[Examination of the relationship between tasks in geriatric health service facilities and benefits of working for older assistant care workers].

Objective　In this study, we clarified the characteristics of tasks performed by older assistant care workers at geriatric health services facilities, by individual characteristics and work status. Additionally, we examined the relationship between the tasks and benefits of working for older assistant care workers.Methods　A self-administered questionnaire survey was provided to 2,571 elderly care facilities employing assistant care workers aged ≥60.　A total of 1,606 responses were obtained, and personal characteristics, working conditions, tasks, and benefits of working for older care assistants were surveyed. Thirteen work tasks were established and categorized into four broad categories; user transfer assistance, facility maintenance, meal-related assistance, and managing and talking to users. Seven benefits of working as care assistants were "contribution to society," "social connection," "purpose of life," "income," "learning from caregiving," "health maintenance and promotion," and "time utilization."Results　Most of the respondents were women and relatively young workers. Among tasks, men, younger workers, and those working >5 days weekly represented a high proportion of those performing user transfer assistance tasks. Tasks on managing and talking to users were not correlated with sex, age, and number of days worked, but those with more flexible work patterns were more likely to be engaged in such tasks. Logistic regression analysis showed that user transfer assistance was correlated with benefits of working, such as "contribution to society," "social connection," and "learning from caregiving." Moreover, facility maintenance was associated with "income," "health maintenance and promotion," and "time utilization" and meal-related assistance was associated with "learning from caregiving." Managing and talking to users was associated with "contribution of society," "social connection," "purpose of life," and "learning from caregiving."Conclusion　The tasks of the workers were associated with individual characteristics and work status. The perception of benefits between the working tasks that involved frequent contact with users and those that did not were considerably different.

Introducing a novel "real-time" outbreak alert and notification system to monitor SARS-CoV-2 outbreaks and case fatality in elderly care facilities, the Netherlands, 2020-2022.

Surveillance systems collating individual-level data may limit timely information sharing during rapidly evolving, infectious disease outbreaks. We present a digital outbreak alert and notification system (MUIZ) in which institutional-level data are reported, allowing real-time outbreak monitoring in elderly care facilities (ECF). We describe trends in the number of outbreaks, mean case number per outbreak, and case-fatality rate (deaths/recovered + deaths) of SARS-CoV-2 in ECF notified through MUIZ in the Rotterdam area (April 2020-March 2022). Overall, 369 outbreaks were reported from 128 ECF that registered with MUIZ (approximately 85% of all ECF), and 114 (89%) notified at least one SARS-CoV-2 outbreak. Trends were consistent with the concurrent national epidemiology and societal control measures in place. MUIZ is a simple outbreak surveillance tool that was highly adopted and acceptable to users. Dutch PHS regions are increasingly adopting the system and it has potential for adaptation and further development in similar institutional outbreak settings.

Influences of Spatial Accessibility and Service Capacity on the Utilization of Elderly-Care Facilities: A Case Study of the Main Urban Area of Chongqing.

With the unprecedented growth of the elderly population in China, elderly-care facilities (ECFs) are in a fast expansion process. However, limited attention has been paid to the imbalance at the actual utilization level of ECFs. This research aims to reveal the spatial inequity of ECFs and to quantitatively examine the effect of accessibility and institutional service capacity on utilization. Taking Chongqing, China, as the study area, we measured the spatial accessibility of different travel modes by the Gaussian Two-Step Floating Catchment Area (G2SFCA) method and investigated distribution differences in spatial accessibility, service capacity, and utilization of ECFs by the Dagum Gini Coefficient and its decomposition. Then, the impact of spatial accessibility and service capacity on the utilization of regional ECFs was quantified by multiscale geographically weighted regression (MGWR). The study findings can be summarized as follows. (1) Walking accessibility has the most significant impact on the utilization of ECFs and shows geographic heterogeneity. Developing a pedestrian-oriented network of pathways is essential to enhance the utilization of ECFs. (2) Accessibility by driving and bus-riding does not correlate with regional ECFs utilization, and relevant studies cannot rely on them alone for assessing the equity of ECFs. (3) In the utilization of ECFs, since the inter-regional difference is more significant than the intra-regional difference, efforts to reduce the overall imbalance should be oriented toward inter-regional variation. The study's findings will assist national policymakers in developing EFCs to enhance health indicators and quality of life for older adults by prioritizing financing for shortage areas, coordinating ECFs services, and optimizing road systems.

Equity of Elderly Care Facility Allocation in a Multi-Ethnic City under the Aging Background.

Societal concerns in ethnic minority areas are global issues. Paying close attention to the equitable allocation of social resources in an aging population is crucial to preserving the cultural diversity and social stability of multi-ethnic countries. This study took a multi-ethnic city-Kunming (KM), China-as an example. The population aging and the comprehensive service level of elderly care institutions at the township (subdistrict) scale were evaluated to discuss the equity of elderly care facility allocation. This study revealed that the overall convenience of elderly care institutions was low. The coupling coordination between the degree of aging and the service level of elderly care institutions in the majority of areas in KM showed poor adaptation. There is spatial differentiation in population aging and an imbalanced distribution of elderly care facilities and relevant service facilities among ethnic minority communities and other areas in KM. We also attempted to provide optimization recommendations for existing problems. This study, on the degree of population aging, the service level of elderly care institutions, and the degree of coupling coordination between them at the township (subdistrict) scale, offers a theoretical foundation for planning elderly care facilities in multi-ethnic cities.

Systematic review of the research on rational drug use among the elderly in Chinese elderly care facilities / 中国药房

OBJECTIVE To understand the current status of the research on rational drug use among the elderly population in Chinese elderly care facilities， and to provide ideas for future related research. METHODS Retrieved from PubMed， Web of Science， Embase， CNKI， Wanfang database and VIP， relevant literature about the research on rational drug use among the elderly population in Chinese elderly care facilities were collected to evaluate the current status of research on the rational drug use among the elderly population in elderly care facilities. RESULTS A total of 14 cross-sectional studies were included. All included studies were completed before 2019 and focused on the eastern coastal areas of China. The AXIS quality scores of the included studies showed a mean score of 11.14±2.25， with six studies having a quality score ＞10. The 14 studies examined a total of 5 770 older adults in elderly care facilities， involving 181 elderly care facilities. Eight studies reported the type of chronic disease in the older adult population of the elderly care facilities； seven studies reported the type of medication used. Nine studies had medication compliance as an outcome， among which seven studies used different analytical methods to analyze the factors influencing medication compliance. The results showed that age， education， duration of illness， type of elderly care facilities， and level of staff attention had significant influence on medication compliance in the elderly population in the elderly care facilities. CONCLUSIONS There is insufficient research related to rational drug use among the elderly population in the elderly care facilities in China， and there is a lack of interventional studies to assess the effectiveness of the rational drug use service in the elderly population in the elderly care facilities. Most of the current research is based on cross-sectional studies， focusing on medication compliance.

Preferences for healthcare worker attire among nursing home residents and residents' preferences as perceived by workers: A cross-sectional study.

Background: In Dutch nursing homes, healthcare workers' attire has been the subject of debate for years. White uniforms and professional white jackets are increasingly being replaced by casual personal attire. Many nursing homes have made this choice because they want to create a homey atmosphere. However, with regard to infection control, casual personal attire is far from ideal. It is unknown what attire is preferred by residents. Objective: To determine both residents' preferences regarding nurses' attire and nurses' perceptions of these preferences. Design: Cross-sectional. Setting: Nursing homes, the Netherlands. Participants: Residents and nurses. Methods: Between February and October 2019, a convenience sample of 94 participants were surveyed across 10 Dutch nursing homes among residents with physical impairments and nurses caring for them. A standardized data collection tool included color photographs of a female nurse dressed in: 1) casual attire; 2) professional polo shirt with blue jeans; 3) professional white jacket with blue jeans; and 4) completely white uniform. Six randomly composed photosets of two different types of attire were shown to each participant.. Participants had to select one out of two displayed photographs (forced choice method) guided by two propositions regarding 'comfort preference' and 'care preference'. The propositions for residents were: 1) I feel most comfortable with this nurse, and 2) I would prefer to be cared for by this nurse. The propositions for nurses were:) I think residents feel most comfortable with this nurse, and 2) I think the residents would prefer to be cared for by this nurse. Some demographic data and personal characteristics of the participants were collected. (Perceived) preferences for nurses' attire were calculated in estimated marginal means (preference per type of attire compared to the other three types of attire) with 95% confidence intervals. Differences were tested with the Chi-squared test. Results: In total, 92 participants were included in the analysis. Overall, the strongest (perceived) preference was for a professional white jacket with blue jeans, compared to the three alternative types of nurses' attire for both propositions in both groups. Casual attire was the least preferred. Residents of 85 years or older and nurses who had been working for two years or fewer were more likely to choose more formal attire. Conclusion: Residents preferred more professional attire, which conforms to infection control requirements. Tweetable abstract: involve nursing home residents in determining nurses' attire; a professional white jacket should be one of the options @AEICP.

An Improved Two-Step Floating Catchment Area (2SFCA) Method for Measuring Spatial Accessibility to Elderly Care Facilities in Xi'an, China.

With the continuous aging of society, the demand among elderly citizens for care facilities is increasing. The accessibility of elderly care facilities is a significant indicator for evaluating whether the layout of urban elderly care facilities is reasonable, and research on the spatial accessibility of related facilities has become an important academic issue in recent years. In this paper, based on the lack of accurate measurement in calculating the spatial accessibility of existing elderly care facilities, we improve the mathematical model based on the two-step floating catchment area method (2SFCA) and introduce the probability function of the elderly population's choice, taking into account the influence of institutional capacity and service quality. In terms of the catchment radius, the calculation accuracy is improved by using the shortest distance along the route combined with the real road network instead of choosing the Euclidean distance. In addition, specific travel thresholds are set for the travel characteristics of the elderly. An evaluation model of the accessibility of urban elderly care facilities is constructed with the help of ArcGIS software to evaluate and analyze the accessibility of the current layout of urban elderly care facilities in Xi'an, China. The results show that the improved 2SFCA model is more effective in evaluating the spatial accessibility of elderly care facilities and has higher accuracy than the previous calculation model, which provides a methodological basis and academic reference for the specific planning of urban elderly care facilities.

Study on Spatial Distribution Equilibrium of Elderly Care Facilities in Downtown Shanghai.

With the growing challenge of aging populations around the world, the study of the care services for older adults is an essential initiative to accommodate the particular needs of the disadvantaged communities and promote social equity. Based on open-source data and the geographic information system (GIS), this paper quantifies and visualizes the imbalance in the spatial distribution of elderly care facilities in 14,578 neighborhoods in downtown (seven districts) Shanghai, China. Eight types of elderly care facilities were obtained from Shanghai elderly care service platform, divided into two categories according to their service scale. With the introduction of the improved Gaussian 2-step floating catchment area method, the accessibility of two category facilities was calculated. Through the global autocorrelation analysis, it is found that the accessibility of elderly care facilities has the characteristics of spatial agglomeration. Local autocorrelation analysis indicates the cold and hot spots in the accessibility agglomeration state of the two types of facilities, by which we summarized the characteristics of their spatial heterogeneity. It is found that for Category-I, there is a large range of hot spots in Huangpu District. For Category-II, the hot-spot and cold-spot areas show staggered distribution, and the two categories of hot spot distribution show a negative correlation. We conclude that the two categories are not evenly distributed in the urban area, which will lead to the low efficiency of resource allocation of elderly care facilities and have a negative impact on social fairness. This research offers a systematic method to study urban access to care services for older adults as well as a new perspective on improving social fairness.

Telemedicine in long-term elderly care facilities as "social accountability" in the context of Covid-19 / Telemedicina nas instituições de longa permanência para idosos como social accountability no contexto da Covid-19

Abstract: Introduction: The World Health Organization defined the compulsory need to redirect all educational, research and public health service activities of medical schools to meet all priority health needs, attributing to them this social responsibility role. Due to the emergency situation in the public health system caused by the COVID-19 pandemic, as a measure of social accountability, remote medical care services and online education were adopted in order to continue following the curricular program and to provide assistance to local city governments. Experience report: Two months before graduation, medical students followed-up on the monitoring of residents and COVID-19 healthcare professionals of forty-three ILPIs (Long-Term Elderly Care Facilities) in the city of Sao Jose do Rio Preto, state of Sao Paulo, Brazil. The medical students made daily telephone calls to all these ILPI units, requesting information, generally from the head nurses and owners, about the main COVID-19 symptoms that were detected in the residents and employees of these facilities. All the collected information was discussed daily with the teacher in charge of mentoring the program, fed into an online database and into a work schedule chart, then relayed to the local Municipal Health Secretariat. A COVID-19 contingency plan was devised by the team, authorized by the Local Health Secretariat and then presented to the ILPIs, aiming to offer them the best guidance throughout the pandemic. Discussion: the COVID-19 pandemic revealed the Health Education System's fragilities, limitations and capacity to adapt to this crisis, thus largely contributing to improving the training of new medical doctors. During the program, medical students faced many challenges, especially regarding the difficulty to contact some ILPIs by telephone, omitted or erroneous information provided by employees in these facilities and delays in reporting suspected cases. In spite of this scenario, daily contact with these facilities allowed the team to identify the ILPIs that were more adequately prepared and the ones that needed auditing and further supervision. Also, this daily contact established a bond between the team and the ILPIs. Conclusion: During the pandemic, it was possible to perform actions according to the logic of social accountability, demonstrating that remote online medical practice is a tool capable of both maintaining interns in contact with the practical aspects of medical care and providing medical assistance to the community and to the local government.

Resumo: Introdução: A Organização Mundial da Saúde definiu a obrigatoriedade do direcionamento das atividades de educação, pesquisa e serviços para atender às preocupações prioritárias de saúde como responsabilidade social das escolas médicas. Considerando a emergência em saúde pública em decorrência da Covid-19, decidiu-se utilizar a telemedicina e implementar o ensino remoto para continuar a programação curricular e prestar apoio à gestão municipal a partir do pressuposto da social accountability. Relato de experiência: A dois meses do fim da graduação, discentes de Medicina acompanharam as 43 instituições de longa permanência para idosos (Ilpis) - públicas e privadas - do município de São José do Rio Preto com o intuito de monitorar residentes e funcionários em relação à Covid-19. Por meio de ligações diárias para as Ilpis, eles solicitaram ao representante de cada unidade, geralmente enfermeiro responsável, ou ao proprietário do estabelecimento informações sobre os principais sintomas da Covid-19 detectados nos moradores e funcionários das instituições. Cotidianamente, essas informações eram registradas numa plataforma on-line, na planilha de organização do trabalho, e depois relatadas para a Secretaria Municipal de Saúde (SMS) e discutidas com o professor responsável pela mentoria. Um plano de contingência para a Covid-19 foi elaborado pela equipe, autorizado pela SMS e repassado às Ilpis, para orientá-las durante a pandemia. Discussão: A Covid-19 apontou as fragilidades, as limitações e a capacidade de adaptação do sistema educacional de saúde, o que possibilitou o aprimoramento da formação dos novos médicos. Durante o monitoramento, os discentes encontraram diversos desafios: dificuldade no contato telefônico com algumas Ilpis, informações omitidas ou fornecidas de forma equivocada pelos funcionários e atrasos na comunicação de casos suspeitos. Contudo, o contato diário permitiu reconhecer as Ilpis que se apresentavam mais adequadas e as que necessitavam de investigação e orientação, criando vínculo com as Ilpis. Conclusão: Durante a pandemia, foi possível realizar ações na lógica da social accountability, evidenciando que o teleatendimento é uma ferramenta que, ao mesmo tempo que mantém os internos nos cenários de práticas, presta assistência à comunidade e à gestão municipal durante a pandemia.

Effects of skin care education for care staff at elderly care facilities on skin conditions of the residents.

Asteatosis is common in elderly people due to a decrease in the moisture content of the epidermal stratum corneum through a loss of skin barrier function caused by aging. Because itching often accompanies asteatosis, this condition may cause a decrease in quality of life. Care staff in elderly care facilities have many opportunities to provide care for residents. In this study, we examined how educational training on skin care changed the thoughts and actions of care staff in these facilities and how these changes impacted the skin conditions of residents. The subjects for the training were all care staff in facilities because these staff work most closely with facility residents. We performed skin care training for the subjects and investigated changes in the skin conditions of the residents before and after the training. The training promoted the understanding of skin care among the care staff and improved the skin symptoms of residents with asteatosis. However, there were no changes in the severity of itchiness based on a verbal rating scale and in interviews of residents. This study showed that skin care training for the care staff in facilities is effective to improve skin conditions of residents. In addition, it was suggested that a full grasp of the residents' skin symptoms based upon an interview on itching alone was difficult, and thus there is a need to observe skin conditions directly.

Questionnaire Survey for Bronchial Asthma in Elderly Care Facilities.

In developed countries such as North America, the decline in mortality from bronchial asthma has ceased since 2006. The decline in mortality rate is also decreasing in Japan, where about 1,500 asthma deaths have been reported. Among these, elderly people aged 65 years or over account for about 90% of cases. Therefore, the treatment of elderly patients with asthma is an important subject. However, few studies have been conducted on asthma in elderly patients. In this survey, we distributed a questionnaire to 253 elderly care facilities in Kobe, Japan. Ninety facilities responded, and 223 patients in 70 out of 90 facilities were diagnosed with asthma. Dry powder inhaler was the most commonly used dosage form of inhaled corticosteroids. Many facilities have patients who need some assistance during inhalation: only 60% of facilities reported that inhalation is performed accurately. While 31 facilities had patients with a history of hospitalization for asthma attacks, only 14 of these facilities were able to provide appropriate initial treatment. Many facilities have difficulty providing assistance with inhalation to elderly patients whose cognitive function has deteriorated. This survey highlights challenges experienced by care facilities in treating asthma in the elderly.