Center for Excellence in Assisted Living CEAL@UNC

Advancing the well-being of the people who live and work in assisted living through research, practice, and policy.

Technology

Understanding Digital Literacy of Persons With Dementia and Their Caregivers: A Scoping Review and an Evolutionary Concept Analysis of Empirical Studies

Jun 1, 2025
WHAT THIS MEANS FOR YOU: This scoping review of 22 studies examined digitial literacy for people with dementia and their caregivers across settings and aimed to understand antecedents, attributes, and consequences of digital literacy. Support systems, and individual and sociodemographic characteristics were identified as antecedents; technological and critical thinking skills are attributes; and technology acceptance, psychosocial impacts, and digital equity were consequences. These concepts could guide the development and implementation of digital interventions for people with dementia and their caregivers.

Understanding Digital Literacy of Persons With Dementia and Their Caregivers: A Scoping Review and an Evolutionary Concept Analysis of Empirical Studies

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This scoping review of 22 studies examined digitial literacy for people with dementia and their caregivers across settings and aimed to understand antecedents, attributes, and consequences of digital literacy. Support systems, and individual and sociodemographic characteristics were identified as antecedents; technological and critical thinking skills are attributes; and technology acceptance, psychosocial impacts, and digital equity were consequences. These concepts could guide the development and implementation of digital interventions for people with dementia and their caregivers.

Artificial Intelligence in Assisted Living and Memory Care: Enhancing Care or Increasing Exposure?

May 1, 2025
WHAT THIS MEANS FOR YOU: This editorial uses data from the CAN Aging Servces Claim Report to examine how artificial intelligence (AI) can alter care, liability, and decision-making in assisted living and memory care settings.

Artificial Intelligence in Assisted Living and Memory Care: Enhancing Care or Increasing Exposure?

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This editorial uses data from the CAN Aging Servces Claim Report to examine how artificial intelligence (AI) can alter care, liability, and decision-making in assisted living and memory care settings.

Keeping Assisted Living Communities Secure: A Comprehensive Approach from the Perimeter to the Interior

Mar 1, 2025
WHAT THIS MEANS FOR YOU: This article highlights the importance of physical and cybersecurity in assisted living using the People, Programs, Training, and Technology (P2T2) system. For the system to be effective, staff training, resident education, and collaboration with law enforcement are integral. Best practices like checklists can be implemented so that physical security, technological solutions, and emergency preparedness can be addressed for quality assurance.

Keeping Assisted Living Communities Secure: A Comprehensive Approach from the Perimeter to the Interior

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This article highlights the importance of physical and cybersecurity in assisted living using the People, Programs, Training, and Technology (P2T2) system. For the system to be effective, staff training, resident education, and collaboration with law enforcement are integral. Best practices like checklists can be implemented so that physical security, technological solutions, and emergency preparedness can be addressed for quality assurance.

Current State of Healthcare Robots for Older Adults in Care Facilities in Japan and the Related Ethical Issues for Nurses

Feb 1, 2025
WHAT THIS MEANS FOR YOU: This review of healthcare robots in Japan examined their introduction from a nursing ethics perspective. Healthcare robots have the potential to help staff with tasks, but ethical concerns need to be considered and weighed against the six principles of nursing ethics. Patients' rights and are the most important thing for nurses to consider when working with healthcare robots.

Current State of Healthcare Robots for Older Adults in Care Facilities in Japan and the Related Ethical Issues for Nurses

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This review of healthcare robots in Japan examined their introduction from a nursing ethics perspective. Healthcare robots have the potential to help staff with tasks, but ethical concerns need to be considered and weighed against the six principles of nursing ethics. Patients’ rights and are the most important thing for nurses to consider when working with healthcare robots.

Applications of Blockchain Technology in Long-Term Care: Use Cases, Potentials, and Barriers

Dec 1, 2024
WHAT THIS MEANS FOR YOU: This systematic review provides an overview of blockchain technology for assistive technologies, data security, and privacy issues in long-term care settings from 29 studies published from 2016-2023. There is interest in the utility of blockchain technology, but real-world studies are needed. Implementation barriers included technical immaturity, stakeholder cooperation, and access to appropriate infrastructure.

Applications of Blockchain Technology in Long-Term Care: Use Cases, Potentials, and Barriers

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This systematic review provides an overview of blockchain technology for assistive technologies, data security, and privacy issues in long-term care settings from 29 studies published from 2016-2023. There is interest in the utility of blockchain technology, but real-world studies are needed. Implementation barriers included technical immaturity, stakeholder cooperation, and access to appropriate infrastructure.

The Efficacy of a Mobile-Based Multidomain Program on Cognitive Functioning of Residents in Assisted Living Facilities

Dec 1, 2024
WHAT THIS MEANS FOR YOU: This study of 20 AL residents who scored in the range of mild cognitive impairment on the MoCA was designed to test the efficacy of a mobile-based program on cognitive functioning (the Silvia program). The intervention group received the mobile program's lifestyle intervention for 50-60 mins, twice weekly, for 12 weeks. The intervention group showed significant improvement in MoCA scores (23.6 vs. 24.3) while the control group declined (22.0 vs. 21.7).

The Efficacy of a Mobile-Based Multidomain Program on Cognitive Functioning of Residents in Assisted Living Facilities

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study of 20 AL residents who scored in the range of mild cognitive impairment on the MoCA was designed to test the efficacy of a mobile-based program on cognitive functioning (the Silvia program). The intervention group received the mobile program’s lifestyle intervention for 50-60 mins, twice weekly, for 12 weeks. The intervention group showed significant improvement in MoCA scores (23.6 vs. 24.3) while the control group declined (22.0 vs. 21.7).

Effect of a Digital Two-Dimensional Animation Program on Attitude Toward Walking Aids, Performance, and Fall Avoidance Behaviors among Older Adults in Assisted Living Facilities

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This quasi-experimental study of 128 AL residents investigated the impact of a two-dimensional animation program on attitudes towards walking aids, performance and fall avoidance behaviors. The intervention group had more positive attitudes towards walking aids, improved walking aid use, and reduced fall concerns than the control group, meaning this teaching strategy could be effective to enhance mobility and reduce falls in this setting.

Effect of a Digital Two-Dimensional Animation Program on Attitude Toward Walking Aids, Performance, and Fall Avoidance Behaviors among Older Adults in Assisted Living Facilities

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This quasi-experimental study of 128 AL residents investigated the impact of a two-dimensional animation program on attitudes towards walking aids, performance and fall avoidance behaviors. The intervention group had more positive attitudes towards walking aids, improved walking aid use, and reduced fall concerns than the control group, meaning this teaching strategy could be effective to enhance mobility and reduce falls in this setting.

Postimplementation Evaluation in Assisted Living Facilities of an eHealth Medical Device Developed to Predict and Avoid Unplanned Hospitalizations: Pragmatic Trial

Oct 1, 2024
WHAT THIS MEANS FOR YOU: This study tested a new monitoring system to predict risk of emergency hospitalizations in seven French AL communities. For the 118 included residents, 38 emergency hospitalizations were documented, and 50% of alerts from the system led to health care interventions. Hospitalizations were correlated with a lack of alert-triggered interventions, suggesting the system leads to improvements.

Postimplementation Evaluation in Assisted Living Facilities of an eHealth Medical Device Developed to Predict and Avoid Unplanned Hospitalizations: Pragmatic Trial

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study tested a new monitoring system to predict risk of emergency hospitalizations in seven French AL communities. For the 118 included residents, 38 emergency hospitalizations were documented, and 50% of alerts from the system led to health care interventions. Hospitalizations were correlated with a lack of alert-triggered interventions, suggesting the system leads to improvements.

Nursing Staff’s Perspectives of Care Robots for Assisted Living Facilities: Systematic Literature Review

Sep 1, 2024
WHAT THIS MEANS FOR YOU: This systematic review examined the results of 15 studies about nurses' attitudes toward care robots in assisted living communities. The studies were conducted with small sample sizes, and there were concerns from nurses regarding ethics, safety, accessibility, and Overall, nurses supported care robots for assisting with physical tasks and reducing workload, but were mixed about whether they should help with social tasks.

Nursing Staff’s Perspectives of Care Robots for Assisted Living Facilities: Systematic Literature Review

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This systematic review examined the results of 15 studies about nurses’ attitudes toward care robots in assisted living communities. The studies were conducted with small sample sizes, and there were concerns from nurses regarding ethics, safety, accessibility, and Overall, nurses supported care robots for assisting with physical tasks and reducing workload, but were mixed about whether they should help with social tasks.

Revolutionizing Patient Surveillance in Assisted Living Facilities: Insights from AUGi Technology Implementation

Jul 1, 2024
WHAT THIS MEANS FOR YOU: The study examined the effectiveness of a remote-surveillance technology (AUGi) to enhance falls surveillance, conduct remote assessments and send out alerts in 3 AL communities in 3 different states. Using data collection, AUGi facilitated a 64% average reduction in falls and had success enhancing nurse surveillance by providing falls notifications.

Revolutionizing Patient Surveillance in Assisted Living Facilities: Insights from AUGi Technology Implementation

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: The study examined the effectiveness of a remote-surveillance technology (AUGi) to enhance falls surveillance, conduct remote assessments and send out alerts in 3 AL communities in 3 different states. Using data collection, AUGi facilitated a 64% average reduction in falls and had success enhancing nurse surveillance by providing falls notifications.

Assessing the Potential of Technology to Describe Resident and Staff Interactions in Assisted Living Facilities

Jul 1, 2024
WHAT THIS MEANS FOR YOU: This study examined 83 staff at an AL community in New York using a remote surveillance technology to assess nurse-resident interactions and improve falls prevention over 170 days. Data showed that staff visited residents an average of 20.7 times a day. As compared to traditional in-person methods, staff responded faster through the app (2.7 minutes via app vs. 3.3 minutes via in-person call requests) to urgent alerts.

Assessing the Potential of Technology to Describe Resident and Staff Interactions in Assisted Living Facilities

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study examined 83 staff at an AL community in New York using a remote surveillance technology to assess nurse-resident interactions and improve falls prevention over 170 days. Data showed that staff visited residents an average of 20.7 times a day. As compared to traditional in-person methods, staff responded faster through the app (2.7 minutes via app vs. 3.3 minutes via in-person call requests) to urgent alerts.