/geroni/igac059.1118.
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Abstract Because the assisted living industry is neither federally regulated nor federally licensed, methodologies to study the quality of long-term care used in other settings (e.g., annual inspection reports, resident assessment data) do not exist for the large and growing number of assisted living communities and their residents. The objective of this presentation is to present a vision for the future of assisted living research to inform quality using large, national datasets. To do this, the presenter will discuss existing approaches to identify and characterize assisted living communities and their residents using administrative data. A specific focus will be to highlight the opportunities and challenges associated with each approach. The presenter will offer suggestions for possible enhancements in existing approaches and next steps in the study of assisted living aimed at understanding and improving the quality of care delivered in these settings.
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Peterson, Lindsay, Sara Hackett, Kallol Kumar Bhattacharyya i Debra Dobbs. "RESTRICTIONS ON RESIDENT CONTACT IN ASSISTED LIVING DURING COVID-19: A MIXED-METHODS STUDY". Innovation in Aging 6, Supplement_1 (1.11.2022): 348–49. http://dx.doi.org/10.1093/geroni/igac059.1380.
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Abstract Efforts to protect assisted living residents from COVID-19 by limiting contact warrant attention. Assisted living was developed as a social model where care is provided in a home-like environment. Given the social dimensions of assisted living, we sought to better understand the effects of COVID-19-based restrictions in assisted living. We surveyed (online) assisted living community (ALC) administrators (N=130) between October 2020 and March 2021 as part of a larger project on COVID-19 in Florida. We then interviewed a subset of participants (N=26). Administrators of chain-affiliated ALCs (compared to non-chain) were 2.7 times more likely to report resident-contact limitations had disrupted care (p=0.02). Larger ALCs (25 or more beds) were marginally more likely to report care disruptions (p<0.10). Three main themes emerged from our qualitative interviews – varying interpretation of COVID-19 guidelines, effect of precautions on residents, assisted living as a home. Policy implications of these findings will be discussed.
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Carder, Paula, Ann McQueen i Ozcan Tunalilar. "Implementing Oregon’s New Quality Measurement Program for Assisted Living Communities". Innovation in Aging 4, Supplement_1 (1.12.2020): 726. http://dx.doi.org/10.1093/geroni/igaa057.2577.
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Abstract Oregon legislation requires assisted living (AL) communities to report selected quality measures to the state licensing agency. The Quality Measurement Program (QMP) includes five metrics that assess different areas of resident safety and wellbeing: falls, antipsychotic medication use, staff training, staff retention, and resident satisfaction. This paper describes findings based on our 2019 survey of AL communities and offers suggestions for stakeholders interested in public reporting and quality metrics. Assisted living providers reported 28% of AL residents and 38% of memory care (MC) residents fell at least once in the prior 90 days, with 39% and 45% reporting an injury, respectively. Antipsychotic medication use was 20% among AL and 44% among MC residents. These findings and the survey methods used to collect them, combined with stakeholder and state agency staff participation, informed the current QMP approach. We describe how to collect meaningful quality metrics within the AL context.
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Zeisel, John. "Dementia-specific assisted living residences". American Journal of Alzheimer's Disease 10, nr 3 (maj 1995): 40–41. http://dx.doi.org/10.1177/153331759501000307.
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Haas, Mattie Ann, LuAnn Haas, Kristine Knoke i Michael Andreski. "Rural Physician-Pharmacist Collaborative Practice Agreements Managing Patients in Supportive Living and Assisted Living Memory Care Facilities". INNOVATIONS in pharmacy 10, nr 4 (26.11.2019): 13. http://dx.doi.org/10.24926/iip.v10i4.1371.
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Setting: Supportive living and assisted living memory care facilities in a rural West-Central Illinois county.
Objectives: 1) Evaluate the impact of active pharmacist participation on patient care for residents living in supportive and assisted living facilities, 2) demonstrate feasibility and financial sustainability of rural community pharmacists providing disease state management services, 3) create processes for best practice to expand the clinical role of the community pharmacist
Design: Case study.
Interventions: Participating residents received disease state management services provided by a community pharmacist as outlined through collaborative practice agreements with local physicians. The disease states managed included hypertension, hyperlipidemia, diabetes mellitus, and warfarin anticoagulation therapy. The pharmacist completed an initial chart review, initial face-to-face visit, subsequent monthly chart reviews, and monthly face-to-face visits with each resident.
Results: During the 6-month period of community pharmacist management, 86 face-to-face visits were completed to deliver a median of 5 visits per resident. The pharmacist identified 23 drug therapy problems with recommended solutions communicated to the resident’s primary care provider. Providers accepted 19 of these recommendations, reflecting an 82.6% acceptance rate.
Conclusions: Community pharmacists can feasibly implement enhanced clinical services to assist with disease state management of supportive living and assisted living residents in collaboration with physicians. Pharmacists can provide clinical assessment, education and effective communication to optimize medication management and utilization.
Article Type: Case Study
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Wyles, Christina, i Kimberly Shea. "UNCOVERING THE HIDDEN WORKFORCE: A STUDY OF DIRECT CARE WORKERS IN ASSISTED LIVING HOMES". Innovation in Aging 7, Supplement_1 (1.12.2023): 526. http://dx.doi.org/10.1093/geroni/igad104.1725.
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Abstract A growing number of 4.5 million U.S. direct care workers (DCWs) provide hands-on care to older adult residents in assisted living homes (ALHs) -- the smallest type of assisted living residences that require employment of DCWs. These homes typically have capacity for 8-10 residents, and they no longer resemble the original non-medical, home-like environment. With an aging population, increasing complexity of residents’ medical and functional needs, and increasing closure of nursing homes, demand for DCWs in ALHs continues to grow. Better information on this growing workforce segment, federal oversight, and consistent licensure are needed. The few available studies indicate high resident acuity and quality of care issues. To address this knowledge gap, a study explored and described the learning interests and needs and technology use of ALH DCWs. Guided by a human factors framework and an interpersonal perspective, DCWs (N = 14/ median age 41) were interviewed one-on-one using semi-structured questions. Data analysis involved qualitative content analysis of transcribed taped interviews. Findings revealed DCWs are interested in work-related topics and acknowledge the complexity of their residents. They use various health-related technologies in the care they provide, but need more access to educational opportunities that accommodate their long work hours and low salaries. The study also noted the expanded scope of practice, high risk of injury, and underrepresentation of DCWs in the literature. This study highlights learning and technology needs of DCWs in ALHs, emphasizing the need for more recognition and support for this vital segment of the long-term care workforce.
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McBride, Sara E., i Wendy A. Rogers. "Optimizing Resident Care in Assisted Living Communities". Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care 2, nr 1 (czerwiec 2013): 92–98. http://dx.doi.org/10.1177/2327857913021018.
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A primary goal of assisted living communities is to help residents maintain their health and wellbeing. One method by which this is accomplished is that caregivers continually monitor residents for cues that might signal problems or concerns, and then respond appropriately. The critical role of knowledge in caregiving has been recognized in the literature, but the existent research has demonstrated that those who provide care directly to assisted living residents may be lacking critical facets of knowledge. Although psychological science has recognized the value of comparing novices to experts for the purposes of understanding and training skill development (e.g., Chi, 2006; Rogers, Maurer, Salas, & Fisk, 1997), the literature in this area has not examined caregiving as a function of expertise or experience. Therefore, we contend that a research priority should be to investigate the cognitive processes involved in detecting resident issues, including problem detection (i.e., using cues to make a judgment about whether there is a need to be concerned), and decision making (i.e., responding in some form to resolve concerns).
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Hua, Cassandra, Portia Cornell, Elizabeth White, Katherine Kennedy, Ian Nelson i Kali Thomas. "DUAL ELIGIBILITY AND INJURY-RELATED EMERGENCY DEPARTMENT VISITS AMONG ASSISTED LIVING RESIDENTS". Innovation in Aging 6, Supplement_1 (1.11.2022): 421. http://dx.doi.org/10.1093/geroni/igac059.1655.
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Abstract Using 2018 Medicare data, we examined the relationship between dual eligibility and injury-related emergency department use among a cohort of assisted living residents (n=116,754). We fit multilevel models with random intercepts at the assisted living community and license type levels. The baseline rate of injury-related emergency department emergency department use was 0.17. After controlling for resident characteristics (i.e., age, sex, race, and chronic conditions), license type characteristics (i.e., dementia care licensure, staffing regulations), and assisted living community characteristics (i.e., size and percentage of residents with dementia), being dually eligible for Medicare and Medicaid was associated with a 12% increase in the probability of having an injury-related emergency department visit (b=.02; p<.001). Assisted living communities that serve duals may have fewer resources and staff to provide personal care, potentially leading to increased rates of injuries.
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Cornell, Portia, i Tetyana Shippee. "Diversity and Variation in Assisted Living Care, Nationally and Over Time". Innovation in Aging 5, Supplement_1 (1.12.2021): 525–26. http://dx.doi.org/10.1093/geroni/igab046.2027.
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Abstract Assisted living is generally understood to offer a greater degree of privacy and independence than a nursing home; most residents pay privately, with some receiving support from state subsidies and Medicaid; regulation and oversight are the purview of state agencies. Within these broad parameters, however, one assisted living community may look quite different from another across the country, or down the street, in its resident population and the regulations that govern its operating license. The purpose of this symposium is to explore that variation. The papers leverage an in-depth review of changes in assisted-living regulation from 2007 to 2019 and a methodology to identify Medicare beneficiaries in assisted living using ZIP codes. To set the stage, the first paper examines variation across assisted living licenses to identify six regulatory types and compare their populations’ characteristics and health-care use. The second paper analyzes trends over time in the clinical acuity of assisted living residents associated with changes in nursing home populations. The third paper investigates racial disparities in assisted living associated with memory-care designations and proportions of Medicaid recipients. The fourth investigates how regulation of hospice providers in assisted living affect end-of-life care and place of death. The final paper describes requirements related to care for the residents with mental illness in seven states. The symposium concludes with an expert in long-term care disparities and quality discussing the implications for policymakers, providers, and the population needing long-term care in assisted living.