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The aim of the study was to explore how health personnel experience use of video bikes and VR (Virtual Reality) in nursing homes. The study had an explorative design with a qualitative approach. Nine individual interviews were conducted with health personnel. Analysis of the data yielded four categories: 1. the activity promoted engagement and well-being; 2. the activity promoted a sense of community; 3. the activity contributed to person-centred practice by being proactive and adaptive to the resident's preferences and needs; 4. the activity was promoted and hindered by several factors. This study illuminates that activity with video bikes and VR promoted moments of engagement, and a sense of well-being and community between the nursing home resident and the staff member. It seems reasonable to assert that the activity resembles person-centred processes and yielded person-centred outcomes. However, it is essential to have the right personnel in place and effectively allocate responsibilities.

Oral care involving a denture cleaning regimen is important for reducing the incidence of systemic diseases. However, limited information is currently available on denture cleaning frequencies and regimens. Therefore, the present study investigated the relationship between the number of Candida spp. present on the complete dentures of nursing home residents and cleaning regimens. Residents were surveyed to assess their denture cleaning methods. Plaque was collected by applying a sterile swab to the mucosal surface of each examined complete denture worn by 77 residents, and the Candida spp. collected were cultured, identified, and quantified. The relationship between denture cleaning regimens and the quantity of Candida spp. was investigated. Correlation and multivariable analyses revealed that the strongest factor influencing the number of Candida spp. on dentures was the frequency of use of denture cleansers. The number of Candida spp. was the lowest on dentures cleaned daily with a denture cleanser. The present results demonstrated that the daily use of a denture cleanser effectively controlled the adherence of Candida spp. to dentures. Oral and other healthcare providers need to provide instructions on and assist nursing home residents with the daily care of dentures, using denture cleansers, including the environment where cleaning is performed.

Objectives Palliative care (PC) consultations, often facilitated by providers external to nursing homes (NHs), can reduce unwanted hospitalizations and improve decision-making and communication for nursing home (NH) residents. However, limited literature has documented the specific elements within PC consultations that drive positive outcomes. Given the critical role of family members, especially for residents with cognitive impairment, this study aimed to: (1) identify actions and interactions during recent PC consultation visits, and (2) summarize family perceptions of these visits. Methods Using a descriptive qualitative research design, family caregivers ( N  = 22) from five NHs across two states (Indiana and Maryland) were recruited to be interviewed within approximately one month of a PC consultation. These family caregivers had participated in a clinical trial of PC. Semi-structured interviews were transcribed, analyzed using thematic content analysis and finalized for discussions. Results Most family caregivers were adult children (59.1%), were female (81.9%), and Black (54.6%). Four interaction themes emerged regarding PC consultations interactions: they (1) promoted physical comfort, (2) supported family members, (3) attended to residents’ social needs, and (4) provided next steps/care planning. Four themes on perceived benefits of consultation visits were identified. Visits (1) improved residents’ quality of life, (2) provided recommendations/referrals, (3) kept family members informed, and (4) supported family members. Discussion Family caregivers had favorable impressions of PC consultation visits and provided insights into specific interactions during visits. Garnering the perspectives of family caregivers involved in PC consultations is vital for designing interventions that better support residents with cognitive impairment and their families. Findings reinforce the importance of expanding access to PC consultations in NHs that prioritize family involvement. Trial Registration The UPLIFT project was registered on ClinicalTrials.gov NCT04520698 on 8/17/2020.

Almost a decade ago, Peter S. Silin wrote Nursing Homes: The Family's Journey to provide family members with practical advice and emotional support. This successor volume incorporates the new and sometimes baffling world of assisted living. Nursing Homes and Assisted Living focuses on the psychological, emotional, and practical aspects of helping family members and seniors make a difficult transition.Silin approaches his subject with compassion and sensitivity, guiding readers through the process of finding the best possible care. He describes how nursing homes and assisted living facilities work and outlines the selection process; he explains how to prepare for the day a relative moves into a facility and suggests ways to help the resident settle in; he focuses on the family member's role in solving problems, obtaining good-quality care, and visiting. The author's insights help caregivers cope with difficult decisions and deal with emotional issues such as guilt and grief, while celebrating the tender, rewarding aspects of being a caregiver. Vignettes from real-life caregivers narrating their experiences amplify Silin's advice and will resonate with families. This book provides caregivers, family members, and seniors with the information they need to effect successful transitions. It is also a valuable tool for social workers, nurses, and family therapists.

Malnutrition and obesity are both common among Americans over age 65. There are also a host of other medical conditions from which older people and other Medicare beneficiaries suffer that could be improved with appropriate nutritional intervention. Despite that, access to a nutrition professional is very limited. Do nutrition services benefit older people in terms of morbidity, mortality, or quality of life? Which health professionals are best qualified to provide such services? What would be the cost to Medicare of such services? Would the cost be offset by reduced illness in this population? This book addresses these questions, provides recommendations for nutrition services for the elderly, and considers how the coverage policy should be approached and practiced. The book discusses the role of nutrition therapy in the management of a number of diseases. It also examines what the elderly receive in the way of nutrition services along the continuum of care settings and addresses the areas of expertise needed by health professionals to provide appropriate nutrition services and therapy.

The shortage of healthcare professionals increasingly challenges the provision of care for institutionalised older adults. This study investigates healthcare professionals’ expectations regarding the added value of social robots in daily care, as their perspective is adamant for implementation of these robots but not yet fully investigated. Two consecutive focus group sessions were conducted across three nursing homes with 24 healthcare professionals. The first session focused on identifying potential ways in which social robots could add value for both staff and residents. After sharing suggestions across all groups, the second session facilitated cross-validation and in-depth discussion of practical implications. Data were analysed using qualitative thematic analysis. Healthcare professionals expected several benefits from using a social robot, including reduced workload and mental strain, improved work atmosphere, and potentially heightened job satisfaction. For residents, expected benefits included promotion of self-care and self-reliance through reminders and notifications, and provision of companionship during lonely periods. Reported possible barriers included limited technical knowledge and lack of support from residents’ families. Participants expected that social robots could help save time and energy, enabling more focused attention on residents needing support—even those who may not actively seek it. Professionals indicated that this might enhance both residents’ well-being and the quality and satisfaction of their own work. Implementing some of the specific suggestions from professionals merits further investigation.

Background Nursing homes have limited capacity to provide medical care to clinically frail residents and therefore rely on transferring residents to hospital-based emergency departments when acute medical needs arise. The utilization of emergency department care varies between nursing homes but the extent of this variation is unexplored. Further, the effect of organizational characteristics of nursing homes on emergency department utilization is unknown. This study aims to characterize the variation in emergency department visit rates between nursing homes, and to identify contextual and organizational characteristics that contribute to this variation. Study design Population-based cohort study of individuals living in nursing homes during 2019 and 2020 in Sweden. Methods National registry data on nursing home residents were linked to nursing homes based on civil- and business registration addresses. Emergency department visits were identified for each resident in the national patient registry and measured as incidence rates per nursing home. Multi-level analysis was performed to investigate the association between emergency department visit rates, and contextual and organizational characteristics of nursing homes. Results The median incidence rate of emergency department visits from nursing homes was 5.2 per 100 person-months in 2019 (IQR = 3.7–6.9) and 4.4 per 100 person-months in 2020 (IQR = 3.0–5.7). Individuals living in nursing homes in the most rural locations had lower odds of emergency department visits (OR 0.51, 95% CI 0.41–0.61 versus the most urban locations). Moreover, individuals in nursing homes specialized in dementia care had lower odds of emergency department visits (OR 0.90, 95% CI 0.87–0.94 versus somatic care). Conclusion The results suggest that the location and organizational characteristics of nursing homes may have an impact on the utilization of medical services by the nursing home resident population. Further research is warranted to investigate any ensuing health inequities. Clinical trial number Not applicable.

The association between presbyphagia (age-related swallowing decline) and urinary incontinence (UI) remains poorly understood. This study therefore investigated the relationship between presbyphagia and both UI and incontinence-specific quality of life (I-QOL) in a distinct population of functionally independent healthy elderly in a nursing home. The presence of presbyphagia was determined in 73 participants in the nursing home using the 100 ml water swallowing test (100mlSwal) and the Eating Assessment Tool-10 (EAT-10) tests. UI was determined using the International Consultation on Incontinence Questionnaire Short (ICIQ-SF) and I-QOL was determined using the King's Health Questionnaire (KHQ). The presence of presbyphagia, age and female gender confounding factors were analysed by multiple regression analysis. Multiple linear and binary logistic regression analyses were performed with presbyphagia, age, gender, and handgrip strength. Binary logistic regression was used to calculate odds ratios for UI presence. Presbyphagia was significantly associated with UI (p = .001). Individuals with presbyphagia had 7.47-fold higher odds of UI. Presbyphagia was also significantly associated with multiple I-QOL sub-domains, including incontinence impact, role limitation, physical limitation, and emotions (all p < .001). Male gender was associated with higher UI presence (OR=5.16), but not with UI severity. Age showed no significant associations with UI or I-QOL. Presbyphagia is independently associated with UI presence and poorer I-QOL in nursing home residents. Male gender was associated with higher UI prevalence but similar severity and I-QOL to females. These findings suggest an independent association between presbyphagia and UI, thereby contributing to the formulation of hypotheses aimed at understanding the complex interactions between oral frailty and the urinary system. Further research is needed to elucidate underlying mechanisms and explore the potential clinical implications of this association. ClinicalTrials.gov NCT06827561.

Background In Germany, 80–90% of people require palliative care in the final stages of life. Inpatient care facilities are increasingly becoming the final place of residence for many people, and therefore also often their place of death. Inadequate identification of palliative care needs can result in substandard palliative care in nursing homes, where residents are often admitted to the hospital towards the end of their lives. This study investigated whether a special palliative care qualifications for nursing staff could improve the care for residents in inpatient care facilities. Methods A cluster-randomised intervention study was conducted. Nursing staff from the participating care facilities in the intervention group took part in the 40-hour ‘Palliative Care – Multiprofessional’ basic qualification course. The outcomes were the use of specialised outpatient palliative care, and the documentation of palliative-relevant symptoms and measures for residents in the three months prior to their death. Data from the patient records were assessed and statistically analysed. Results During the observation period, 119 residents deceased in the 10 participating nursing homes (5 of which were in the intervention group), of whom 42 were in the intervention group and 77 were in the control group. Specialised outpatient palliative care was documented for 19.0% of residents in the intervention group and 9.1% of residents in the control group. Pain was documented in 57.1% of residents in the intervention group versus 49.4% in the control group. This palliative symptom was documented 225 times in total. An appropriate subsequent measure was documented in 150 cases (73.6% in the intervention group versus 61.9% in the control group). Logistic multilevel analysis showed that residents in the intervention group were more likely to receive a measure for a documented pain event (OR 1.804). Conclusions The results show that having a qualification in palliative care leads to palliative symptoms being identified more accurately and appropriate measures being implemented more effectively. Using data from real healthcare settings is challenging because there are no overall standards. Nevertheless, the results reflect real healthcare practice. Advanced training in palliative care helps improves the care provided to palliative residents in nursing homes. Trained staff can help to identify the need for care more accurately and ensure that appropriate palliative care is provided. Trial registration German Clinical Trials Register, DRKS00020749 ( https://drks.de/search/en/trial/DRKS00020749/entails ), 7 May 2020.