Ageing International最新文献

Involvement of Care workers in geriatric care is essential; few studies have identified the ethical issues faced by Care workers compared to medical professionals. This study aimed to clarify the ethical issues faced by Care workers engaged in geriatric care in Japan, the value conflicts among other professionals and their causes, and to obtain suggestions on how to address ethical issues. A qualitative study was conducted through semi-structured interviews using a descriptive approach. Forty-eight Care workers (18 men and 30 women) worked in geriatric care facilities etc. Narrative research methods and thematic analyses were used to analyze the data. Ethical issues related to the principle of respect for autonomy; beneficence, and non-maleficence; and justice were identified. Characteristically, ethical issues arose in daily life and were related to the “routinization” and “regularity”. Value conflict among other professionals was characterized by the conflict between the Care workers’ emphasis on the independence and quality of life of older people and the medical professionals’ emphasis on prolonging life and treatment. The reason behind this conflict was that care workers ware positioned at the lowest level of all care providers. The results suggest that focusing on “everyday ethics” in care settings can clarify the causes of ethical issues and provide insights for addressing them.

This umbrella review aimed to synthesize evidence on the key elements of care models integrating health and social services for older people and the evidence about what works in such models and their mechanisms of change. A literature search was performed using six electronic databases: Ovid MEDLINE, Ovid Embase, CINAHL, AgeLine, PsycINFO and Cochrane Database of Systematic Reviews. A narrative synthesis was used for reporting. We included 19 eligible reviews 14 of which focused on the integration of health and social care, four on integrating health care services, and one on integrating health and residential aged care. The findings show a focus on delivery of clinical care (micro), with limited focus on organizational (meso) and broader system (macro) levels of integration. The main outcomes of integrated care models (ICMs) reported in the reviews were measurements of hospital admission rates, quality of life, and uptake of community services. The key mechanisms for the success of ICMs are coordinated care, patient-centeredness, co-location, commitment and shared vision across implementing partners, and strong leadership shaping organizational cultural support for implementing the model.

Despite the proportion of older people caring to someone aged 65 + is increasing worldwide, the research about the impact of caregiving on health remains focused on intergenerational support. This study conducts a scoping review to explore the international evidence about how caring affects the older carers’ health, identifying the knowledge gaps and future lines of research. The study performs a scoping review of 12 studies published between 2010 and 2022, conducted following the five-stage methodological framework proposed by Arksey and O’Malley. Evidence so far revealed that caregiving has a negative impact on the physical, mental, and emotional health of the older caregivers. However, positive health outcomes were also observed. The impact of caregiving on older carers’ health is an emerging research topic that needs further theoretical and methodological developments, as well as multidisciplinary approaches, to advance in the understanding about how caregiving affect older carers’ health.

This study aims to assess person-centeredness in communication between people with dementia (PWD) and caregivers in a nursing home, focusing on the effectiveness of IoT-based communication monitoring and training. Caregivers received pre-education on Person-Centered Care (PCC) and mid-term feedback, during which natural conversations with PWD were unobtrusively recorded using a long-distance audio device. Transcribed conversations were analyzed using a mixed-methods approach that combined quantitative and qualitative analyses to evaluate the quantity and quality of communication in dementia care. Quantitative results demonstrated that communication time increased for both caregivers and PWD, particularly after the mid-term feedback. Additional piecewise and spline regression analyses indicated that the caregiver’s communication time and the PWD’s emotional state positively influenced the increase in PWD communication. For the qualitative analysis, Dementia Care Mapping—an analytical framework grounded in PCC—was used to evaluate communication based on the five psychological needs of PWD. Initially, negative aspects such as outpacing, infantilization, invalidation, and accusation were frequently observed; however, following the feedback, communication shifted toward personhood-enhancing behaviors such as a relaxed pace, warmth, respect, and acceptance. Drawing on findings from this mixed-methods analysis, the authors conclude that the changes in communication may have been facilitated by field-based training and feedback. However, more rigorous research designs and additional studies are needed to support generalization. This pilot study suggests the potential of technology-enhanced, field-based training to improve caregivers’ person-centered communication skills.

Background

Mild Cognitive Impairment (MCI) is a transitional stage between normal aging and the onset of dementia. The early detection of MCI is essential to avoid certain irreversible brain damage at the end of life. While there have been a variety of preventive interventions used in the past three decades, need to know the current trends is necessary for developing updated preventive modules for MCI.

Objectives

This bibliometric study examines the current trends in interventional research for treating MCI.

Methods

Published records were obtained from the Web of Science Core Collection (WoSCC) for the period of 1989–2023. CiteSpace 6.2.R4 (64-bit) advanced version software was utilized for mapping and bibliometric analysis of this study. Overall, 400 records were retrieved and analyzed using document co-citation analysis (DCA), author co-citation analysis (ACA), institutional, country based, and keyword analysis.

Results

It was found that the publication records were steadily increased in the recent five years (2018–2022) and shows that more than half of the interventional studies (234) were conducted on the recent times. Although United States (US) published highest number of publications (115), Canada secured top position based on burst (3.89) in country wise analysis. In ACA, Petersen RC_2003 secured top position based on citation counts (237), Rapp S_2006 on Burst strength (10.69), Ball K_2006 on Centrality (0.19) and Sigma value (2.00). Through the DCA analysis, clusters such as computerized cognitive training, virtual reality, rhythm training, and dance intervention, were considered to be the indicators of emerging trends.

Older people returning home after unplanned hospital admissions often experience fragmented care, leading to poor health outcomes and rehospitalisation. Taking a person-centred approach, we co-designed and piloted a care transition service with older people, their carers, and health professionals, to improve the care of older people as they transitioned from hospital to home. We conducted five co-design workshops with healthcare professionals and older people who had experienced frequent hospital presentations, to explore ways to improve the transition from hospital to home. The workshops culminated in the co-design of a Care transition Coordinator (CTC) role. We undertook a 6-month pilot study in one metropolitan hospital in Adelaide, Australia, to determine the feasibility and preliminary effectiveness of the role from an older person and health system perspective. Descriptive data were extracted from Comprehensive Geriatric Assessments, action sheets, patient checklists, and hospital databases, while semi-structured interviews were conducted with service users, providers, and referrers and thematically analysed to provide qualitative insights into the service. Thirty-five older people were cared for by the CTC during their transition from hospital to home. The CTC was perceived to meet the needs of older people and was well received by older people, their families/carers, and referrers. However, there were some challenges to the feasibility of the service from a service-provider perspective. Our findings indicate that it is possible to engage frail, older people who are frequent hospital presenters in a co-design process, and to design services that are informed by, and meet their needs.

This study examined the relationship between nursing staff's knowledge and attitudes toward dementia caregiving and their proficiency in managing dementia-related behavioral issues. We conducted a cross-sectional correlational study involving 198 nursing participants with a minimum of three months of clinical nursing experience in central Taiwan. The findings indicate that nursing staff scored well in dementia care knowledge (11.71 ± 1.67), dementia nursing attitudes (29.35 ± 2.73), and their ability to address dementia-related behavioral issues (63.90 ± 11.33). Statistical analysis demonstrates that various factors influenced the nursing staff's ability to address behavioral issues, with past experience in caring for a family member with dementia, a nursing progression designation of N1/N2, certification in a professional dementia care program in long-term care, and positive attitudes toward dementia-related issues as significant predictors. Accumulating experience and knowledge, along with cultivating positive attitudes, can enhance nursing staff's capacity to manage behavioral challenges in dementia care. This study underscores the need for continuous training and education for nursing staff, focusing on dementia care, to improve behavioral health outcomes. It emphasizes the importance of supporting family caregivers and promoting specialized certification programs, along with implementing quality improvement measures, to enhance dementia care and patient outcomes in clinical practice.

Elder abuse among nursing home (NH) residents is growing over time. Elder abuse includes multiple forms, including physical, psychological, financial, and sexual, which seriously impact older adults' quality of life. Despite the issue's significance, few studies have studied elder abuse among NH residents, and to our knowledge, no study has examined the prevalence of elder abuse and its associated factors among NH residents in Jordan. This study aimed to examine the predictors of elder abuse among NH residents in Jordan. A descriptive correlational study was conducted on a convenience sample of NH residents recruited from six NHs in Amman, Jordan. Using the function ability scale for the elderly questionnaire, the MoCA instrument, the Wisconsin Agitation Inventory (WAI), the accumulative illness rating scale (CRIS), the Communication of Need-Dementia Alzheimer's Type (CON-DAT), and the Elder Assessment Instrument (EAI) to measure ability to perform activities of daily living, level of dementia, agitation, the comorbid burden, verbal ability, and elder abuse, respectively. Pearson correlation was utilized to examine the relationship between the major variables of this study. The binary logistic regression analysis was used to examine the association of elder abuse with the rest of the variables. A total of 78 NH residents aged between 55–85, with a mean of 72.52 ± 9.45, participated in our study. About 53 participants showed potential exposure to elder abuse from staff members, family visitors, or other residents, and older people with dementia (PWD) were more likely to experience elder abuse than younger PWD, without any significant difference regarding how long they stayed in NH. The results of the chi-square tests showed that PWD who were widowed/divorced were more likely to be a victim of elder abuse than married and single ones. Binary logistic regression results showed that, after controlling for age and marital status, PWD were more exposed to elder abuse as the severity of dementia worsened, and they exhibited more agitated behaviors. The study's findings regarding elder abuse and the factors that contribute to it are significant enough to warrant early detection and preventive measures for NH residents. More training programs are needed to enhance healthcare providers' awareness of elder abuse and how to build effective and proper intervention and care plans. Our research suggests that robust patient care policies be developed, emphasizing quality monitoring systems and frequent staff training sessions on the prevention and management of elder abuse.