scholarly journals Towards Responsible Artificial Intelligence in Long-term Care: A Scoping Review on Practical Approaches

2021 ◽  
Author(s):  
Dirk R M Lukkien ◽  
Henk Herman Nap ◽  
Hendrik P Buimer ◽  
Alexander Peine ◽  
Wouter P C Boon ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Scoping Review ◽  
Long Term Care ◽  
Empirical Studies ◽  
Responsible Innovation ◽  
Term Care ◽  
Ethical Implications ◽  
Local Contexts ◽  
Design And Methods

Abstract Background and Objectives Artificial intelligence (AI) is widely positioned to become a key element of intelligent technologies used in the long-term care (LTC) for older adults. The increasing relevance and adoption of AI has encouraged debate over the societal and ethical implications of introducing and scaling AI. This scoping review investigates how the design and implementation of AI technologies in LTC is addressed responsibly: so called responsible innovation (RI). Research Design and Methods We conducted a systematic literature search in five electronic databases using concepts related to LTC, AI and RI. We then performed a descriptive and thematic analysis to map the key concepts, types of evidence and gaps in the literature. Results After reviewing 3,339 papers, 25 papers were identified that met our inclusion criteria. From this literature, we extracted three overarching themes: user-oriented AI innovation; framing AI as a solution to RI issues; and context-sensitivity. Our results provide an overview of measures taken and recommendations provided to address responsible AI innovation in LTC. Discussion and Implications The review underlines the importance of the context of use when addressing responsible AI innovation in LTC. However, limited empirical evidence actually details how responsible AI innovation is addressed in context. Therefore, we recommend expanding empirical studies on RI at the level of specific AI technologies and their local contexts of use. Also, we call for more specific frameworks for responsible AI innovation in LTC to flexibly guide researchers and innovators. Future frameworks should clearly distinguish between RI processes and outcomes.

scholarly journals Mapping Research Conducted on Long-Term Care Facilities for Older People in Brazil: A Scoping Review

2021 ◽  
Vol 18 (4) ◽  
pp. 1522
Author(s):  
Patrick Alexander Wachholz ◽  
Deborah Cristina De Oliveira ◽  
Kathryn Hinsliff-Smith ◽  
Reena Devi ◽  
Paulo José Fortes Villas Boas ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Older People ◽  
Study Design ◽  
Scoping Review ◽  
Long Term Care ◽  
Assessment Tools ◽  
Small Scale ◽  
Term Care ◽  
Care Facilities

This scoping review aimed to explore the characteristics, strengths, and gaps in research conducted in Brazilian long-term care facilities (LTCFs) for older adults. Electronic searches investigating the residents (≥60 years old), their families, and the LTCF workforce in Brazil were conducted in Medline, EMBASE, LILACS, and Google Scholar, within the timescale of 1999 to 2018, limited to English, Portuguese, or Spanish. The reference lists were hand searched for additional papers. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal of evidence. Data were reported descriptively considering the study design, using content analysis: 327 studies were included (n = 159 quantitative non-randomized, n = 82 quantitative descriptive, n = 67 qualitative, n = 11 mixed methods, n = 6 randomized controlled trials, and n = 2 translation of assessment tools). Regardless of the study design, most were conducted in a single LTCF (45.8%), in urban locations (84.3%), and in non-profit settings (38.7%). The randomized trials and descriptive studies presented the lowest methodological quality based on the MMAT. This is the first review to provide an overview of research on LTCFs for older people in Brazil. It illustrates an excess of small-scale, predominantly qualitative papers, many of which are reported in ways that do not allow the quality of the work to be assured.

scholarly journals Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review

2021 ◽  
pp. 1-24
Author(s):  
Fiona Höbler ◽  
Katherine S. McGilton ◽  
Walter Wittich ◽  
Kate Dupuis ◽  
Marilyn Reed ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Nursing Staff ◽  
Scoping Review ◽  
Pure Tone ◽  
Long Term Care ◽  
Pure Tone Audiometry ◽  
Care Homes ◽  
Term Care

Background: Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. Objective: To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. Methods: Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O’Malley’s scoping review and appraisal process was followed. Results: There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. Conclusion: Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.

scholarly journals Dancing with dementia: Exploring the embodied dimensions of creativity and social engagement

2020 ◽  
Author(s):  
Pia Kontos ◽  
Alisa Grigorovich ◽  
An Kosurko ◽  
Rachel J Bar ◽  
Rachel V Herron ◽  
...  
Keyword(s):  
Social Engagement ◽  
Social Inclusion ◽  
Long Term Care ◽  
Participant Observation ◽  
Term Care ◽  
Embodied Self ◽  
And Function ◽  
Design And Methods ◽  
Residential Long Term Care

Abstract Background and Objectives Dance is increasingly being implemented in residential long-term care to improve health and function. However, little research has explored the potential of dance programs to support social inclusion by supporting embodied self-expression, creativity, and social engagement of persons living with dementia and their families. Research Design and Methods This was a qualitative sequential multiphase study of Sharing Dance Seniors, a dance program that includes a suite of remotely streamed dance sessions that are delivered weekly to participants in long-term care and community settings. Our analysis focused on the participation of 67 persons living with dementia and 15 family carers in residential long-term care homes in Manitoba, Canada. Data included participant observation, video-recordings, focus groups, and interviews; all data was analyzed thematically. Results We identified two themes: playfulness and sociability. Playfulness refers to the ways that the participants let go of what is ‘real’ and became immersed in the narrative of a particular dance, often adding their own style. Sociability captures the ways in which the narrative approach of the Sharing Dance Seniors program encourages connectivity/intersubjectivity between participants and their community; participants co-constructed and collaboratively animated the narrative of the dances. Discussion and Implications Our findings highlight the playful and imaginative nature of how persons living with dementia engage with dance and demonstrate how this has the potential to challenge stigma associated with dementia and support social inclusion. This underscores the urgent need to make dance programs such as Sharing Dance Seniors more widely accessible to persons living with dementia everywhere.

scholarly journals Correction to: factors affecting residents transition from long term care facilities to the community: a scoping review

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Shannon Freeman ◽  
Kristen Bishop ◽  
Lina Spirgiene ◽  
Erica Koopmans ◽  
Fernanda C. Botelho ◽  
...  
Keyword(s):  
Scoping Review ◽  
Long Term Care ◽  
Term Care ◽  
Factors Affecting ◽  
Care Facilities

scholarly journals Monitoring polypharmacy in healthcare systems through a multi-setting survey: should we put more attention on long term care facilities?

2016 ◽  
Vol 5 (3) ◽  
Author(s):  
Luca Arnoldo ◽  
Giovanni Cattani ◽  
Piergiorgio Cojutti ◽  
Federico Pea ◽  
Silvio Brusaferro
Keyword(s):  
Long Term Care ◽  
Beers Criteria ◽  
Regional Health ◽  
Term Care ◽  
Point Prevalence Study ◽  
Healthcare Settings ◽  
Care Facilities ◽  
Acute Hospitals ◽  
Design And Methods

<em>Background</em>. Polypharmacy is a main issue of patient safety in all healthcare settings (<em>i.e.</em> increase adverse drug reactions and incidence of drug-drug interactions, etc.). The main object of the study was to evaluate the prevalence of polypharmacy and the appropriateness of drugs prescriptions in the regional health system (RHS) of Friuli Venezia-Giulia Region, Italy. <br /><em>Design and methods</em>. We carried out a point prevalence study in May 2014; 1582 patients ≥65 years were included from: 14 acute hospitals, 46 Long Term Care Facilities (LTCFs) and 42 general practitioners’ (GPs) clinics. Data analysis included the evaluation of potentially inappropriate prescriptions (PIPs) taking Beers criteria as a reference. <br /><em>Results</em>. Patients in therapy with 10 drugs or more were 13.5%: 15.2% in hospitals, 9.7% in GPs’ clinics and 15.6% in LTCFs. According to Beers criteria we identified 1152 PIPs that involved globally almost half of patients (46.0%): 41.9% in hospitals, 59.6% in LTCFs and 37.0% in GP’s clinics. The 53.9% of patients received at least one mainly kidney excreted drug; for these patients the evaluation of serum creatinine was overall present in the 87.7% (747/852): 96.4% in hospital ones, 87.5% in GPs’ clinics and 77.8% in LTCFs. LTCFs residents were significantly (P&lt;0.05) more exposed to PIPs and less monitored for the renal function. <br /><em>Conclusions</em>. A reliable estimation of the phenomenon in all the main healthcare settings is a necessary prerequisite to set tailored policies for facing polypharmacy within a RHS; the results showed the necessity to put a special attention on LTCFs.

Ethics of Assisted Autonomy in the Nursing Home: Types of Assisting Among Long-Term Care Nurses

1996 ◽  
Vol 3 (3) ◽  
pp. 224-235 ◽  
Author(s):  
June M. Whitler
Keyword(s):  
Decision Making ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Personal Autonomy ◽  
Self Determination ◽  
Decisional Capacity ◽  
Term Care ◽  
Ethical Implications

Twenty-five long-term care nurses in eight nursing homes in central Kentucky were inter viewed concerning ways in which they might assist elderly residents to preserve and enhance their personal autonomy. Data from the interviews were analysed using grounded theory methodology. Seven specific categories of assisting were discovered and described: personalizing, informing, persuading, shaping instrumental circumstances, considering, mentioning opportunities, and assessing causes of an impaired capacity for decision-making. The ethical implications of these categories of assisting for clinical prac tice are examined. Although nurses recognized the importance of resident autonomy, the majority of them failed consistently to employ the categories of assistance to foster resi dent self-determination and most of them held an inadequate understanding of the con cepts of consent and decisional capacity. To assure confidentiality, pseudonyms are used in the following cases and discussions for all names of nurses, residents and facilities.

scholarly journals Protocol for a scoping review on the methods for engaging long-term care residents with dementia in research and guideline development

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e051602
Author(s):  
Caitlin McArthur ◽  
Adria Quigley ◽  
Rebecca Affoo ◽  
Marie Earl ◽  
Elaine Moody
Keyword(s):  
Scoping Review ◽  
Patient Engagement ◽  
Long Term Care ◽  
Guideline Development ◽  
Research Question ◽  
Grey Literature ◽  
Optimal Strategies ◽  
Term Care ◽  
People With Dementia

IntroductionPatient engagement is important when developing health guidelines to ensure high-quality and patient-centred recommendations. However, patient engagement in research and guideline development remains suboptimal, particularly for vulnerable populations, including residents with dementia living in long-term care (LTC) who are often not included in research and guideline development because of perceived and actual challenges with their health, memory, concentration and communication. Optimal strategies and methods for engaging LTC residents with dementia in research and guideline development remain unknown.Methods and analysisWe will conduct a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension to answer the research questions: (1) What methods have been used to engage LTC residents with dementia in research and guideline development? (2) What are the outcomes of resident engagement? (3) What are the barriers and facilitators to resident engagement? Systematic searches for peer-reviewed articles will be conducted in: Academic Search Premier (EBSCO), APA PsycINFO (EBSCO), CINAHL (EBSCO), Medline (OVID), Embase (Elsevier), Web of Science, and Cochrane Database and in grey literature. Two team members will screen articles and extract data. Results will be presented according to the research question they address. We will engage stakeholders including residents, family members, healthcare providers and representatives from relevant organisations throughout the study.Ethics and disseminationThe scoping review will synthesise what is known about resident engagement in research and guideline development. It may identify gaps in the literature about the optimal methods to engage residents in performing research and developing guidelines and reveal opportunities for new methods. The results will be helpful for researchers and policy-makers seeking to develop guidelines and researchers engaging in topics that reflect the priorities and experiences of people with dementia. Results of the scoping review will be disseminated via publication in a peer-reviewed journal and conference presentations, and a one-page lay summary will be shared with our engaged stakeholders.

scholarly journals Eating Difficulties among Older Adults with Dementia in Long-Term Care Facilities: A Scoping Review

2021 ◽  
Vol 18 (19) ◽  
pp. 10109
Author(s):  
Dukyoo Jung ◽  
Kyuri Lee ◽  
Jennie C. De Gagne ◽  
Minkyung Lee ◽  
Hyesoon Lee ◽  
...  
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Long Term Care ◽  
Skill Training ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Term Care ◽  
Feeding Difficulties ◽  
Care Facilities

This paper reports a scoping review of the literature on eating difficulties among older adults with dementia in long-term care facilities to identify key concepts, methods of measuring outcomes, interventions, and related factors. A scoping review was performed using the bibliographic databases PubMed, CINAHL, PsycINFO, and Cochrane Library. A combination of keywords and subject headings related to eating or feeding difficulties was used. Inclusion criteria were limited to materials published in English. A total of 1070 references were retrieved, of which 39 articles were selected after applying the inclusion and exclusion criteria. Articles that met the criteria were published between 1987 and 2020. “Eating disabilities” have been defined as problems related to choosing food and/or the ability to get food to one’s mouth, chew, and swallow. Interventions for eating difficulties described in the literature include spaced retrieval training, Montessori training, and feeding skill training. Intrapersonal, interpersonal, and environmental factors related to eating difficulties were identified. This scoping review will provide direct care workers, nursing educators, and administrators with an overview of eating performance and a broad understanding of eating difficulties for older adults with dementia in long-term care facilities.

scholarly journals Provincial legislative and regulatory standards for pain assessment and management in long-term care homes: a scoping review and in-depth case analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Natasha L. Gallant ◽  
Allie Peckham ◽  
Gregory Marchildon ◽  
Thomas Hadjistavropoulos ◽  
Blair Roblin ◽  
...  
Keyword(s):  
Scoping Review ◽  
Pain Assessment ◽  
Clinical Guidelines ◽  
Long Term Care ◽  
Case Analysis ◽  
Assessment Tools ◽  
Evidence Based ◽  
Term Care ◽  
Limited Ability

Abstract Background Among Canadian residents living in long-term care (LTC) facilities, and especially among those with limited ability to communicate due to dementia, pain remains underassessed and undermanaged. Although evidence-based clinical guidelines for the assessment and management of pain exist, these clinical guidelines are not widely implemented in LTC facilities. A relatively unexplored avenue for change is the influence that statutes and regulations could exert on pain practices within LTC. This review is therefore aimed at identifying the current landscape of policy levers used across Canada to assess and manage pain among LTC residents and to evaluate the extent to which they are concordant with evidence-based clinical guidelines proposed by an international consensus group consisting of both geriatric pain and public policy experts. Methods Using scoping review methodology, a search for peer-reviewed journal articles and government documents pertaining to pain in Canadian LTC facilities was carried out. This scoping review was complemented by an in-depth case analysis of Alberta, Saskatchewan, and Ontario statutes and regulations. Results Across provinces, pain was highly prevalent and was associated with adverse consequences among LTC residents. The considerable benefits of using a standardized pain assessment protocol, along with the barriers in implementing such a protocol, were identified. For most provinces, pain assessment and management in LTC residents was not specifically addressed in their statutes or regulations. In Alberta, Saskatchewan, and Ontario, regulations mandate the use of the interRAI suite of assessment tools for the assessment and reporting of pain. Conclusion The prevalence of pain and the benefits of implementing standardized pain assessment protocols has been reported in the research literature. Despite occasional references to pain, however, existing regulations do not recommend assessments of pain at the frequency specified by experts. Insufficient direction on the use of specialized pain assessment tools (especially in the case of those with limited ability to communicate) that minimize reliance on subjective judgements was also identified in current regulations. Existing policies therefore fail to adequately address the underassessment and undermanagement of pain in older adults residing in LTC facilities in ways that are aligned with expert consensus.

Sign in / Sign up

Export Citation Format

Share Document