Factors influencing the employed caregiver burden for patients with dementia residing in nursing homes:A cross-sectional study from China

Objective:The institutionalization of care for patients with dementia is becoming a trend.Understanding the burden on employed caregivers and exploring associated factors are of great importance in practice.Therefore,this study aimed to examine the relationship between basic attributes,caring ability,and caregiver burden in employed caregivers practicing in nursing homes.Methods:This cross-sectional study included 541 employed caregivers in 11 four-star nursing homes in Zhejiang Province from April to December 2022.Caregiver burden was assessed using the Zarit Burden Interview(ZBI).Demographic characteristics of participants,characteristics of the older patients with dementia,caring characteristics,training in dementia care,and caring abilities were collected for analysis of influencing factors.A hierarchical multiple regression analysis was conducted to explore the factors influencing the burden on employed caregivers in nursing homes.Results:The ZBI score of employed caregivers in nursing homes was 40.42±10.18,representing a moderate caregiver burden.Factors such as age(U=27.82,P<0.001),residence(U=7.89,P<0.001),educational level(H=55.81,P<0.001),self-care of older patients with dementia(H=85.21,P<0.001),daily care hours(H=73.25,P<0.001),number of older people with dementia cared for(H=14.56,P<0.012)and training in dementia care(U=-9.43,P<0.001)were significantly associated with caregiver burden.Caring ability was negatively associated with caregiver burden(r=-0.22,P<0.01).Furthermore,after controlling for demographic characteristics,the characteristics of older people with dementia,caring characteristics,training in dementia care,and caring ability explained 8.5%,5.8%,and 4.8%of the caregiver burden,respectively.Conclusion:The burden of employed caregivers on patients with dementia in nursing homes can be attributed to various factors.We recommend tailored interventions,such as dementia care training and reviewing the number and duration of hours worked to reduce the burden experienced by caregivers.

LSTM Based Neural Network Model for Anomaly Event Detection in Care-Independent Smart Homes

This study introduces a long-short-term memory(LSTM)-based neural network model developed for detecting anomaly events in care-independent smart homes,focusing on the critical application of elderly fall detection.It balances the dataset using the Synthetic Minority Over-sampling Technique(SMOTE),effectively neutralizing bias to address the challenge of unbalanced datasets prevalent in time-series classification tasks.The proposed LSTM model is trained on the enriched dataset,capturing the temporal dependencies essential for anomaly recognition.The model demonstrated a significant improvement in anomaly detection,with an accuracy of 84%.The results,detailed in the comprehensive classification and confusion matrices,showed the model’s proficiency in distinguishing between normal activities and falls.This study contributes to the advancement of smart home safety,presenting a robust framework for real-time anomaly monitoring.

Application of horticulture therapy as a health intervention for elderly people in nursing homes:a scoping review

Objective:To review the scope of interventional studies on horticultural therapy(HT)applied to elderly people in nursing institutions to support the efficient implementation of HT among this target group.Methods:In accordance with the scoping review framework proposed by the Joanna Briggs Institute(JBI),the Pub Med,JSTOR,Web of Science,CNKI,and Wanfang databases were searched.Data from the retrieved literature were summarized and analyzed.Results:In all,18 studies were included in this review.The target population groups of interventions included self-supporting elderly people,cognitively impaired elderly people,elderly people with negative emotions,and elderly people with frailty living in nursing institutions.HT interventions,including planting,craft activities,derivative activities,and outdoor viewing activities,are implemented indoors,outdoors,or in mixed settings.The most common duration of the intervention was 8 weeks,the most common frequency was once per week,and the most common session duration was 60 min.Conclusions:The measurements used in HT interventions included assessments of physical,psycho-mental,and social health;quality of life;and activity effects.Future studies should include partially dependent groups and completely dependent groups of elderly individuals,interventions that last at least 6 months,scientifically designed activity intensity and safety-guarantee plans,and outcomeevaluation indicators such as compliance and intervention benefits.

基于NodeMCU和Home Assistant的智能家居控制系统

为了提高家居生活的舒适性和便利性,开发了一套智能家居控制系统。该系统采用节点微控制单元(NodeMCU)作为基础硬件,负责收集传感器数据并操控相关执行器件。同时,该系统利用消息队列遥测传输协议(MQTT)和WiˉFi技术构建数据传输链路。此外,该系统利用开源的Home Assistant系统建立了后台服务端,以实现数据的图形化展示。用户可通过安卓移动设备实时监控家居环境状况,并对智能设备实施控制。该系统经过严格测试,表现稳定,显著提高了家居环境的智能化程度。

RFID Systems in Healthcare Settings and Activity of Daily Living in Smart Homes: A Review

Elderly inhabitants have a strong influence to healthcare facilities globally in the last few years as a result of the high demand on the healthcare services and the gap between the services provided by caregivers and the increasing number of older people. Radio Frequency Identification (RFID) technologies have been increasingly adopted in smart homes and used widely for indoor localisation. These technologies have been benefiting to healthcare domain where they improve the quality of services delivering by healthcare providers. This article presents a comprehensive review on RFID systems and healthcare research works in smart homes. We also compare RFID-based solutions in healthcare and distinguish challenges of smart home technologies in indoor environment. We also discuss research challenges related to Activity in Daily Living (ADL) in smart homes for wellbeing.

Staff characteristics and care in Chinese nursing homes: A systematic literature review

The need for institutional long-term care(LTC)services,including nursing homes(NHs),is increasing in China's Mainland in part due to the aging population and changing family structures.In developing NH staff training programs,a review is needed to synthesize knowledge about staff and resident characteristics,and care provided in NHs.This systematic review aims to describe,in Chinese NHs,(1)NH staff characteristics and the care they provide,(2)resident characteristics and care needs,and (3)the role of family members.The 45 articles included in this review covered both urban and rural areas of China's Mainland.We found that staff in Chinese NHs were older and had lower education levels in comparison with those in western countries.Most direct caregivers in urban areas were migratory workers from rural area.Chinese NHs had few qualification standards for staff preparation for their roles in NHs.Also,functional levels of residents in Chinese NHs were higher compared to NH residents in western countries.In addition,family members played important roles in caring for NH residents.These findings suggest a need for staff development programs that tailor for lower educated NH staff and care needs of residents with widely varying levels in function from independent to bedbound in China's Mainland.The findings also suggest that staff qualification standards require critically policy development to improve the capacity of Chinese NHs to provide competent and safe care.

Evolution of Programs to Improve Transfers between Hospitals and Nursing Homes at the Community Level

This study described the evolution of programs to improve the efficiency of patient movement between hospitals and nursing homes in the metropolitan area of Syracuse, New York. These programs were needed in order to improve coordination among providers in the absence of networks that included both acute and long term care providers. The mechanisms included the exchange of data and monitoring the movement of Difficult to Place patients from hospitals to nursing homes. Between 2006 and 2014, the annual number of Difficult to Place patients increased from 983 to 1836. During this period, annual hospital medical/surgical discharges increased by 7.5 percent, severity of illness increased by 13.7 percent, and the population aged 65 years and over increased by 9.8 percent. Most of the Difficult to Place patients were admitted by the four largest facilities in the community, which accounted for 60 percent of the nursing home beds. The initiatives also included Subacute and Complex Care Programs that provided financial incentives for admission of certain types of patients, such as intravenous therapy and extensive wound care. The programs described how these programs were implemented using minimal financial resources and without adding positions to the participating provider organizations.

Training program for caregivers to prevent pressure ulcers among elderly residents at geriatric homes

Objectives:Pressure ulcer(PU)is one of the most common problem among the bedridden elderly and has significantly more burden on elderly and caregivers.This study is aimed to evaluate the effects of the training program for caregivers to prevent PUs among elderly residents at geriatric homes.Methods:A quasi-experimental design was used to carry out the current study.A purposive sample comprised of all formal(39 nurses)or informal caregivers(39)and all immobilized elderly residents(35)who are found in all geriatric centers in Helwan district.A structured questionnaire was used to assess caregivers’socio-demographic characteristics,knowledge,attitude,and observational checklists for their practice for prevention of PU at pre-and posttest and during follow-up.Results:After the training program,there were improvements in the level of knowledge,practice,and positive attitude of caregivers about PU prevention with a statistically significant difference between pre-,post-,and follow-up training programs(P<0.001).Conclusions:The study revealed that the training program seemed to change the knowledge,practice,and attitude of the subjects to PU prevention.This,in turn,implies that adequate knowledge affects directly the elderly caregivers’attitudes as well as practice for prevention could be important in reducing the burden of PU among the elderly.Thus,conducting a training program for caregivers at different geriatric homes about caring skills for elders can prevent PU,and using spontaneous reposition is very effective to prevent PUs.

Working experiences of nursing aides in nursing homes:A qualitative study

Objective:To examine how nursing aides in nursing homes perceived their caring work.Methods:Twenty-four nursing aides from one public and one private nursing home in Fuzhou,Fujian Province,China were selected and interviewed in focus groups.Phenomenological analysis was performed.Results:Two themes(positive and negative working experiences)and six sub-themes were drawn:companionship,happiness,trust,achievement,hard work,and grievance.Conclusion:A reasonable work arrangement,positive psychological intervention,and the strengthening of professional,medical and social supports are recommended to improve the work quality and satisfaction of nursing aides in elderly homes.

A Novel Probabilistic Hybrid Model to Detect Anomaly in Smart Homes

Anomaly detection in smart homes provides support to enhance the health and safety of people who live alone.Compared to the previous studies done on this topic,less attention has been given to hybrid methods.This paper presents a two-steps hybrid probabilistic anomaly detection model in the smart home.First,it employs various algorithms with different characteristics to detect anomalies from sensory data.Then,it aggregates their results using a Bayesian network.In this Bayesian network,abnormal events are detected through calculating the probability of abnormality given anomaly detection results of base methods.Experimental evaluation of a real dataset indicates the effectiveness of the proposed method by reducing false positives and increasing true positives.

A randomized controlled trial of group mindfulness therapy on sleep quality of the elderly in nursing homes

Background:Poor sleep quality of the elderly in nursing homes will reduce the quality of life,which needs to be treated properly.The purpose of the study is to investigate the effect of group mindfulness therapy on sleep quality of the elderly in nursing homes.Methods:A parallel randomized controlled trial was used in this study.The semi-structure interview and the mindfulness therapy intervention was used as the intervention.The Pittsburgh sleep quality index scale and Glaizzi phenoenological data for a 7-step was used to analyze the results.Results:After 8 weeks of intervention,the sleep quality of elderly people was improved to a certain extent(P<0.05).Our investigation showed that some elderly people think that through this kind of training they had reduced the frequency of taking sleeping pills.Conclusion:Group mindfulness therapy could improve sleep quality to some extent.

Factors Affecting Verbal Agitation in Dementia Patients Living in Nursing Homes, South Korea

The purpose of this study using secondary data analysis was to identify factors affecting verbal agitation in patients with dementia staying at nursing home. This study is a secondary analysis of an existing original quantitative data set (n = 193). A total of 166 subjects’ data were included in this current study after 27 subjects’ data were excluded from the original data because they did not appear verbal agitation. Multiple regression analyses identified hallucination (β = 0.27), total number of physiologic discomforts (β = 0.19) and pain (β = 0.17) as significant predictors of verbal agitation and these factors explained 27.8% of the variance in the model. The findings of this study showed that hallucination, total number of physiologic discomforts and pain with dementia need to be considered when intervention programs to control verbal agitation in patients with dementia were developed.

Internet of Things Cloud Framework for Smart Homes

Smart appliances and renewable energy resources are becoming an integral part of smart homes. Nowadays, home appliances are communicating with each other with home short-range home area gateways, using existing network communication protocols such as ZigBee, Bluetooth, RFID, and WiFi. A Gateway allows homeowners and utilities to communicate remotely with the appliances via long-range communication networks such as GPRS, WiMax, LTE, and power liner carrier. This paper utilizes the Internet of Things （IoT） concepts to monitor and control home appliances. Moreover, this paper proposes a framework that enables the integration and the coordination of Human-to-Appliance, Utility-to- Appliance, and Appliance-to-Appliance. Utilizing the concepts of Internet of Things leads to one standard communication protocols, TCP/IPV6, which overcomes the many diverse home area networks and neighborhood area networks protocols. This work proposes a cloud based framework that enables the IoTs integration and supports the coordination between devices, as well as with device-human interaction. A prototype is designed, implemented, and tested to validate the proposed solution.

Barriers and facilitators to an outreach rehabilitation program delivered in nursing homes after hip fracture surgical repair

Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services;2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.

Correlation of Depression with the Functional Profile of Elderly People Living in Homes for the Aged

Introduction: Due to the growth of the elderly population, there is a notable lack of preparation among family members and society to face the challenges of this new reality, resulting in an increasing demand for homes for the aged (HA). It is necessary to understand how the impairment of physical health, mental health and the level of depression can affect the functional capacity of the institutionalized elderly who live in homes for the aged. Objective: To describe the correlation between depression and functionality of elderly people who live in homes for the aged. Method: A cross-sectional, descriptive study with 70 elderly people of both sexes, aged 60 years or older, who live in HA in the state of Rio de Janeiro. Result: It was verified that the female gender was predominant in the HA consulted. The majority of elderly live in HA voluntarily 48.6% and that 41.43% did not complete elementary school. The majority of the elderly 81.43% had the ability to perform basic activities of daily living and the elderly 52.86% had normal psychological pictures. The worsening of the depressive picture is associated with the worse functioning of elderly who live in HA (p < 0.02). Conclusion: Depression is a factor that is associated with the functional capacity of the institutionalized elderly. The worse the functional level of the institutionalized elderly, the greater the chances of presenting a depressive state.

Oral health status of older people in residential homes in Saudi Arabia

The aim of the study was to de-termine the oral health status and treatment needs of elderly residents of residential homes in Riyadh, Saudi Arabia. Methods: Among 129 elderly residents, 83 (51 males, and 32 females) of them were interviewed and clini-cally examined according to WHO criteria by two calibrated dentists. Results: The mean age of the subjects was 72 ± 8.5. Male subjects had a higher smoking rate than females. Among elderly subjects below 74 years old, 20.8% had a functional dentition (> or = 20), while only 6.7% for those aged greater or equal to 75 years (p = 0.0004). Mean number of the sound teeth in all subjects was 6.7 ± 8.5. The mean number of DMFT was 18.6 ± 12.6. The missing component was the highest (16 ± 13) for both genders. The mean number of decayed roots was 2.75 ± 3.95 in males and 0.63 ± 1.96 in females. Overall, males had more sound and decayed teeth and less filled and missed teeth than females. There was no significant difference between males and females in periodontal problems except the calculus scores. The majority of subjects in need for tooth extraction were male subjects. With no gender difference 63% were in need for restorations, 40% needed upper and lower full dentures. Need for partial dentures was 38% upper and 48% lower. Conclusion: The oral health of the institutionalized elderly population in Saudi Arabia is generally poor and their treatment needs are high.

Advance Directives in the Context of Uncertain Prognosis for Residents of Nursing Homes

This report documents the findings of a mixed-methods study focused on the advanced directives of 182 residents of three LTC facilities in southern Ontario, Canada. Although almost all had a completed advance directive within 3 months of death, most did not have a palliative designation or directive until a few days before they died. Each facility’s written Progress Notes revealed staff members usually sought additional confirmation of care preferences from residents’ substitute decision-makers within a few days of the death. It was thus common for advance directives to change from a more interventionist approach to the least interventionist approach near death. This change indicates that the meaning and significance of advance care planning and resulting advance directives must be considered in light of the processes and temporal factors involved in their completion and use within this distinct population. The relational nature of advance care planning and concern about ageism as a factor for withholding or withdrawing life support for LTC residents are considered as possible explanatory factors. These findings and their implications are described in relation to end-of-life care policies and practices in LTC facilities.

NET ZERO ENERGY HOMES: An Evaluation of Two Homes in the Northeastern United States

This paper will discuss two Net Zero Energy homes in the United States.The aim is to discuss the differences and similarities in the construction type,energy use,active and renewable systems of the two homes.While each of the homes is designed to achieve net zero site energy use,the design and systems are very different.Furthermore,the measure that is used to qualify a home as net zero energy does not account for the full scope of work on each home.It is suggested that a new set of metrics be developed to allow for a more robust understanding of net zero energy buildings,one that integrates passive design strategies,occupant health and comfort,and durability.The objective is to facilitate a broader understanding of efficient and sustainable residential design.This understanding is critical to bringing Net Zero Energy Buildings to the public.

Drug Utilization in Homes for the Aged in Brasilia, Brazil

This paper aims to describe the socioeconomic and epidemiological profile, as well as the standards of medicine consumption in a group of 154 elderly people from five homes for the aged in Brasilia, in order to expand the understanding about some characteristics and individual needs of this population and its influence on the quality of drug’s therapy. Data were collected between January and December of 2007, it was used a questionnaire adapted from Dader’s method (2002) and a pharmacotherapeutic follow up method and it was responded by the elders and caregivers. Data were supplemented with information from medical records and prescriptions available in the institutions. The studied group has an average age of 74.6 years, living in their current homes for about 5.4 years and the group consists mainly of men with preserved cognitive status. The members of the group have low monthly income, low education level and are sedentary. They consume 4 - 5 drugs and are affected mainly by cardiovascular and psychiatric diseases. Results suggest that low monthly income, low education level, the prevalence of sedentary lifestyle, elders with compromised cognitive status, the increasing number of chronic diseases and the high consumption of drugs in the researched group may be important factors for the emergence or injury drugs-related problems (DRP) as non-adherence to treatment, medication errors, drug interactions and adverse drug reactions compromising the quality of medication therapy. This study points out the necessity of including a pharmacotherapeutic follow-up for the elderly people in order to minimize such problems and provide better quality of life for patients.

How Secure Having IoT Devices in Our Homes?

Nowadays, technology has evolved to be in our daily lives to assist in making our lives easier. We now have technology helping us in our lives at home. Devices used to create our “smart home” have done a great deal in making our lives at home less burdensome, but sadly, these devices have secured our personal lives to be more accessible to outsiders. In this paper, the security of home smart devices and their communication will be researched by using other academic articles to support facts found. The operation of the devices will be discussed along with security risks and future trends on security attacks. The results found will be crucial to knowing exactly how well our own home is protected. After understanding where the risks lie and a demonstration of how hackers can take control of our smart home, solutions will be given to shield ourselves from security attacks. We protect our homes from physical threats by locking doors, but it is time we guard ourselves from cyber threats as well.