Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Objectives: to determine whether a repetitive activities of daily living (ADL) activity programme improves health status, life satisfaction and mobility for older people living in residential care. Design: cluster randomised controlled trial. Setting: five low-level dependency residential care homes in Auckland, New Zealand. Participants: one hundred and forty-nine older residents (mean age 84.7 years). Intervention: trained research staff worked with residents in intervention wards to set a goal and complete a functional assessment for each resident. They then designed an individualised activity programme based on ADL and worked with residential care home staff to implement the programme into daily activities of residents. Measurements: mobility: timed-up-and-go (TUG); life satisfaction: late life satisfaction index (LSI-Z); and health status: SF-36 were assessed at baseline, 3- and 6-months follow-up. Results: in the intervention group the SF-36 total physical component summary (PCS) score improved at 3 months in comparison with the control group. There was no difference between groups on mobility measures at any time, nor any measures at 6-months follow-up. Significant contamination is likely to have affected the 6-month follow-up measures. Conclusions: a repetitive ADL exercise programme may improve health status in the short term in a group of frail older people living in residential care. Further research is needed to establish sustainability of change.

Older adults in rural communities who have chronic health conditions are often isolated from social support and medical clinics. Robots may be able to assist with day to day healthcare and provide companionship. This paper presents four case studies of older adults who had chronic health conditions in a rural community. They were given a healthcare robot in their homes for a period of three months to a year. The robot reminded people to take medications, had entertainment and memory games, and skype. Rates of hospitalizations, primary care visits, and phone calls to the medical practitioners before the study began were compared to rates during the study period. Participants also completed questionnaires about their quality of life, mental health, medication adherence, and robot attitudes and were interviewed. The results showed a decrease in primary care visits and phone calls to the practitioners while the robot was present and increases in quality of life were observed. Despite encountering technical issues, patients were mostly positive and accepting of the robot, acknowledging its benefits as a companion.

We explore the intergenerational pattern of resource transfer and possible associated factors. A scoping review was conducted of quantitative, peer-reviewed, English-language studies related to intergenerational transfer or interaction. We searched AgeLine, PsycINFO, Social Work Abstracts, and Sociological Abstracts for articles published between Jane 2008 and December 2018. Seventy-five studies from 25 countries met the inclusion criteria. The scoping review categorised resource transfers into three types: financial, instrumental, and emotional support. Using an intergenerational solidarity framework, factors associated with intergenerational transfer were placed in four categories: (1) demographic factors (e.g., age, gender, marital status, education, and ethno-cultural background); (2) needs and opportunities factors, including health, financial resources, and employment status; (3) family structures, namely, family composition, family relationship, and earlier family events; and (4) cultural-contextual structures, including state policies and social norms. Those factors were connected to the direction of resource transfer between generations. Downward transfers from senior to junior generations occur more frequently than upward transfers in many developed countries. Women dominate instrumental transfers, perhaps influenced by traditional gender roles. Overall, the pattern of resource transfer between generations is shown, and the impact of social norms and social policy on intergenerational transfers is highlighted. Policymakers should recognise the complicated interplay of each factor with different cultural contexts. The findings could inform policies that strengthen intergenerational solidarity and support.

Physical activity shows potential in combating the poor outcomes associated with depression in older people. Meta-analyses show gaps in the research with poor trial design compromising certainty in conclusions and few programmes showing sustained effects.