Long-Term Care Planning, Preparedness, and Response Among Rural Long-Term Care Providers

Effectiveness of Physical Activity Programs for Older Adults during COVID-19 across Districts with Different Healthcare Resource: A Case Study of Keelung City in Taiwan

While past research has largely supported the importance of physical activity for the health of older adults, during the COVID-19 pandemic, older individuals may have reduced their opportunities and levels of physical activity to lower the risk of infection by minimizing outings or interactions with others. Additionally, the adequacy of medical resources in a region is often closely related to factors such as infrastructure and economic resources. Therefore, it is important to consider whether there are differences in health promotion among older adults living in areas with varying levels of medical resources. This study aimed to implement a physical activity program for older adults, selecting Keelung City, Taiwan, as the implementation area, and comparing the differences in implementation effectiveness among administrative districts with different levels of medical resources in the city. The study employed a two-way analysis of variance to examine the differences in the effectiveness of the physical activity program among administrative districts, where the average service population in medical institutions was higher or lower than the city average. The results revealed significant improvements in participants' right-hand grip strength and the number of sit-to-stand repetitions in the overall sample after the program intervention. Moreover, in administrative districts where the average service population in medical institutions was higher than the city average, participants showed greater improvement in grip strength, while in districts where it was lower than the city average, participants demonstrated greater improvement in sit-to-stand repetitions. Future research could draw upon these findings to design physical activity programs tailored to different regions with distinct allocations of medical resources. Tailored program designs considering local medical resources are necessary to optimize effectiveness. Governments and organizations should focus on elderly health, especially in resource-scarce areas, by increasing investment and support for these programs to promote well-being and bridge disparities.

Improving Nursing Home Disaster Readiness Through Implementation Science

As large-scale disasters continue to become increasingly common worldwide, nursing homes, whose residents are more vulnerable to disaster-related health and psychosocial shocks, and their staff, are carrying progressively more responsibility for health care readiness practices. Implementation science is a research discipline that seeks to improve uptake of evidence-based practices, such as health care readiness planning, and thus has potential to improve nursing home care delivery during and after disasters. We describe the limited field of existing evidence-based strategies in the peer-reviewed literature that seek to advance health care readiness in the nursing home setting and illustrate how implementation science can better support health care readiness planning for nursing homes. We rest on 3 main themes: (1) implementation science frameworks can strengthen nursing home staff engagement around health care readiness; (2) implementation science can support tailoring of emergency preparedness plans to individual nursing homes' unique needs; and (3) implementation science can advance the integration of nursing homes into local, state, and federal health care readiness planning initiatives. Finally, research is urgently needed to both generate and disseminate implementation strategies that increase uptake of evidence-based health care readiness practices in the nursing home setting.

Effectiveness of Comprehensive Physical Activity Health Promotion Program on the Essential Physical Functions of Older Patients With Multiple Diseases and Dementia in Rural Area

Against the backdrop of aging populations worldwide, physical activity programs aimed at promoting the health of older adults have begun to flourish. However, few studies have focused on elderly residents in rural areas who may have multiple comorbidities. Therefore, the current study aimed to investigate the effects of a 12-week physical activity program on health promotion among rural elderly with multiple diseases. The study included 18 elderly participants, with a mean age of 82.39 years, who had dementia and one or more additional diseases. Among the participants, 89% were female. The results showed that the 12-week physical activity program intervention significantly improved participants' walking speed and range of motion of the arm joints. Based on these findings, it is hoped that this study will provide a reference for future researchers and practitioners targeting rural or elderly populations who may have multiple diseases to develop more comprehensive physical activity programs.

The Enhancement of Fire Safety in Small-Scale Senior Citizen Welfare Institutions Based on Fire Protection Defense-in-Depth Strategy

The number of elderly living in small-scale senior citizen welfare institutions in Taiwan has been increasing. Hence, enhancing the quality of care and safety of the residents in these institutions is a pressing issue. Our research team visited and reviewed data on 53 small-scale institutions in Tainan based on in-depth fire protection defense strategies and proposed a three-layer protection mechanism. The results showed that: (1) half (50%) of these institutions only meet the old anti-seismic system; (2) 26 (49%) institutions have multi-story buildings, thus, more staff needs to be arranged for night shifts to enable emergency responses on each floor; (3) all institutions have fire detectors; (4) 84% of the elderly living in these institutions are mobility-impaired and need to rely on the assistance of staff for evacuation; (5) most institutions (91%) employ foreign female caregivers which mostly work on night shifts; thus, routine training of emergency response should also consider the abilities of the foreign caregivers; (6) 35 (66%) institutions arrange only 50% of the day-shift manpower for the night shift; (7) 37 (70%) institutions should evaluate whether the function of their fire detectors is affected by fan air; and (8) 11 (21%) institutions use inflammable materials for furnishings to create a “cozy” atmosphere. This study also suggests that preventing smoke from spreading from a room that is on fire to other areas is an important evaluation item. Hopefully, these findings can serve as a reference for countries that are facing an increasingly aging population.