Green Care Farms Promote Activity Among Elderly People With Dementia

In the Netherlands, an increasing number of green care farms are providing day care to community-dwelling elderly people with dementia. Currently, it is unknown whether activities, activity participation, and facility use of elderly people with dementia at green care farms differ from those at regular day care facilities. The authors performed group and individual observations at 11 green care farms and 12 regular day care facilities. Activities of elderly people at green care farms were more frequent, occurred outdoors more often, were of a higher physical intensity, and more often were aimed at individuals than activities at regular day care facilities. Therefore, the green care farms’ environment may be more beneficial for elderly people with dementia than the regular day care facility environment.     

An Assessment,Using the Multiphasic Environmental Assessment Procedure (MEAP), of a Rural Life-Care Residential Center for the Elderly

This study reports the findings of an assessment of a life-care center for elderly persons in a rural area using the Multiphasic Environmental Assessment Procedure (Moos and Lemke, 1979a). The study assesses the physical and architectural features, the social climate, and the policies and programs of the home. The results are compared to previous assessments of sheltered-care facilities, and the findings of the study support similar research conducted by Moos and Lemke. The facility's selection process leads to a population with similar characteristics, tending to promote a harmonious environment. The residents have a positive perception of their personal environment which encompasses the physical and social environment and organizational structure. This type of environment offers a smooth transition from living in a private residence to a residential life-care center.     

A review of private residential care in Hong Kong: implications for policy and practice

Hong Kong government policy encourages and facilitates families to care for their older members as long as possible by providing families and their older relatives with community support services. Residential care for the elderly is viewed as a last resort. Due to the inadequate supply of community support services, the long period of care required, and the gradual breakdown of values of filial support, families may increasingly give up their caring roles and seek residential care for their dependent elderly relatives. A shortfall in subsidized residential care may lead to needy elderly persons' being cared for in private residential facilities. The demand for private residential care is projected to increase, despite criticism about the standard of care provided. Although an Ordinance, a Regulation, and a Code of Practice for residential care homes are in place to control, monitor, and upgrade private residential care in Hong Kong, problems remain that put the elderly at risk of receiving substandard services. These include the existence of substandard private aged care homes operating either with or without a license; the provision of substandard "places" to the elderly under the government's "bought place" scheme and "enhanced bought place" scheme; ineffective inspection; a lack of grading to indicate the quality of private aged care homes; and a general neglect of the quality of care. We provide recommendations to address these concerns. This requires paying attention to both the quality of care, as well as to the physical environment of homes.     

A Study of Residential Condition and Satisfaction of the Elderly in China

This article investigates the current housing reality and subjective appraisal of the elderly in China by presenting the latest empirical evidence. Based on a literature review, survey data of September 2009 were analyzed, which included 692 Chinese households with a focus on their elderly members. Major findings were the following: (1) affordability was an outstanding issue, with 56.6% of the elderly respondents feeling overburdened by housing costs; (2) facilities in the homes were less of an issue than their community facilities, which were inadequate especially for the handicapped; (3) the elderly respondents as a whole seemed to enjoy their housing property, though significant differences in homeownership and residential satisfaction were found among them; (4) differences were also found among the elderly in terms of access to healthcare (including emergency help), transportation, and housing environment; and (5) residential satisfaction of the elderly were related to their occupational status before retirement, income, health, distance to healthcare facilities, living arrangements, homeownership, housing conditions, social contacts/visits, and gender. Implications of the findings are discussed for research and policy considerations.     

Applying a Treatment Effects Model to Investigate Public Amenity Effect on Physical Activity of the Elderly

The increasing elderly population puts significant health, economic, and social burdens on society. Physical activity is one of the most cost-effective ways to maintain the health of the elderly. This study adopts a treatment effects model to investigate the causal relationship between environment attributes and physical activity among the elderly, while taking endogeneity into account. The data were collected from 274 participants by face-to-face interviews in Taichung, Taiwan. Performing physical activity regularly in parks is the most important measure of the amount of physical activity by the elderly. Providing sufficient and accessible parks in metropolitan residential neighborhoods could be one of the most cost-effective ways to promote physical activity for the elderly living in midsize Asian cities.     

Perceptions of physical activity among elderly residents and professionals in assisted living facilities

Background

Physical activity is often described as being important for people of all ages, but what different people mean when they talk about physical activity is unclear.

Method

A phenomenographic method was used to analyze how 13 older people and 17 professionals answer the question, “If I say physical activity, what does the concept mean to you?” as part of semi-structured interviews conducted in four assisted living facilities in two different municipalities.

Results

We identified a number of different perceptions of physical activity, with the older people and professionals having different responses. Elderly and professionals alike, define physical activity as a requirement for life and as an opportunity to maintain the body although they define the concepts in different ways. Elderly define the concept as a way to create meaning and the professionals have the attitude that the concept means everyday activities.

Conclusion

The concept of physical activity may be defined in many different ways. This study has shown that elderly and professionals do not define physical activity in the same way. Therefore, professionals need to be aware of these differences when talking with elderly about individual needs in everyday life.

     

High-Tech Amenities for the Elderly: The Technological Assistance Needs of Elderly Koreans Aging at Home

This study builds on existing literature regarding residential technological systems and the elderly. This study investigates elderly Koreans’ needs for technological systems in their residential environments and makes appropriate suggestions for creating high-tech amenities to support their aging at home. This study surveyed 60 elderly Koreans and presented them with 5 categories of 24 technological systems to evaluate. Results of this study show that participants were willing to adapt technological systems in their residential environment without any technophobia. In terms of their needs, the participants ranked the safety and security system category first, the indoor environment control system category second, and the health-related system category third. The results of this study suggest that residential environments, including individual housing and apartment properties, should incorporate technological systems to extend elderly residents’ independent living at home.     

Facility Ownership and Resident Satisfaction with Assisted Living

Abstract

Although the majority of assisted living facilities operate as for-profit organizations and serve increasingly frail elderly populations, little is known about the impact of ownership on the quality of care in assisted living. This study examines the relationship between facility ownership and the quality of care in assisted living, using resident satisfaction as a quality indicator. The assessed aspects of satisfaction include health care, housekeeping, physical environment, relationships with staff, and social life/activities. The relationship of facility ownership to resident satisfaction is examined controlling for resident psychological well-being, functional ability, facility size, and staff resources. Data were collected in personal interviews with 156 residents, including 96 residents in eight for-profit facilities and 60 residents in five nonprofit facilities in Maryland. Residents in the sampled nonprofit facilities were more satisfied with assisted living than were residents in the for-profit facilities. In particular, residents in nonprofit facilities were more satisfied with health care, physical environment, and social life/activities in the facility. Better understanding of the relationship between facility ownership and resident satisfaction can help administrators create environments that maximize resident satisfaction in both nonprofit and for-profit facilities.     

Rehabilitation and welfare restructuring in East Asia: deciphering an assessment tool for people with disabilities in Hong Kong

While many East Asian economies have in the past witnessed the coexistence of economic growth and modern welfare provisions, this has no longer been the case since the Asian Financial Crisis. This article is an attempt to unravel the latent policy objectives behind an assessment tool for residential services ostensibly aimed at rationalizing residential services for people with physical and/or mental disabilities in Hong Kong. The central argument is that such a policy instrument, whilst appearing technocratic and professional in policy discourse, nonetheless fails to hide its true purpose of implementation - the rationalization of welfare resources within a cutback environment. Moreover, in screening out people with disabilities, the new Assessment Tool further perpetuates a rehabilitation service rooted in paternalism and traditionalism, a service which sees those affected by disabilities as dependent and helpless, and which moves ever further away from the ideals of inclusion, dignity and independent living.     

Housing Concepts For and By the Elderly: From Subjects of Design to a Design Resource

ABSTRACT

The perception of elderly residents as a homogeneous group is challenged by the diversification of lifestyles and emphasis on individuality in housing. Recently, there has been a rise in Finland in housing projects initiated by groups of elderly people, where the seniors themselves are seeking to fill in qualitative gaps in the offering of housing. This article presents a comparative analysis of four senior housing concepts that represent both a producer-driven (“for the elderly”) and a resident-driven (“by the elderly”) approach. The study shows that elderly people can be a resource for residential development and that this necessitates a different “design logic” than in conventional senior housing.     

Toward a Definition of Assisted-Living

The purpose of this research was to identify the concept of assisted-living (A.L.) by the physical characteristics of the setting, services offered therein, and functional competence of residents and to ascertain its position within an existing continuum of care typology. Ten A.L. facilities in southeastern Florida participated in this study. Photographic documentation, informal interviews, and promotional literature generated the data for content analysis. Response to a survey questionnaire provided additional information. Findings show that physical characteristics of facilities focus on creating a residential milieu. Services include meals, personal care, medical assistance, housekeeping, utilities, social activities, scheduled transportation, and security. Residents are semi-independent. They do not require skilled care. Placement of A.L. within an existing continuum of care typology is considered to be on the same level as homes for the aged, also called adult homes or personal care homes. From this standpoint A.L. is considered to be an old concept made new.     

Strength-training behavior and perceived environment among Japanese older adults

The authors examined the relationship between strength-training behavior and perceived environment in older Japanese adults. An Internet-based survey was conducted of 293 adults age 68.2 ± 2.8 yr. The dependent variable was regular strength-training behavior. The IPAQ environment module, access to facilities for strength training, and home equipment for strength training were environmental factors. Logistic-regression analysis was employed. After demographic variables (gender, age, educational background, household income, body-mass index, self-rated health status, smoking habit, and residential area) were adjusted for, home equipment for strength training (OR = 2.14, 95% CI = 1.50-3.06), access to facilities for strength training (OR = 2.53, 95% CI = 1.32-4.85), and observing active people (OR = 2.20, 95% CI = 1.06-4.58) were positively correlated with regular strength-training behavior. In conclusion, environmental factors associated with strength-training behavior were access to facilities for strength training, having home equipment for strength training, and observing active people.     

Acessibility in collective housing for the elderly: a case study in Portugal

Physical spaces need to be adjusted to suit the changes of a physical, cognitive and emotional order occasioned by the natural aging of people. Ergonomics of the built environment contributes to improving the interaction of the user and physical environment, with a view to their comfort and safety. By thinking through the influence that environments have on the quality of life of the elderly, this article presents an assessment of accessibility in private units--bedrooms and bathrooms--of a Long-Stay Institution for the Elderly (ILPI in Portuguese) in Portugal. The analysis of the physical and spatial conditioning factors by means of the Ergonomics Methodology for the Built Environment (EMBE), proposed by VILLAROUCO (2008), gave evidence of the need for interventions to suitably adapt physical infrastructure, with the objective of promoting the physical well-being of the elderly, and thus, enhancing the autonomy and independence of a wider range of users.     

Resident councils between lifeworld and system: Is there room for communicative action?

In long-term care facilities, the participation of older people relates to individual care provision (individual level) and to policy decisions that affect all residents in a care organization (collective level). In the Netherlands, resident councils are set up in order to improve resident participation on a collective level. However, our research shows that managers and resident councils are faced with mutual frustration and ineffective interaction. This article investigates the extent to which Habermasian communicative action (herrschaftsfreie Kommunikation) between resident councils and managers in residential elderly care is actually possible by examining the interaction between resident councils and managers in two case studies. We conclude that resident councils find themselves between lifeworld and system. There is communicative action between resident councils and managers, but it is easily dominated by strategic action. Therefore, space for communicative action needs to be deliberately created in order to support resident council participation and influence.     

Does family reunification from residential care facilities serve children's best interest? A propensity-score matching approach in Ghana

The U.N. Convention on the Rights of the Child declares that children are entitled to grow up in a family environment with love, happiness and understanding. Governments and international child welfare agencies have promoted the reintegration of children currently in residential care facilities with family or other caregivers. We assess whether 157 children who spent time in a Ghanaian residential care facility but who have been reunified with their families scored differently on a battery of standardized child wellbeing measures than 204 children still living in residential care facilities using propensity score matching models. Results suggest that outcomes, including overall hope (as well as hope pathways and hope agency) and access to basic resources as measured on the Child Status Index, differ between children who were and were not reunified. These results underline the importance of supporting children's physical and psychosocial developmental needs. Children who were reunified with family members or other kin may require additional support regarding access to basic resources whereas interventions designed to increase hope in the future may benefit children in residential care. We urge a redoubling of efforts to care for children under carefully designed national schemes providing resources, trained personnel, and sustained case management.     

Is “Walkability” A Useful Concept for Gerontology?

The study tested two hypotheses: that in a walkable neighborhood, residents will exercise more, eat healthier, and suffer from less obesity and that relation between environment and health outcomes will be stronger for the elderly. Health was measured by physical activity, the number of portions of fruits and vegetables eaten daily, and body mass index. Walkability was measured by three distinct environmental factors—distress, amenities, and residential. The three health outcomes were related to the three environmental factors. Age was not a significant predictor of health outcomes. Although the environment does contribute to health outcomes, the ways that contribution is expressed and its relation to age is complex.     

Comparison of basic data for the National Survey of Residential Group Care Facilities: 1966-1982

Major findings from this analysis of the data gathered in preparation for the 1966 and 1981 surveys of children's residential group care facilities are as follows below. In the field of residential care of pregnant adolescents, it appears that, despite an increase in the number of births to adolescent mothers since 1966, the preferred mode of serving this population is no longer residential group care. While there has been a small increase (6 facilities) in the number of residential facilities for pregnant adolescents that operate under public auspices, the 49% decrease in facilities under private auspices is the real indicator of the direction of residential services to pregnant adolescents since 1965. In the Child Welfare Stream, the most notable change between 1965 and 1981 was the decrease in the relative proportion of residential group care facilities for dependent, neglected, or abused children and youth. Overall, child welfare facilities accounted for 55% of all residential facilities listed for survey in 1965; in 1981 this percentage had fallen to 37%. As in 1965 the Child Welfare Stream was dominated by the private sector in 1981, with 83% of all child welfare facilities operating under private auspices. This pattern was found for most of the 50 individual states as well. In the Juvenile Justice Stream, the overall increase of 154% in the number of residential facilities since the 1965 listing is due in part to a notable increase in the number of private facilities in this stream of care. Although the majority of juvenile justice facilities are still public, there has been an increase of 17% since 1965 in the proportion of facilities under private auspices. An even greater increase in total number of facilities than was seen in the Juvenile Justice Stream is seen in the mental health field between 1965 and 1981. There were almost four times as many residential mental health facilities listed for survey in 1981 as in 1965. From representing about one-eighth of the total number of all residential group care facilities for children and youth with special problems or needs, the Mental Health Stream increased to a quarter of all such facilities by 1981. As in the earlier study, the Mental Health Stream was dominated by the private sector in 1981. The proportion of mental health facilities under private auspices had increased by 16% since 1965, indicating an even greater involvement of the private sector in the delivery of residential mental health services to children and youth.(ABSTRACT TRUNCATED AT 400 WORDS)     

Demographic Characteristics

This article aims to describe the characteristics of and design elements in gardens/patios at 87 residential living homes for older people and to describe and compare residents’ and staff members’ perceptions of outdoor spaces. The aim was also to investigate factors related to residents' satisfaction with and stays in the garden/patio. The result showed that many gardens/patios had several recommended design elements and, at the same time, obvious deficiencies. The residents (n = 415) valued various aspects of the garden/patio more highly than did the staff (n = 667). Managers responsible for residential living homes for elderly people should take measures to ameliorate deficiencies and deficient elements in design and accessibility that are lacking so that the garden/patio can be used as an important health promotion resource in the care of elderly people. Residents and staff are important actors in such development work.     

Differences in facilities' acceptance of patients under long-term care insurance in Japan

OBJECTIVES: In April 2000, Japan launched a public, long-term care insurance (LTCI) plan for elderly people who need support. This study describes how medical support for the elderly is delivered at LTCI care facilities in Japan now and gaps between system goals and current activity. Recommendations are made for enhancing the implementation of LTCI. METHODS: We mailed questionnaires to all health service facilities for the elderly (HSF) and special nursing homes for the elderly (SNH) located in the Kyushu area of Japan, asking whether they would accept patients with nine specific conditions. RESULTS: We found that HSFs, which are required to employ a full-time doctor and are reimbursed at a higher rate, accept significantly fewer patients with four conditions that need medical support than are accepted by SNHs, which are not required to employ a full-time doctor. DISCUSSION: In this study, we find discrepancies between system goals and current activities at LTCI care facilities. For the Japanese LTCI system to work well in the limitation of medical resources, we must understand how it really works and to reform the system continuously.     

Accessibility of sports facilities for persons with reduced mobility and assessment of their motivation for practice

This study aims to create awareness, both within the scientific community and among providers of sports facilities, for individuals with impaired or reduced mobility, promoting the development of technical solutions that allow greater autonomy and social integration of people with disabilities. The purpose of this work is, on the one hand, to evaluate the accessibility of sports facilities for people with reduced mobility and, on the other hand, to investigate why this user group has such low rates of participation in sporting activities. Firstly, using the Portuguese norms and legislation transcribed from European Community directives, a check list was created comprising all the items that sports facilities should abide by in order to provide accessibility and safety to people with reduced mobility. Another questionnaire was designed aimed at this user group, with questions pertaining to their desire and ability to use sports facilities. This questionnaire was distributed in Portugal, in the greater metropolitan area of Porto, to users of Rehabilitation Centres and Physiotherapy Clinics. The results obtained from the check-list showed the compliances and non-compliances of the respective sports facilities, proving that many barriers preventing the participation of people with reduced mobility still exist. Twenty-four people with permanent impairment of the lower extremities (paraplegia) answered the questionnaire pertaining to the desire and ability to perform physical activity. Two individuals (8%) had sporting activities available to them in their area of residence and only five (21%) performed any physical activity. The main reason given for not taking part in any activity was the lack of adapted sports facilities. All the participants felt that taking part in sports is beneficial. The benefits stated were: general well-being and development of the psychomotor component (e.g. coordination, balance, body posture), of physical condition (e.g. strength, resistance, flexibility) and social integration and quality of life. Besides wellbeing, they also mentioned social interaction, a way of occupying their time and an escape from the routine as the main motives for which they would like to take up physical exercise.