Long-Term Care

This project will compare two training models of an evidence-based online dementia care training program for direct care staff in assisted living to a waitlist control: 1) essentiALZ training and 2) essentiALZ training + Project ECHO. It will examine the extent to which each model is implemented and achieves its intended outcomes to improve staff knowledge and attitudes, change care practices, and improve the wellbeing of staff, residents, and residents' family members. Results will inform next steps in dementia care training for the assisted living (AL) and broader long-term care workforce. To examine these outcomes, data will be collected from AL staff and families over the course of 6 months. Staff will complete questionnaires and participate in interviews (as applicable) at baseline, post-training, 3-months, and 6-months. Families will participate in interviews at baseline, 3-months, and 6-months.

Globally, studies indicated that 16% of community dwelling older adults have been exposed to some form of abuse in the past 12 months. Furthermore, a global meta-analysis about AOP in long-term care facilities used staff as respondents and found that the pooled estimate of overall self-reported perpetration of staff to resident abuse during the past 12 months was 64.2% (95% CI 53.3-73.9%). Similar findings was also reported in a study from Norway in which the overall prevalence of observed staff-to-resident abuse was 76% and 60% of respondents report self-perpetration of abusive acts during the past 12 months. Resident-to-resident aggression was even more common, observed by 88% of respondents. This study is part of the Swedish national research program APPEAL (A Path to Prevention of Elder Abuse in Long-term care) with the long-term goal to co-create an intervention for abuse of older people (AOP) in nursing homes together with stakeholders, i.e., staff, managers, care recipients and relatives. Study design and data collection: A cross-sectional study design will be used with slightly different data collection modes. 1. Population sample. Statistics Sweden combine data from the Swedish Occupational Register with data about industry codes (SNI-codes) to make a national randomized sample of staff working in home care services (n=12000) and nursing homes (n=11000) in Sweden. Data will be collected through a digital survey. Data will be combined with available register data from Statistics Sweden, including for example sex, age, civil state and occupational related data. 2. Workplace sample. Sweden has 290 Municipalities. The Swedish Association of Local Authorities and Regions (SALAR) have an official categorization of the municipalities based on e.g., urban area size, proximity to a larger urban area, and commuting patterns. One municipality in each of the nine categories has been randomly selected for participation. In the randomization process, geographical location of the municipalities has been considered to assure national representativeness, meaning that in case several municipalities in the same geographical region were selected a new randomization was conducted. Staff in each selected municipalities will be invited to participate through managers in each organization. Data will be collected through a digital questionnaire. Organizations will be encouraged to set a side time at a staff meeting for completing the questionnaire. If this is not possible, a link to the questionnaire will be sent out by e-mail. Data will be collected anonymously. Material: The questionnaire used in the previously mentioned Norwegian study about AOP in long-term care facilities has been translated and culturally adapted. In addition, items about background characteristics of respondents as well as risk factors for AOP on both an individual and system level are included, e.g., workload and perceived support at the workplace and ageist attitudes. Analysis: Primary outcomes will be proportion of staff reporting different types of abuse (psychological, physical, sexual, financial abuse and neglect) in different relational contexts, i.e., self-perpetrated, staff-to-resident and relative-to resident abuse, and in long-term care facilities resident-to-resident abuse. Secondary outcome will be staff reported own exposure to different forms of abuse at the workplace, including by residents, co-workers, relatives and managers. Logistic regression analysis will be used to investigate associations between reporting different forms of abuse and potentially explanatory factors.

This protocol describes a pilot study evaluating the effectiveness of the Self-Empowerment Care Model in promoting independence and quality of life among frail older adults in Hong Kong. Rooted in Nordic re-enablement principles and refined in Japan, the intervention adopts a holistic approach that focuses on hydration, exercise, diet, and defecation care. This 12-week intervention will be tested across three care settings-residential, day care, and home care. The study uses a quasi-experimental design involving 60 participants, aiming to compare outcomes of the intervention group with a control group receiving standard care. The study also assesses its impact on caregivers' burden and job satisfaction.