Does Nursing Education in Turkey Affect the Attitudes Toward Ageing and Elderliness?

The aim of this study is to explore the attitudes of nurse students in Turkey, towards ageing and elderliness and to determine differences in terms of year of study. The study uses a comparative design with data collected from February to March 2020. A random sample of 306 nursing students was selected. A demographic data form and the Attitudes toward Ageing and Elderliness Scale (ATAES) were used to collect data. Of the students, 47.7% reported that they cared for older adults in their clinical practice and 53.6% confirmed that they had successfully completed the theoretical lessons on elderly care. Theoretical education (Hedge’s g = 0.23) and clinical practice (Hedge’s g = 0.34) on elderly care have minimal effects on the attitudes toward ageing and elderliness. Theoretical education and clinical practice as conducted currently in a university in Turkey, failed to improve attitudes toward ageing and elderliness. Keywords: ageing, elderliness, nursing, nursing education, nursing students

The Moderation of Perceived Comfort and Relations with Patients in the Relationship between Secure Workplace Attachment and Organizational Citizenship Behaviors in Elderly Facilities Staff

This study focuses on caregivers who work in residential facilities (RFs) for the elderly, and specifically on their organizational citizenship behaviors (OCBs) in relation to their interaction respectively with the overall context (workplace attachment dimension), the spatial-physical environment (perceived environmental comfort), and the social environment (relationship with patients). A sample of health care workers (medical or health care specialists, nurses, and office employees, n = 129) compiled a self-report paper-pencil questionnaire, which included scales measuring the study variables. The research hypotheses included secure workplace attachment style as independent variable, OCBs as the dependent variable, and perceived comfort and relations with patients as moderators. Results showed that both secure workplace attachment and perceived comfort promote OCBs, but the latter counts especially as a compensation of an insecure workplace attachment. As expected, difficult relationships with patients hinder the relationship between secure workplace attachment style and OCBs. In sum, our study highlights the importance of the joint consideration of the psychological, social, and environmental dimensions for fostering positive behaviors in caregivers employed in elderly care settings.

Video Calls for Older Adults: A Narrative Review of Experiments Involving Older Adults in Elderly Care Institutions

Social isolation in geriatric institutions is a real threat to older adults' (OAs) well-being. Visits from family members, when they are not impacted by geographical distance or illness, sometimes fail to provide sufficient opportunities for social connectedness and interaction to prevent and/or combat OAs' loneliness and social isolation. Information and Communication Technologies (ICTs) offer promising solutions to this problem. Video calls provide a quick and convenient way for remote communication between OAs and their families, and a complement to face-to-face visits in geriatric settings. Over the last months, during the several confinements imposed to stop the transmission of COVID-19 over the world, several care homes and long-care facilities have equipped themselves with laptops, tablets and video call applications to help OAs remain in contact with their relatives. However, numerous technical and human-related factors may hinder the use of video calls in these settings. The complexity of technological devices, as well as OAs limited digital skills, low confidence and experience in the use of technology are some examples. Furthermore, the specific context of use and the required implication of multiple actors (care professionals, family members) should also be considered when examining the use and implementation of video calls in geriatric institutions. We conducted a narrative review of literature describing the use of video calls in geriatric institutions between 2000 and 2021, especially because of the little information related to OAs' use of video calls in geriatric settings. One thousand one hundred ninety-seven references were screened and 15 studies focusing on the usability, acceptability and effectiveness of video calls were included. A qualitative, deductive thematic analysis inspired by a Health Technology Assessment (HTA) multidimensional model was used to identify barriers, enablers and solutions to video calls implementation in geriatric institutions. The results from the HTA-based analysis provide encouraging evidence for the feasibility of video call use in geriatric settings, and its efficacy on reducing social isolation among residents. However, numerous technical, human-related, ethical and organizational barriers persist and should be addressed in future works. The present analysis has also allowed the identification of potential solutions to overcome these barriers, which are discussed in this publication.

Content Comparison of Long-Term Care Instruments Based On The International Classification of Functioning, Disability And Health (ICF)

Background: Aging crisis is proposing a huge challenge to the whole Chinese social welfare system, however a national Long-term Care (LTC) Instrument has not established yet. The objective of this study was to analyze and compare the content of six selected LTCs based on the linkage of the International Classification of Functioning, Disability and Health (ICF), so as to provide insights for the development of Chinese national LTC instrument in the future. Methods: Two trained health professionals performed the linkage according to the refined ICF linking rules. The main concepts included in the items of three international LTC instruments, namely Minimum Data Set 3.0 (MDS 3.0), Initial Assessment Instrument(IAI), and New Assessment Tool for Determining Dependency on Nursing Care (NBA), as well as three Chinese instruments, namely Disability Assessment of Long-Term Care (DA-LTC), Specification for Elderly Care Unified Need Assessment in Shanghai Version 2.0 (SEC-UNA 2.0), and pictorial-based Longshi Scale (LS) were selected and linked to the ICF categories. The six selected LTC instruments were analyzed and compared at the levels of ICF components, chapters, and categories. Results: The main concepts of 340 valid items of the six LTC instruments were linked to 112 different ICF categories. Within the ICF framework, the “Activities and Participation” component was most frequently addressed in the LTC instruments followed by the “Body functions” component, and the percentages were 0.52 and 0.38, respectively. At the ICF chapters level, “b1 mental functions,” “d4 mobility,” and “d5 self-care” were the core of the LTC instruments. In addition, the contents of the six selected LTC instruments differed greatly. Conclusions: The ICF provides a useful external reference for the analysis and comparison of different LTC instruments. The findings suggest that key elements to determine eligibility for LTC in China need to be further identified. It is anticipated that this study will provide new insights for the development of Chinese national LTC instruments.

Aging, care and dependency in multimorbidity: how relationships affect elderly women’s homecare and health service use

Relationships are multidimensional, and we know little about the facets of relationships in the way elderly patients’ with multimorbidity utilise homecare and health services. Gerontology literatures emphasize the importance of place of care, inequalities, availability of health services and affordability. However, the diversity of relationships and associated dependency in elderly care remain underassessed. A qualitative study involving a demographic survey and interviews was conducted to explore relationship experiences of elderly women with multimorbidity in homecare and health services utilization. Civil Surgeon of Sylhet District in Bangladesh was contacted to recruit participants for the study, and this resulted in 33 interviews [11 staff and 22 elderly women with multimorbidity]. Three domains of Axel Honneth’s Theory of Recognition and Misrecognition [i.e. intimate, community and legal relationships] were used to underpin the study findings. Data was analysed using critical thematic discourse method. Four themes were emerged: nature of caregiving involved; intimate affairs [marital marginalization, and parent-children-in law dynamics]; alienation in peer-relationships and neighbourhood [siblings’ overlook, neighbourhood challenges, and gender inequality in interactions]; and legal connections [ignorance of rights, and missed communication]. A marginalization in family relationships, together with poor peer supports and a misrecognition from service providers, resulted in a lack of care for elderly women with multimorbidity. Understanding the complexities of elderly women’s relationships may assist in policy making with better attention to their health and well-being support needs. Staff training on building relationships, and counselling services for family and relatives are essential to improve the quality of care for the women.

Subsidy policy selection of elderly care service projects under uncertain actual demand: a real options analysis based on China’s experience

Background Elderly care service projects (ECSPs) aim to provide care services with the help of market forces on the supply side to satisfy the huge demand of the elderly. Subsidies play an important role in motivating the investors to invest in the ECSPs immediately. The optimal subsidy scheme should balance the policy costs and the investors’ interests. Methods Based on the policy background of China, this study applied the real options theory to compare the effects of construction subsidy and operating subsidy on achieving policy goals from the perspective of uncertain actual demand. It introduced numerical examples to identify the optimal subsidy scheme and embedded the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to verify the uncertainty of actual demand. Results The results showed that in the context of uncertain actual demand, operating subsidy has greater advantages in reducing investment thresholds, saving subsidy costs and increasing spillover values. Moreover, a sound quality supervision system, a differentiated operating subsidy scheme and a sustainable growth market demand environment are conducive to increasing the long-term interests of the government and the investors. Conclusions The study emphasized the importance of subsidy selection in the context of uncertain actual demand, and provided a practical reference for policy designers in China and other developing countries to choose the optimal subsidy scheme for the ECSPs.

An Effectiveness and Cost-Estimation Model for Deploying Assistive Technology Solutions in Elderly Care

Background Deployment of modern assistive technologies is one of the major trends contained in the strategies of developed countries. However, the use of technology in households is not yet a common practice. The aim of this paper is present a model for assessment of selected smart device solutions in elderly care and the evaluation of overall care costs. The model provides the optimal set of devices for different target groups in terms of financial savings. Methods The model uses demographic projections taken from Eurostat for EU countries and the disability incidence from the annual report of the Ministry of Labour and Social Affairs of the Czech Republic as an input. The model was implemented in the software Stella Professional dedicated to system dynamics modelling including a web interface and is accessible online. Results In relation to the combination of five assistive devices for the elderly, the optimal solution, the cost savings are 37.8% or182 billion CZK), cumulatively in the simulated time period 2021-2060. Out of the five available assistive devices, up to three - UpWalker, Jaco robotic arm and Poseidon - were employed by the model for different target groups. Conclusion According to the performed analysis the assistive technologies proved a significant potential to maintain the quality of life of elderly and lessen the burden on public budgets. With respect to the ongoing demographic transition, the need to employ smart device solutions should further increase and their price could decline with increasing scale of production and overall advancement in technology.

A Credit Conflict Detection Model Based on Decision Distance and Probability Matrix

Considering the credit index calculation differences, semantic differences, false data, and other problems between platforms such as Internet finance, e-commerce, and health and elderly care, which lead to the credit deviation from the trusted range of credit subjects and the lack of related information of credit subjects, in this paper, we proposed a crossplatform service credit conflict detection model based on the decision distance to support the migration and application of crossplatform credit information transmission and integration. Firstly, we give a scoring table of influencing factors. Score is the probability of the impact of this factor on credit. Through this probability, the distance matrix between influencing factors is generated. Secondly, the similarity matrix is calculated from the distance matrix. Thirdly, the support vector is calculated through the similarity matrix. Fourth, the credit vector is calculated by the support vector. Finally, the credibility is calculated by the credit vector and probability.

Lessons Learned: Occupational Therapy in Nursing Homes during the First Wave of COVID-19 in Spain

This research aims to explore the perception that occupational therapists working in elderly care facilities have about the measures implemented against the COVID-19 pandemic in their resources, and the impact that these measures have had on occupational therapy in these facilities. An interpretive paradigm was selected, using a qualitative approach and a phenomenological design. Sixteen occupational therapists working in elderly care facilities in two Spanish regions were included. Data were collected through semi-structured interviews. A discourse analysis of the narrative information was carried out using open, axial, and selective coding processes and the constant comparison method. Four themes were extracted from the analysis results: The initial chaos in senior centers; The blurring of occupational therapists’ roles; The emergence of technology; and organizational and therapeutic proposals for future pandemics. The pandemic had a significant impact on the care and therapeutic processes in elderly care facilities. Occupational therapists had to stop performing their functions to dedicate themselves to other support, auxiliary or communication tasks between the center and the families. Similarly, it is worth noting the emergence of low-cost technology to facilitate communication and to carry out some therapeutic interventions.