A systematic review of gerontechnologies to support aging in place among community-dwelling older adults and their family caregivers.

Objective: Paucity of information concerning the efficacy of gerontechnologies to support aging in place among community-dwelling older adults prevents potential users, healthcare professionals, and policymakers from making informed decisions on their use. The goal of this study was to identify gerontechnologies tested for home support in dyads of community-dwelling older adults with unimpaired cognition and their family caregivers, including their benefits and challenges. We also provide the level of evidence of the studies and recommendations to address the specific challenges preventing their use, dissemination, and implementation. Methods: We conducted a systematic review of the literature published between 2016 and 2021 on gerontechnologies tested for home support in dyads. Two independent reviewers screened the abstracts according to the inclusion/exclusion criteria. A third reviewer resolved eligibility discrepancies. Data extraction was conducted by two independent reviewers. Results: Of 1,441 articles screened, only 13 studies met the inclusion criteria with studies of moderate quality. Mostly, these gerontechnologies were used to monitor the older adult or the environment, to increase communication with family caregivers, to assist in daily living activities, and to provide health information. Benefits included facilitating communication, increasing safety, and reducing stress. Common challenges included difficulties using the technologies, technical problems, privacy issues, increased stress and dissatisfaction, and a mismatch between values and needs. Conclusion: Only a few gerontechnologies have proven efficacy in supporting community-dwelling older adults and their family caregivers. The inclusion of values and preferences, co-creation with end users, designing easy-to-use technologies, and assuring training are strongly recommended to increase acceptability and dissemination. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=310803, identifier CRD42022310803.

The differential influence of culture change models on long-term care staff empowerment and provision of individualized care.

With this study we set out to determine if differences exist across culture change models (CCM) in relation to formal caregivers' perceived access to empowerment structures and reported provision of individualized care. We recruited staff working in facilities that had implemented the Eden Alternative, GentleCare, Facility Specific Social Models of Care (FSSMOC), or no CCM. Multivariate analyses of variance (MANOVA) compared these constructs by CCM for each of three caregiver groups (Registered Nurses, Licensed Practical Nurses, and care aides). Results suggest that considerable differences exist between formal caregivers and by CCM. The greater caregivers' day-to-day contact with residents, the more CCMs appear to affect perceived empowerment and reported provision of individualized care. Findings suggest the greatest benefits existed for staff working in facilities with a FSSMOC. Conversely, in only one instance did responses from staff in Eden Alternative facilities differ from those in facilities with no CCM.

Cognitive status and the psychological well-being of long-term care residents over time.

The majority of research within long-term care (LTC) has emphasized the physical health of residents, has been cross-sectional in design and has focused almost exclusively on residents with dementia. Few longitudinal studies have followed participants over intervals longer than 1 year. In contrast, the current study set out to examine the experience of LTC residents with and without significant cognitive loss over a 2-year period comparing the psychological well-being of groups over time. Significant Group x Time interaction effects were observed between residents with and without significant cognitive loss in life satisfaction and depressive symptomatology. Results of this study underscore the need for longitudinal measurement in LTC research, the use of multivariate statistical procedures and the need to identify and meet the distinct needs of residents with and without significant cognitive loss.