Long-term care home residents' experiences with socially assistive technologies and the effectiveness of these technologies: a mixed methods systematic review.

OBJECTIVE: The objectives of this review were to determine the effectiveness of socially assistive technologies for improving depression, loneliness, and social interaction among residents of long-term care (LTC) homes, and to explore the experiences of residents of LTC homes with socially assistive technologies. INTRODUCTION: Globally, the number of older adults (≥ 65 years) and the demand for LTC services are expected to increase over the next 30 years. Individuals within this population are at increased risk of experiencing depression, loneliness, and social isolation. The exploration of the extent to which socially assistive technologies may aid in improving loneliness and depression while supporting social interactions is essential to supporting a sustainable LTC sector. INCLUSION CRITERIA: This mixed methods systematic review included studies on the experiences of older adults in LTC homes using socially assistive technologies, as well as studies on the effectiveness of these technologies for improving depression, loneliness, and social interaction. Older adults were defined as people 65 years of age and older. We considered studies examining socially assistive technologies, such as computers, smart phones, tablets, and associated applications. METHODS: A JBI mixed methods convergent, segregated approach was used. CINAHL (EBSCOhost), MEDLINE (Ovid), Embase, APA PsycINFO (EBSCOhost), and Scopus databases were searched on January 18, 2022, to identify published studies. The search for unpublished studies and gray literature included ProQuest Dissertations and Theses Global, Open Access Theses and Dissertations, Google, and the websites of professional organizations associated with LTC. No language or geographical restrictions were placed on the search. Titles, abstracts, and full texts of included studies were screened by 2 reviewers independently. Included studies underwent quality appraisal and data extraction. Quantitative and qualitative data findings were analyzed separately and then integrated. Where possible, quantitative data were synthesized using comparative meta-analyses with a fixed-effects model. RESULTS: From 12,536 records identified through the search, 14 studies were included. Quantitative (n = 8), mixed methods (n = 3), and qualitative (n = 3) approaches were used in the included studies, with half (n = 7) using quasi-experimental designs. All studies received moderate to high-quality appraisal scores. Comparative meta-analyses for depression and loneliness scores did not find any significant differences, and narrative findings were mixed. Qualitative meta-aggregation identified 1 synthesized finding (Matching technology functionality to user for enhanced well-being) derived from 2 categories (Enhanced sense of well-being, and Mismatch between technology and resident ability). CONCLUSIONS: Residents' experiences with socially assistive technologies, such as videoconferencing, encourage a sense of well-being, although quantitative findings related to depression and loneliness reported mixed impact. Residents experienced physical and cognitive challenges in learning to use the technology and required assistance. Future work should consider the unique needs of older adults and LTC home residents in the design and use of socially assistive technologies. REVIEW REGISTRATION: PROSPERO CRD42021279015.

Recent innovations in long-term care coverage and financing: a rapid scoping review.

OBJECTIVES: To identify, chart and analyse the literature on recent initiatives to improve long-term care (LTC) coverage, financial protection and financial sustainability for persons aged 60 and older. DESIGN: Rapid scoping review. DATA SOURCES: Four databases and four sources of grey literature were searched for reports published between 2017 and 2022. After using a supervised machine learning tool to rank titles and abstracts, two reviewers independently screened sources against inclusion criteria. ELIGIBILITY CRITERIA: Studies published from 2017-2022 in any language that captured recent LTC initiatives for people aged 60 and older, involved evaluation and directly addressed financing were included. DATA EXTRACTION AND ANALYSIS: Data were extracted using a form designed to answer the review questions and analysed using descriptive qualitative content analysis, with data categorised according to a prespecified framework to capture the outcomes of interest. RESULTS: Of 24 reports, 22 were published in peer-reviewed journals, and two were grey literature sources. Study designs included quasi-experimental study, policy analysis or comparison, qualitative description, comparative case study, cross-sectional study, systematic literature review, economic evaluation and survey. Studies addressed coverage based on the level of disability, income, rural/urban residence, employment and citizenship. Studies also addressed financial protection, including out-of-pocket (OOP) expenditures, copayments and risk of poverty related to costs of care. The reports addressed challenges to financial sustainability such as lack of service coordination and system integration, insufficient economic development and inadequate funding models. CONCLUSIONS: Initiatives where LTC insurance is mandatory and accompanied by commensurate funding are situated to facilitate ageing in place. Efforts to expand population coverage are common across the initiatives, with the potential for wider economic benefits. Initiatives that enable older people to access the services needed while avoiding OOP-induced poverty contribute to improved health and well-being. Preserving health in older people longer may alleviate downstream costs and contribute to financial sustainability.

Experiences of residents of long-term-care homes with the use of socially assistive technologies and the effectiveness of these technologies: a mixed methods systematic review protocol.

OBJECTIVE: The objective of this review is to explore the experiences of residents of long-term-care homes using socially assistive technologies and the effectiveness of these technologies in relation to depression, loneliness, and social interaction. INTRODUCTION: Research related to the experiences of residents of long-term-care homes with socially assistive technologies, and their effectiveness, is limited. This population of older adults is projected to steeply increase in the future, as will the need for services, such as long-term care. Older adults (≥65 years) in long-term care are at increased risk of depression, loneliness, and social isolation. Therefore, there is a need to explore the experiences of long-term-care residents with the use of socially assistive technologies and to determine the effectiveness of these technologies in relation to depression, loneliness, and social interaction. INCLUSION CRITERIA: This review will include studies about the experiences of older adults in long-term care using socially assistive technologies, and the effectiveness of these technologies. Older adults are defined as people 65 years of age and above. We will consider human-to-human socially assistive technologies, such as computers, smart phones, tablets, and associated applications. We will review quantitative, qualitative, and mixed methods studies. METHODS: A JBI mixed methods convergent segregated approach will be used. Select databases and gray literature will be searched for published and unpublished studies, with no date or language limits. Titles, abstracts, and full texts of included studies will be screened by at least two reviewers, and undergo quality appraisal, data extraction, and synthesis of quantitative and qualitative data followed by integration of the two types of evidence. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021279015.