Family Caregivers’ Experiences with Tele-Rehabilitation for Older Adults with Hip Fracture

This research was funded by EIT Health (210752).Background: There is a knowledge gap for implementing tele-rehabilitation (telerehab) after hip fracture. We recently conducted a clinical trial (ClinicalTrials.gov Identifier: NCT02968589) to test a novel online family caregiver-supported rehabilitation program for older adults with hip fracture, called @ctivehip. In this qualitative substudy, our objective was to use semi-structured interviews to explore family caregivers experience with the telerehab program. Methods: Twenty-one family caregivers were interviewed between three and six months after the older adults completed @ctivehip. One occupational therapist with research and clinical experience, but not involved in the main trial, conducted and transcribed the interviews. We conducted a multi-step content analysis, and two authors completed one coding cycle and two recoding cycles. Results: Family caregivers who enrolled in @ctivehip were satisfied with the program, stated it was manageable to use, and perceived benefits for older adults’ functional recovery after hip fracture. They also suggested improvements for the program content, such as more variety with exercises, and increased monitoring by health professionals. Conclusions: This work extends existing literature and generates research hypotheses for future studies to test telerehab content and program implementation.EIT Health 21075

Integrating social and health services for people, communities, homes, and places

The challenge of an ageing population requires a paradigmatic shift in the way we provide social and healthcare services, demanding the need to prioritize the functionality and independence of older adults. The risk and subsequent fear of falling is one of the most high-risk states for older adults, as it generates a destabilizing effect on their health that is often hard to recover. It is essential to thoroughly address their risk factors and mitigators. This discussion needs to be made in light of a person-centered perspective that goes beyond fragilities to capitalize on the strengths of the older adults. The chapter provides examples of how to connect assessment, interventions, and monitoring to a coherent framework approach that mitigates the risks and the impact of falls on an ageing society. The authors explore how technological innovation, urban planning, and regional policies that are culturally relevant can be incorporated in creating a circular economy while meeting the needs of an aging population and preventing falls and cognitive decline

Evaluating the impact of a falls prevention community of practice in a residential aged care organisation

Falls in the residential aged care (RAC) sector are a global concern with humanitarian and economic consequences. Reducing falls using a multifactorial approach involving multidisciplinary staff is recommended, but it is not clear how RAC organisations in Australia can achieve this in a resource constrained environment. One potential solution is to develop a sustainable means of addressing falls prevention from within an organisation, creating a forum for staff to share ideas, expertise and achieve goals in a community of practice (CoP). The purpose of this research was to evaluate the impact of a falls prevention CoP on falls outcomes in a RAC setting. A mixed methods design framed by a realist approach was undertaken, to better understand how CoP interventions were influenced by current conditions (contexts) in triggering (mechanisms) the observed outcomes. Diverse data sources including surveys, electronic CoP discussion transcripts, semi-structured interviews and organisational falls data were used to triangulate findings. The CoP was mapped across three phases. Phase 1 described how the CoP was developed, then evaluated its establishment and operation across 13 geographically diverse RAC sites. In Phase 2 the CoP identified gaps in falls prevention practice using evidence-based audit and feedback, determining the areas for priority intervention. Phase 3 comprehensively evaluated the impact of CoP activity at three levels; member, site and organisation. Overall the CoP had a positive impact; members gained new peer connections and falls prevention knowledge, the proportion of residents supplemented with vitamin D improved significantly and a falls prevention policy and risk assessment tool were developed and implemented across the organisation. Management recognition and support were key mechanisms in achieving successful outcomes. Falls rates pre CoP were 10.1/1000 occupied bed days (OBD) compared with 10.9 /1000 OBD post CoP operation [coefficient 0.7, 95% CI (-33.5, 34.9) p = .967]. This was potentially confounded by an increased use of beds for short stay transition care services and identified differences in defining falls between sites. A downward trend in the rate of injurious falls resulting in fractures was observed (pre CoP 0.2/1000 OBD compared with 0.1/1000 OBD post CoP; [coefficient -0.3, 95% CI (-1.1, 0.4) p = .423]. As the prioritised CoP interventions required design and development, implementation only occurred towards the end of the research period meaning the intervention effect on falls outcomes may require longer term follow up. The CoP remains operational and is ideally positioned to continue to lead evidence-based falls prevention practice change as determined by its membership

Employing Information and Communications Technologies in Homes and Cities for the Health and Well-Being of Older People

YesHe X and Sheriff RE (Eds.) Employing ICT in Homes and Cities for the Health and Well-Being of Older People. Workshop Proceedings of ICT4HOP’16. 15-17 Aug 2016. Sichuan University, Chengdu, China.British Council, Researcher Links, Newton Fund, NSF

Occupational Therapy and the Use of Technology on Older Adult Fall Prevention: A Scoping Review

[Abstract] Introduction: Falls are the second leading cause of accidental or non-intentional deaths worldwide and are the most common problem as people age. The primary purpose of addressing falls is to detect, prevent, treat, and reduce their incidence and consequences. Previous studies identified that multifactorial programs, an interprofessional team, and assistive technology are required to address falls in older adults effectively. Accordingly, the research question is as follows: what are the scope, type of studies, and approaches and strategies to fall risk using technology in the existing occupational therapy literature regarding interventions to address the effects of falls in older adults on daily living? Methods: This scoping review was carried out in January 2020 through Biblioteca Virtual de Salud España, C.I.N.A.H.L., Cochrane Plus, OTSeeker, PubMed, Scopus, and Web of Science. Results: Twelve papers were included. We analyzed the year and journal of publication, authors’ affiliation, and design of the study, and thematic categories. There were three themes: participants’ characteristics, type of intervention, and fall approach and type of technology used. Discussion and Conclusions: The literature obtained is scarce. It is considered to still be an emerging theme, especially when considering the use of technology for occupational therapy.The authors disclosed the receipt of the following financial support for the research, authorship, and/or publication of this article: The research team will bear all the economic costs involved in the study, with the support of the CITIC, as Research Center accredited by Galician University System that is funded by “Consellería de Cultura, Educación e Universidades from Xunta de Galicia,” which provided 80% of funds through ERDF Funds, ERDF Operational Programme Galicia 2014-2020, and the remaining 20% was provided by “Secretaría Xeral de Universidades [Grant ED431G 2019/01]. Moreover, P.C.-M. obtained a scholarship [Ref.ED481A-2019/069] and M.D.C.M.-D. [Ref.ED481A 2018/205] gained a scholarship to develop a Ph.D. In addition, this work is also supported in part by the Ministerio de Ciencia e Innovación R+D+I projects in the framework of the national programs of knowledge generation and scientific and technological strengthening of the R+D+I system and the challenges of society’s-oriented R+D+I 2019 call (PID2019-104323RB-C33

Wearable Technology Supported Home Rehabilitation Services in Rural Areas:– Emphasis on Monitoring Structures and Activities of Functional Capacity Handbook

The sustainability of modern healthcare systems is under threat. – the ageing of the population, the prevalence of chronic disease and a need to focus on wellness and preventative health management, in parallel with the treatment of disease, pose significant social and economic challenges. The current economic situation has made these issues more acute. Across Europe, healthcare expenditure is expected to rice to almost 16% of GDP by 2020. (OECD Health Statistics 2018). Coupled with a shortage of qualified personnel, European nations are facing increasing challenges in their ability to provide better-integrated and sustainable health and social services. The focus is currently shifting from treatment in a care center to prevention and health promotion outside the care institute. Improvements in technology offers one solution to innovate health care and meet demand at a low cost. New technology has the potential to decrease the need for hospitals and health stations (Lankila et al., 2016. In the future the use of new technologies – including health technologies, sensor technologies, digital media, mobile technology etc. - and digital services will dramatically increase interaction between healthcare personnel and customers (Deloitte Center for Health Solutions, 2015a; Deloitte Center for Health Solutions 2015b). Introduction of technology is expected to drive a change in healthcare delivery models and the relationship between patients and healthcare providers. Applications of wearable sensors are the most promising technology to aid health and social care providers deliver safe, more efficient and cost-effective care as well as improving people’s ability to self-manage their health and wellbeing, alert healthcare professionals to changes in their condition and support adherence to prescribed interventions. (Tedesco et al., 2017; Majumder et al., 2017). While it is true that wearable technology can change how healthcare is monitored and delivered, it is necessary to consider a few things when working towards the successful implementation of this new shift in health care. It raises challenges for the healthcare systems in how to implement these new technologies, and how the growing amount of information in clinical practice, integrates into the clinical workflows of healthcare providers. Future challenges for healthcare include how to use the developing technology in a way that will bring added value to healthcare professionals, healthcare organizations and patients without increasing the workload and cost of the healthcare services. For wearable technology developers, the challenge will be to develop solutions that can be easily integrated and used by healthcare professionals considering the existing constraints. This handbook summarizes key findings from clinical and laboratory-controlled demonstrator trials regarding wearables to assist rehabilitation professionals, who are planning the use of wearable sensors in rehabilitation processes. The handbook can also be used by those developing wearable sensor systems for clinical work and especially for use in hometype environments with specific emphasis on elderly patients, who are our major health care consumers

Sustainable technologies for older adults

: The exponential evolution of technology and the growth of the elderly population are two phenomena that will inevitably interact with increasing frequency in the future. This paper analyses scientific literature as a means of furthering progress in sustainable technology for senior living. We carried out a bibliometric analysis of papers published in this area and compiled by the Web of Science (WOS) and Scopus, examining the main participants and advances in the field from 2000 to the first quarter of 2021. The study describes some interesting research projects addressing three different aspects of older adults’ daily lives—health, daily activities and wellbeing—and policies to promote healthy aging and improve the sustainability of the healthcare system. It also looks at lines of research into transversal characteristics of technology. Our analysis showed that publications mentioning sustainability technologies for older adults have been growing progressively since the 2000s, but that the big increase in the number of research works in this area took place during the period 2016–2021. These more recent works show a tendency to study those factors that improve healthy aging, ensure the social inclusion of the elderly through technology and prolong the time in which they can live independent lives thanks to smart environments. Current research gaps in the literature are also discussed.: This work was funded by the Spanish Ministry of Economy, Industry and Competitiveness, (CSO2017-86747-R) and supported in part by the FEDER/Ministerio de Ciencia, Innovación y Universidades-Agencia Estatal de Investigación, through the Smartlet and H2O Learn Projects under Grants TIN2017-85179-C3-1-R and PID2020-112584RB-C31, and in part by the Madrid Regional Government through the e-Madrid-CM Project under Grant S2018/TCS-4307