IntroductionHigh exercise adherence is a key factor for effective exercise programmes. However, little is known about predictors of exercise adherence to a multimodal machine‐based training in older ...retirement home residents.AimsTo assess exercise adherence and potential predictors of adherence. Furthermore, to evaluate user acceptance of the multimodal training and the change in exercise self‐efficacy.MethodsIn this sub‐analysis of the bestform‐F study, a total of 77 retirement home residents ≥65 years (mean age: 85.6 ± 6.6 years, 77.9% female) participated in a 6‐month machine‐based resistance, coordination and endurance training. Attendance to the training was documented for each training session. To identify potential predictors a multiple linear regression model was fitted to the data. Analyzed predictors included age, sex, body mass index (BMI), physical function, exercise self‐efficacy, and physical activity history. Different domains of user acceptance (e.g. safety aspects, infrastructure) and exercise self‐efficacy were assessed by a questionnaire and the exercise self‐efficacy scale (ESES), respectively.ResultsMean exercise adherence was 67.2% (median: 74.4%). The regression model (R2 = 0.225, p = 0.033) revealed that the 6‐minute walk test (6‐MWT) at baseline significantly predicted exercise adherence (β: 0.074, 95% confidence interval (CI): 0.006–0.142, p = 0.033). Different user domains were rated at least as good by 83.9%–96.9% of participants, reflecting high acceptance. No statistically significant change was found for exercise self‐efficacy over 6 months (mean change: 0.47 ± 3.08 points, p = 0.156).ConclusionRetirement home residents attended more than two thirds of offered training sessions and physical function at baseline was the key factor for predicting adherence. User acceptance of the training devices was highly rated. These findings indicate good potential for implementation of the exercise programme.
The current debate on demographic change often revolves around seniors (over 65-years-old), their housing preferences, and their spatial mobility. Our study contributes to this discussion by ...examining how seniors make evaluations concerning retirement homes guided by concepts such as functional congruity, self-congruity, and lifestyle congruity. An experimental study was conducted involving 325 Austrian and 546 French seniors (60+). The results were supportive of the hypotheses that seniors evaluate retirement homes positively when they (1) perceive the retirement home to have high service quality (high functional congruity), (2) identify with the occupant residents (high self-congruity), (3) believe that living in the retirement home is consistent with their own lifestyle (high lifestyle congruity), and (4) anticipate feeling satisfied with their social life, leisure life, health, love life, and life overall (high anticipated life satisfaction).
•An autonomous homecare system can ensure independence for elderly people.•An autonomous homecare system can increase cooperation, social interaction, and adaptation.•Trust required for elderly ...people to accept autonomous homecare systems instead of human support.•Elderly people can be motivated to develop trust in this less-familiar subject to finding a sense of belongingness.
An autonomous homecare system can ensure independence for elderly people and increase cooperation, social interaction, and adaptation. Widespread diffusion and inclusion of information and communication technology (ICT) in modern equipment has advanced the concept of machine autonomy. This study seeks to understand the effect of trust required for elderly people to accept autonomous homecare systems instead of human support. It attempts to reveal how trust and personal characteristics can increase intent to adopt an autonomous system. In this regard, different trust models and literature on human psychology to adopt ICT driven system are explored and analyzed to develop a parsimonious trust disposition model for autonomous system. The study was conducted among elderly and disabled people in retirement homes and rehabilitation centers of different major cities of Ontario, Canada through random sampling by employing both experiment and survey. In the first phase, a structured and designed experiment was conducted in three retirement homes which included 159 elderly people and in two rehabilitation centers which included 20 disabled people. Then a survey-based empirical study was conducted among the same people with the structured questionnaire to answer the questions based on their perceptions of both receiving service from human beings and viewing the video about an autonomous system governed by ambient intelligence. This study reveals that elderly people can be motivated to develop trust in this less-familiar system if they both believe they can operate it and find a sense of belongingness and feelings of social interactivity from this seemingly living machine system. The findings of this study provide clear direction for academics and practitioners. This research indicates that elderly people must have control on using any system in the absence of human support while maintaining a more solitary life in a retirement home. However, the system must be easy to learn and operate. It should also be designed in such a way that can create and impart social feelings.
Background: Because there are no standardized reporting systems specific to residents of retirement homes in North America, little is known about the health of this distinct population of older ...adults. We evaluated rates of health services use by residents of retirement homes relative to those of residents of long-term care homes and other populations of older adults. Methods: We conducted a retrospective cohort study using population health administrative data from 2018 on adults 65 years or older in Ontario. We matched the postal codes of individuals to those of licensed retirement homes to identify residents of retirement homes. Outcomes included rates of hospital-based care and physician visits. Results: We identified 54 733 residents of 757 retirement homes (mean age 86.7 years, 69.0% female) and 2 354 385 residents of other settings. Compared to residents of long-term care homes, residents of retirement homes had significantly higher rates per 1000 person months of emergency department visits (10.62 v. 4.48, adjusted relative rate RR 2.61, 95% confidence interval CI 2.55 to 2.67), hospital admissions (5.42 v. 2.08, adjusted RR 2.77, 95% CI 2.71 to 2.82), alternate level of care (ALC) days (6.01 v. 2.96, adjusted RR 1.51, 95% CI 1.48 to 1.54), and specialist physician visits (6.27 v. 3.21, adjusted RR 1.64, 95% CI 1.61 to 1.68), but a significantly lower rate of primary care visits (16.71 v. 108.47, adjusted RR 0.13, 95% CI 0.13 to 0.14). Interpretation: Residents of retirement homes are a distinct population with higher rates of hospital-based care. Our findings can help to inform policy debates about the need for more coordinated primary and supportive health care in privately operated congregate care homes.
While Australia has a natural advantage as an island, it also swiftly built surge capacity in the health system; deployed robust test, trace, and isolate systems; rolled out effective public health ...campaigns; and provided the eligible population with an economic safety net. ...private investment into aged care was able to flourish, which, experts say, turned people from patients into consumers. Recognising that maintaining the quality of life was just as important as preparing for a pandemic, the Commission urged the government to help aged care providers to “ensure there are adequate staff available to allow continued visits to people living in residential aged care by their families and friends.” Eagar, who has undertaken research commissioned by the Royal Commission into the adequacy of residential aged care staffing, found that quality and safety in homes is driven by four factors: total staff numbers, staff skill mix, staff continuity, and clinical governance.
•There is a real public health interest in tracking SARS-CoV-2 positive asymptomatic elderly people in nursing homes to avoid the COVID-19 propagation.•This study shows a new way of medical care ...different from our usual system: a medicine outside the walls, closer to patient expectations.
Since the beginning of the pandemic, COVID-19 affected specifically elderly people aged 70 years and over in whom the mortality rate is high. We may underestimate asymptomatic people or persons with atypical COVID-19 symptoms who may spread the disease.
A large screening campaign was launched all over France in several retirement homes in order to screen asymptomatic persons for SARS-CoV-2 to isolate carriers from other residents.
From April 24th to 27th 2020, mobile teams of nurses from the Hôtel-Dieu Hospital were sent to five Parisian nursing homes to conduct SARS-CoV-2 RT-PCR screening tests among all asymptomatic.
This cross-sectional study included 297 residents: 274 asymptomatic participants (92.3%) were tested for COVID-19, mostly women (n=249/274), median age was 90 (IQR 95% 86–94) with females being significantly older than males (90 versus 88 years, P=0.028). A total of 35 residents (12.8%) were tested positive for COVID-19: 29 women (11.7%) and six men (24%). The proportion of PCR-positive residents was extremely variable between retirement homes and analysis of COVID-19 positive cases dispersion in each nursing home showed there was no area cluster.
There is a real public health interest in tracking SARS-CoV-2 positive asymptomatic elderly people in nursing homes.
The prevalence of dizziness increases with age. We aimed to determine the point prevalence of dizziness and, in particular, of benign paroxysmal positional vertigo (BPPV) among retirement home ...residents. Furthermore, we aimed to evaluate the efficacy of a 2-axis turntable based BPPV treatment.
We contacted all large retirement homes in or around the city of Zurich (Switzerland). 10 retirement homes (with a total of 536 residents) agreed to participate in this study. 83 rejected inquiries by residents led to a potential study population of 453 residents. After a structured interview evaluating the presence and characteristics of dizziness, all willing patients were tested for positional vertigo and nystagmus on a portable and manually operated 2-axis turntable that was transported to the retirement home. Testing consisted of the Dix-Hallpike and supine roll maneuvers to both sides. Participants were immediately treated with the appropriate liberation maneuver whenever BPPV was diagnosed. Otherwise, taking the resident's medical history, a neuro-otological bedside examination, and a review of the available medical documentation was used to identify other causes of dizziness.
Out of the 453 residents, 75 (16.6%; average age: 87.0 years; 68% female) were suffering from dizziness presently or in the recent past and gave their consent to participate in this study. Among the participants tested on the turntable (n = 71), BPPV was present in 11.3% (point prevalence). Time-related properties, triggering factors and qualitative attributes of vertigo or dizziness were not significantly different between the dizzy participants with and those without BPPV. In all BPPV patients, appropriate liberation maneuvers were successful.
BPPV could be demonstrated in about one tenth of retirement home residents with dizziness or recent dizziness. Such point prevalence of BPPV translates to a much higher yearly prevalence if one assumes that BPPV is not present on every day. Our finding suggests that retirement home residents suffering from dizziness should be regularly tested for BPPV and treated with appropriate liberation maneuvers, ideally on turntable to reduce strain.
ClinicalTrials.gov Identifier NCT03643354 .
Purpose: The study aimed to examine the effect of visual impairment, eye diseases and other risk factors on health‐related quality of life (HRQoL) in retirement home residents in Armenia.
Methods: ...The survey was conducted among 313 beneficiaries from retirement homes. Interviewer‐administered structured questionnaire explored socio‐demographic characteristics of participants, presence of chronic non‐communicable diseases, depressive symptoms, HRQoL, smoking, physical activity, receiving and giving instrumental and emotional social support, sleeping disorder, and adverse life events. Ophthalmic examinations were conducted to assess participants' visual acuity and presence of eye diseases.
Results: The mean age was 72.5 years. Women constituted 50% of the sample. About 28% of participants reported depressive symptoms. The prevalence of normal vision was 49%, mild/moderate and severe visual impairment was 46%, and blindness was 5%. Uncorrected refractive errors were found in 20% of participants. In the adjusted linear regression model, presence of chronic non‐communicable diseases (β = −11.3; CI: −15.3; −7.39), physical activity (β = 15.3; CI: 9.04; 21.5), sleeping disorders (β = −5.58; CI: −10.2; −0.96), receiving emotional support (β = 0.09; CI: 0.01; 0.17) and giving instrumental support (β = 0.17; CI: 0.08; 0.25), presence of depressive symptoms (β = −11.7; CI: −16.0; −7.46) and uncorrected refractive errors (β = −9.15; CI: −17.3; −1.04) were associated with HRQoL.
Conclusions: This study found high prevalence of uncorrected refractive errors, visual impairment and blindness among people in retirement homes. Regular eye screening programs and distribution of spectacles could improve eye health in the target population. Promote healthy behaviours including regular physical activity to enhance HRQoL. A focus on people with chronic non‐communicable diseases and depressive symptoms is warranted.
Using employer–employee matched data from Sweden between 2001 and 2008, we test hypotheses designed to assess the contingent nature of the relationship between wage dispersion and cross-firm ...mobility. Whereas past research has mostly established that dispersed wages increase interfirm mobility, we investigate the conditions under which pay variance might have the opposite effect, serving to retain workers. We propose that the effect of wage dispersion is contingent on organizational rank and that it depends on whether wages are dispersed vertically (between job levels) or horizontally (within the same job level). We find that vertical wage dispersion suppresses cross-firm mobility because it is associated with outcomes beneficial for employees, such as attractive advancement opportunities. By contrast, horizontal wage dispersion increases cross-firm mobility because it is associated with outcomes harmful for employees, such as inequity concerns. We further find that the vertical-dispersion effect is amplified (mitigated) for bottom (top) different-level wage earners because bottom (top) wage earners have the most (least) to gain from climbing the job ladder. Similarly, the horizontal-dispersion effect is amplified (mitigated) for bottom (top) same-level wage earners because bottom (top) wage earners are most (least) subject to negative consequences of this dispersion. More broadly, this study contributes to our understanding of the relationship between wage dispersion and cross-firm mobility.
The online appendix is available at
https://doi.org/10.1287/orsc.2017.1169
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