scholarly journals Contactless In-Home Monitoring of the Long-Term Respiratory and Behavioral Phenotypes in Older Adults With COVID-19: A Case Series

2021 ◽  
Vol 12 ◽  
Author(s):  
Guo Zhang ◽  
Ipsit V. Vahia ◽  
Yingcheng Liu ◽  
Yuzhe Yang ◽  
Rose May ◽  
...  
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Case Series ◽  
Home Monitoring ◽  
Longitudinal Outcomes ◽  
Novel Approach ◽  
Radio Signals ◽  
Passive Sensors ◽  
Motor Abnormalities

Currently, there is a limited understanding of long-term outcomes of COVID-19, and a need for in-home measurements of patients through the whole course of their disease. We study a novel approach for monitoring the long-term trajectories of respiratory and behavioral symptoms of COVID-19 patients at home. We use a sensor that analyzes the radio signals in the room to infer patients' respiration, sleep and activities in a passive and contactless manner. We report the results of continuous monitoring of three residents of an assisted living facility for 3 months, through the course of their disease and subsequent recovery. In total, we collected 4,358 measurements of gait speed, 294 nights of sleep, and 3,056 h of respiration. The data shows differences in the respiration signals between asymptomatic and symptomatic patients. Longitudinally, we note sleep and motor abnormalities that persisted for months after becoming COVID negative. Our study represents a novel phenotyping of the respiratory and behavioral trajectories of COVID recovery, and suggests that the two may be integral components of the COVID-19 syndrome. It further provides a proof-of-concept that contactless passive sensors may uniquely facilitate studying detailed longitudinal outcomes of COVID-19, particularly among older adults.

scholarly journals Vulnerable Older Adults in Disasters: Effects of Hurricane Irma on Nursing Homes and Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 733-734
Author(s):  
Lindsay Peterson ◽  
David Dosa ◽  
Patricia D’Antonio
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Gulf Coast ◽  
Secondary Data ◽  
Morbidity And Mortality ◽  
Term Care ◽  
The Face ◽  
Qualitative Methodologies ◽  
Hurricane Irma

Abstract Preparedness of residents in long-term care (LTC) in the face of hurricane emergencies is a contested and largely unanswered question. Our prior work involving the U.S. Gulf Coast hurricanes of 2005-08 showed that exposure to various storms on nursing home (NH) residents resulted in significantly more deaths than reported by health care officials. This work also highlighted that evacuation of NH residents, compared to sheltering in place, was independently associated with morbidity and mortality. Hurricane Irma struck Florida on Sept. 10, 2017, prompting the evacuation of thousands of NH and assisted living community (ALC) residents. This symposium will discuss the effects of Hurricane Irma on vulnerable older adults residing in NHs and ALCs using mixed quantitative and qualitative methodologies. The first presentation will discuss morbidity and mortality of NH residents exposed to Hurricane Irma and will stratify by long stay/short stay status and hospice enrollment. The second presentation will discuss improvements and continued barriers to NH preparedness based on interviews with 30 administrators following Hurricane Irma. Using a novel methodology to identify residents of ALCs using secondary data sources, the third presentation will document AL resident morbidity and mortality risk following Hurricane Irma. The final presentation will highlight results of interviews with 70 stakeholders from small and large ALCs concerning the hurricane experiences of residents, including those with dementia. This symposium offers a multi-faceted view of a disaster’s effects on LTC residents across Florida, including novel data from the NH environment and lesser-examined ALCs.

scholarly journals Satisfaction With Outdoor Activities Over Time Among Long-Term Services and Supports Recipients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 189-190
Author(s):  
Justine Sefcik ◽  
Karen Hirschman ◽  
Darina Petrovsky ◽  
Liming Huang ◽  
Nancy Hodgson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Assisted Living ◽  
Term Care ◽  
Chronic Health ◽  
Outdoor Activities ◽  
Services And Supports ◽  
Over Time

Abstract Approximately 85% of older adults have at least one chronic health condition. The onset of chronic health conditions and mobility issues can constrain activities, including outdoor recreation. There is limited knowledge of older adults receiving long-term services and supports (LTSS) and their satisfaction with outdoor activities over time after enrolling in services. This study examined predictors of change in ratings of satisfaction with outdoor activities. A secondary analysis was conducted of data involving structured interviews with older adults (N=470) over the first two years of receiving LTSS (Health-Related Quality of Life: Elders in Long-Term Care; R01AG025524). Participants lived in assisted living communities, nursing homes, or their home. A single item on satisfaction with outdoor activities (assessed using a 5-point Likert scale: not at all to extremely satisfied) was the primary outcome. Mixed effects linear regression modeling using a backward elimination process was used for building a final multivariable model. In the final model, older age (p<0.001) and higher overall quality of life ratings (p<0.001) at baseline were associated with slower rates of increase in outdoor satisfaction over time. Higher education level (p=0.035) at baseline was associated with a faster rate of increase in outdoor satisfaction over time. Additionally, those who moved into an assisted living community (p=0.024) or nursing home (p=0.016) at baseline were associated with faster rates of increase in outdoor satisfaction over time compared to those in the home. Knowledge of factors influencing satisfaction with outdoor activities can assist interdisciplinary teams implement interventions for individual or organizational changes.

scholarly journals AI and robotics to help older adults: Revisiting projects in search of lessons learned

2021 ◽  
Vol 12 (1) ◽  
pp. 356-378
Author(s):  
Gabriella Cortellessa ◽  
Riccardo De Benedictis ◽  
Francesca Fracasso ◽  
Andrea Orlandini ◽  
Alessandro Umbrico ◽  
...  
Keyword(s):  
Older Adults ◽  
Technology Acceptance ◽  
Assisted Living ◽  
Lessons Learned ◽  
Technology Acceptance Models ◽  
Key Points ◽  
New Research ◽  
And Robotics

Abstract This article is a retrospective overview of work performed in the domain of Active Assisted Living over a span of almost 18 years. The authors have been creating and refining artificial intelligence (AI) and robotics solutions to support older adults in maintaining their independence and improving their quality of life. The goal of this article is to identify strong features and general lessons learned from those experiences and conceive guidelines and new research directions for future deployment, also relying on an analysis of similar research efforts. The work considers key points that have contributed to increase the success of the innovative solutions grounding them on known technology acceptance models. The analysis is presented with a threefold perspective: A Technological vision illustrates the characteristics of the support systems to operate in a real environment with continuity, robustness, and safety; a Socio-Health perspective highlights the role of experts in the socio-assistance domain to provide contextualized and personalized help based on actual people’s needs; finally, a Human dimension takes into account the personal aspects that influence the interaction with technology in the long term experience. The article promotes the crucial role of AI and robotics in ensuring intelligent and situated assistive behaviours. Finally, considering that the produced solutions are socio-technical systems, the article suggests a transdisciplinary approach in which different relevant disciplines merge together to have a complete, coordinated, and more informed vision of the problem.

scholarly journals Factors Associated With Perceived Worsened Physical Health Among Older Adults Who Are Newly Enrolled Long-term Services and Supports Recipients

2020 ◽  
Vol 57 ◽  
pp. 004695801990083
Author(s):  
Jasmine L. Travers ◽  
Karen B. Hirschman ◽  
Alexandra L. Hanlon ◽  
Liming Huang ◽  
Mary D. Naylor
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Physical Health ◽  
Assisted Living ◽  
Limited Information ◽  
Health Care Need ◽  
Related Quality ◽  
Services And Supports

Limited information exists on the perceived health of older adults new to receiving long-term services and supports (LTSS) compared with the year prior, posing challenges to the anticipation of health care need and optimization of wellness efforts for this growing population. In response, we sought to identify differences in perceived worsened physical health across three LTSS types (nursing home, assisted living, and home and community-based services) along with health-related quality of life (HRQoL) characteristics associated with older adults’ ratings of perceived worsened physical health at the start of receiving LTSS. Enrolled LTSS recipients completed a single interview assessing their HRQoL. Bivariate and multivariable logistic regression analyses were performed to determine associations in LTSS types and HRQoL characteristics with perceived worsened physical health among older adults (≥60 years old) since 1 year prior to study enrollment. Among the 467 LTSS recipients, perceived physical health was rated as worse than the previous year by 36%. Bivariate analyses revealed no differences in perceived worsened physical health across LTSS types. In adjusted analyses, religiousness/spirituality and better mental and general health perception had a decreased odds of being associated with perceived worsened physical health ( P < .05). Participants with major changes in their health in the past 6 months were more likely to report perceived worsened physical health ( P < .001). Findings provide information that may be used to target efforts to enhance perceived physical health and improve quality of life among LTSS enrollees.

scholarly journals Maybe She’ll Make Some Friends?: Family Members Cultivating Intimacy in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 486-487
Author(s):  
Andrea Fitzroy ◽  
Candace Kemp ◽  
Elisabeth Burgess
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Intimate Relationships ◽  
Long Term Care ◽  
Participant Observation ◽  
Family Members ◽  
Later Life ◽  
Theory Approach ◽  
Term Care

Abstract Intimacy continues to be important in later life, including for older adults in long-term care settings such as assisted living (AL). Our past work shows that intimacy is a multi-dimensional process and can involve a variety of partners. Drawing on data from the qualitative longitudinal “Convoys of Care” study (R01AG044368), we extend this research to examine the role family members play in cultivating intimacy and close relationships of AL residents. Using a grounded theory approach, we analyzed 2,224 hours of participant observation, and formal interviews with 28 assisted living residents (aged 58-96) and their formal and informal care partners (n=114) from four diverse AL communities. Findings show that family members can play integral roles in residents’ experiences with intimacy, directly as relationship partners, and by facilitating or impeding residents’ contacts with others. Family members cultivated residents’ intimacy opportunities and experiences by direct engagement, resident advocacy, to non-involvement and disengagement. Family members’ roles in cultivating intimacy fluctuated over time, increasing at times of health concerns and family change. Perceptive family members considered older adults’ intimacy preferences when cultivating their intimate relationships. Family members concerned for the safety of their loved one sometimes acted as “gatekeepers” to intimacy by interfering in intimate relationships. We conclude with a discussion of implications for policy and practice aimed at improving the intimacy process and opportunities for older adults receiving long-term care.

scholarly journals Heterogeneity in Regional Damage Detected by Neuroimaging and Neuropathological Studies in Older Adults With COVID-19: A Cognitive-Neuroscience Systematic Review to Inform the Long-Term Impact of the Virus on Neurocognitive Trajectories

2021 ◽  
Vol 13 ◽  
Author(s):  
Riccardo Manca ◽  
Matteo De Marco ◽  
Paul G. Ince ◽  
Annalena Venneri
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Fatal Outcome ◽  
Case Series ◽  
Chronic Phase ◽  
Cellular Damage ◽  
Brain Areas ◽  
Hospitalised Patients ◽  
Long Term Impact

Background: Other than its direct impact on cardiopulmonary health, Coronavirus Disease 2019 (COVID-19) infection affects additional body systems, especially in older adults. Several studies have reported acute neurological symptoms that present at onset or develop during hospitalisation, with associated neural injuries. Whilst the acute neurological phase is widely documented, the long-term consequences of COVID-19 infection on neurocognitive functioning remain unknown. Although an evidence-based framework describing the disease chronic phase is premature, it is important to lay the foundations for future data-driven models. This systematic review aimed at summarising the literature on neuroimaging and neuropathological findings in older over-60 patients with COVID-19 following a cognitive neuroscientific perspective, to clarify the most vulnerable brain areas and speculate on the possible cognitive consequences.Methods: PubMed and Web of Science databases were searched to identify relevant manuscripts published between 1st March 2020 and 31th December 2020. Outputs were screened and selected by two assessors. Relevant studies not detected by literature search were added manually.Results: Ninety studies, mainly single cases and case series, were included. Several neuroimaging and neuropathological findings in older patients with COVID-19 emerged from these studies, with cerebrovascular damage having a prominent role. Abnormalities (hyperintensities, hypoperfusion, inflammation, and cellular damage) were reported in most brain areas. The most consistent cross-aetiology findings were in white matter, brainstem and fronto-temporal areas. Viral DNA was detected mainly in olfactory, orbitofrontal and brainstem areas.Conclusion: Studies on COVID-19 related neural damage are rich and diverse, but limited to description of hospitalised patients with fatal outcome (i.e., in neuropathological studies) or severe symptoms (i.e., in neuroimaging studies). The damage seen in this population indicates acute and largely irreversible dysfunction to neural regions involved in major functional networks that support normal cognitive and behavioural functioning. It is still unknown whether the long-term impact of the virus will be limited to chronic evolution of acute events, whether sub-clinical pathological processes will be exacerbated or whether novel mechanisms will emerge. Based on current literature, future theoretical frameworks describing the long-term impact of COVID-19 infection on mental abilities will have to factor in major trends of aetiological and topographic heterogeneity.

HIGH COMPLIANCE, CONTINUOUS LONG-TERM HOME MONITORING OF SLEEP ACTIVITY IN DIVERSE POPULATIONS DIFFERENTIATES LOWER COGNITIVE FUNCTIONING OLDER ADULTS

2019 ◽  
Vol 15 (7) ◽  
pp. P152-P153
Author(s):  
Jeffrey Kaye ◽  
Lisa Silbert ◽  
Zachary Beattie ◽  
Nora Mattek ◽  
Rachel Wall ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Functioning ◽  
Home Monitoring ◽  
Diverse Populations ◽  
High Compliance

scholarly journals QUALITY OF LIFE AND PERCEIVED NEEDS AMONG OLDER ADULTS RECEIVING LONG-TERM SERVICES AND SUPPORTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S625-S625
Author(s):  
Eleanor Rivera ◽  
Karen Hirschman ◽  
Mary Naylor
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Physical Therapy ◽  
Assisted Living ◽  
Secondary Analysis ◽  
Social Activities ◽  
Perceived Needs ◽  
Services And Supports

Abstract Long term services and supports (LTSS) are vital for older adults with physical and cognitive disabilities. LTSS can be provided in settings such as nursing homes, assisted living, or via community-based services. The aim of this study is to describe the perceived needs for older adults new to LTSS, examine whether those needs are met in the first three months of LTSS, and determine the relationship with quality of life (QoL). This secondary analysis included data from 470 older adults new to LTSS (average age: 81, 71% female, 51% white, 35% black, 20% Hispanic.) The main outcome of QoL was measured using a single item (“How would you rate your overall quality of life at the present time?”). Perceived needs included supportive equipment devices, transportation, physical therapy, and social activities. Analyses at baseline and three months included t-tests, ANOVAs and simple regression modeling. LTSS recipient reported needs at baseline were: 29% supportive equipment, 31% transportation, 20% physical therapy, and 25% social activities. Those who reported needs at baseline had a lower QoL than those who reported no needs (for all). At three months reported needs decreased by an average of 6% (range: 3%-10%). QoL ratings were associated with changes in physical therapy and social activities needs at three months. The implications of these results related to LTSS recipients’ QoL in the first three months of services, with emphasis on physical therapy and social activities needs, is an opportunity to be more person-centered in delivery of care.

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