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.

Academic Publication

The Meaningful Engagement Assessment for Residents with Dementia in Assisted Living Settings

Jan 1, 2025
WHAT THIS MEANS FOR YOU: This study tested the Meaningful Engagement Assessment (MEA) tool with 31 residents with mild to severe dementia in two assisted living communities. The MEA is designed to create individualized care plannning for residents. With brief training, this pilot study revealed that the tool can feasibly be used by staff to promote meaningful activity for AL residents.

The Meaningful Engagement Assessment for Residents with Dementia in Assisted Living Settings

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study tested the Meaningful Engagement Assessment (MEA) tool with 31 residents with mild to severe dementia in two assisted living communities. The MEA is designed to create individualized care plannning for residents. With brief training, this pilot study revealed that the tool can feasibly be used by staff to promote meaningful activity for AL residents.

Assisted Living, Residential Care, and Memory Care Staffing Level Dynamics: Oregon, 2017-2023

Jan 1, 2025
WHAT THIS MEANS FOR YOU: This longitudinal study examined staffing levels, as measured by care hours per resident per day, from 535 long-term care communities in Oregon between 2017-2023. There was an increase in staff immediately after the pandemic and staffing levels were, on average, 28 minutes higher in 2023 than 2017. However, there was significant variation among AL communities' staffing levels, likely due to organizational-level factors like resource allocation, resident case mix, and operational structures.

Assisted Living, Residential Care, and Memory Care Staffing Level Dynamics: Oregon, 2017-2023

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This longitudinal study examined staffing levels, as measured by care hours per resident per day, from 535 long-term care communities in Oregon between 2017-2023. There was an increase in staff immediately after the pandemic and staffing levels were, on average, 28 minutes higher in 2023 than 2017. However, there was significant variation among AL communities’ staffing levels, likely due to organizational-level factors like resource allocation, resident case mix, and operational structures.

Understanding Urinary Incontinence and Urinary Tract Infections as Key Contributors to Falls in Assisted Living and Memory Care Communities

Jan 1, 2025
WHAT THIS MEANS FOR YOU: This editorial examined how urinary incontinence (UI) and urinary tract infections (UTIs) are contributors to falls for assisted living and memory care residents. Impacts on balance, stability, confusion, and fatigue all contribute to the increased risk. Future falls prevention approaches should consider UI and UTIs, structured toileting, and caregiver training to reduce risk.

Understanding Urinary Incontinence and Urinary Tract Infections as Key Contributors to Falls in Assisted Living and Memory Care Communities

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This editorial examined how urinary incontinence (UI) and urinary tract infections (UTIs) are contributors to falls for assisted living and memory care residents. Impacts on balance, stability, confusion, and fatigue all contribute to the increased risk. Future falls prevention approaches should consider UI and UTIs, structured toileting, and caregiver training to reduce risk.

The Impact of Enhanced Group Activity Kits (EGAKs) on Well-being of Persons with Dementia

Jan 1, 2025
WHAT THIS MEANS FOR YOU: This study examined 123 people living with dementia (PLwD) from 6 nursing centers and 4 adult day units in Israel to investigate the impact of group activities and whether group activity kits (EGAKs) enhanced activity quality. Use of EGAKs significantly improved resident well-being compared to activities without EGAKs, and participating in no activities at all significantly lowered well-being, supporting possible implementation of EGAKs to improve group activities for residents.

The Impact of Enhanced Group Activity Kits (EGAKs) on Well-being of Persons with Dementia

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study examined 123 people living with dementia (PLwD) from 6 nursing centers and 4 adult day units in Israel to investigate the impact of group activities and whether group activity kits (EGAKs) enhanced activity quality. Use of EGAKs significantly improved resident well-being compared to activities without EGAKs, and participating in no activities at all significantly lowered well-being, supporting possible implementation of EGAKs to improve group activities for residents.

The Role of Workday Characteristics on Perceived Stress and Time Pressure among Nurses in Finnish Long-Term Care – A Cross-Sectional Study

Dec 1, 2024
WHAT THIS MEANS FOR YOU: This study examined 503 nurses from 44 AL communities in Finland to examine the relationship between workday characteristics and perceived stress and time pressure. More care task events, clients with greater needs, reduced break times, and disruptions during the day were related to stress and time pressure for staff. Findings indicate that dividing workload evenly among nursing teams can help reduce stress and time pressure.

The Role of Workday Characteristics on Perceived Stress and Time Pressure among Nurses in Finnish Long-Term Care – A Cross-Sectional Study

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study examined 503 nurses from 44 AL communities in Finland to examine the relationship between workday characteristics and perceived stress and time pressure. More care task events, clients with greater needs, reduced break times, and disruptions during the day were related to stress and time pressure for staff. Findings indicate that dividing workload evenly among nursing teams can help reduce stress and time pressure.

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.

A New Measure of Professional Caregiver Coping in Long-Term Care: The LTC COPE

Dec 1, 2024
WHAT THIS MEANS FOR YOU: This study developed a new measure for how professional caregivers cope with stress. Data was collected from 391 caregivers in 13 long-term care communities across 3 states using the Long-Term Care Cope instrument. Coping strategies were found to be highly individual with many reporting using multiple strategies. Further testing of the scale is needed to understand and narrow the items in the subcomponents.

A New Measure of Professional Caregiver Coping in Long-Term Care: The LTC COPE

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study developed a new measure for how professional caregivers cope with stress. Data was collected from 391 caregivers in 13 long-term care communities across 3 states using the Long-Term Care Cope instrument. Coping strategies were found to be highly individual with many reporting using multiple strategies. Further testing of the scale is needed to understand and narrow the items in the subcomponents.

Stress-Related Coping and its Relationship to Well-Being in Nursing Assistants and Personal Care Aides in Nursing Homes and Assisted Living

Dec 1, 2024
WHAT THIS MEANS FOR YOU: This cross-sectional study used questionnaire data from 391 professional caregivers from 13 facilities in 3 states to examine coping and its relationship with demographic characteristics of direct caregivers in long-term care. Older staff used adaptive psychological strategies more than younger staff, and traditionally minoritized staff used more adaptive and less maladaptive psychological strategies than white staff. Using avoidance and maladaptive coping strategies was associated with depressive and anxiety symptoms, as well as burnout. Professional caregivers use a variety of coping mechanisms, and training on adaptive coping could improve outcomes for this population.

Stress-Related Coping and its Relationship to Well-Being in Nursing Assistants and Personal Care Aides in Nursing Homes and Assisted Living

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This cross-sectional study used questionnaire data from 391 professional caregivers from 13 facilities in 3 states to examine coping and its relationship with demographic characteristics of direct caregivers in long-term care. Older staff used adaptive psychological strategies more than younger staff, and traditionally minoritized staff used more adaptive and less maladaptive psychological strategies than white staff. Using avoidance and maladaptive coping strategies was associated with depressive and anxiety symptoms, as well as burnout. Professional caregivers use a variety of coping mechanisms, and training on adaptive coping could improve outcomes for this population.

Examining Engagement Calendar Deviations in Assisted Living: A Focus on Residents With Dementia

Dec 1, 2024
WHAT THIS MEANS FOR YOU: This study used data from 3 AL communities over one year to examine deviations from scheduled activity programming, identify influential factors, and understand the outcomes on residents. The analysis showed general adherence to calendars, but deviations did occur. Staffing, capacity, programming guidance and support, staff attitudes, and unforeseen circumstances all influenced these deviations. Cancellations of programming were more detrimental to resident well-being than substitutions.

Examining Engagement Calendar Deviations in Assisted Living: A Focus on Residents With Dementia

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study used data from 3 AL communities over one year to examine deviations from scheduled activity programming, identify influential factors, and understand the outcomes on residents. The analysis showed general adherence to calendars, but deviations did occur. Staffing, capacity, programming guidance and support, staff attitudes, and unforeseen circumstances all influenced these deviations. Cancellations of programming were more detrimental to resident well-being than substitutions.

Medical Care Provider Involvement in Ontario Assisted Living Homes: A Descriptive Cross-Sectional Survey Analysis

Dec 1, 2024
WHAT THIS MEANS FOR YOU: This cross-sectional Canadian study examined 88 AL communities' survey responses to assess medical care provider involvement. A total of 54 AL communities had an established medical care provider, and doctors cared for more than 50 patients in 36% of homes and 46% visited homes weekly. Almost two-thirds of communities had nurses accompany physicians on rounds, and two-thirds provided residents with palliative care. Residents in homes with medical care providers were 76% less likely to seek care from a physician in the community.

Medical Care Provider Involvement in Ontario Assisted Living Homes: A Descriptive Cross-Sectional Survey Analysis

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This cross-sectional Canadian study examined 88 AL communities’ survey responses to assess medical care provider involvement. A total of 54 AL communities had an established medical care provider, and doctors cared for more than 50 patients in 36% of homes and 46% visited homes weekly. Almost two-thirds of communities had nurses accompany physicians on rounds, and two-thirds provided residents with palliative care. Residents in homes with medical care providers were 76% less likely to seek care from a physician in the community.

Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients

Dec 1, 2024
This Canadian cohort study included 10,012 AL residents and 131,679 home care recipients who applied for beds in nursing homes to examine the transition differences between the 2 groups. There were 6,049 transitions from AL residents and 85,190 from home care to nursing homes. Living in an AL, rather than in the community, led to a roughly 13% decrease in the 5-year risk of transition to nursing homes despite similar relative clinical complexity and healthcare needs, meaning that assisted living is an important part of the long-term care continuum.

Transitions to Nursing Homes Among Residents of Assisted Living and Community-Dwelling Home Care Recipients

by Lea Efird-Green

This Canadian cohort study included 10,012 AL residents and 131,679 home care recipients who applied for beds in nursing homes to examine the transition differences between the 2 groups. There were 6,049 transitions from AL residents and 85,190 from home care to nursing homes. Living in an AL, rather than in the community, led to a roughly 13% decrease in the 5-year risk of transition to nursing homes despite similar relative clinical complexity and healthcare needs, meaning that assisted living is an important part of the long-term care continuum.

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).

“What Does ‘Age-Friendly’ Mean to You?”: The Role of Microaggressions in a Retirement and Assisted Living Community

Dec 1, 2024
WHAT THIS MEANS FOR YOU: This case study compared four residents' perspectives on the age-friendliness of an AL in the Midwest using semi-structured interviews and observational data. Themes of built design vs. identity of age-friendliness, resident-resident microaggressions, and desired experiences of age-friendliness emerged. Visible diversity created experiences of ableism and racism, whereas invisible diversity did not have the same negative effects. Resident-resident microaggressions undermined the age-friendliness of the facility.

“What Does ‘Age-Friendly’ Mean to You?”: The Role of Microaggressions in a Retirement and Assisted Living Community

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This case study compared four residents’ perspectives on the age-friendliness of an AL in the Midwest using semi-structured interviews and observational data. Themes of built design vs. identity of age-friendliness, resident-resident microaggressions, and desired experiences of age-friendliness emerged. Visible diversity created experiences of ableism and racism, whereas invisible diversity did not have the same negative effects. Resident-resident microaggressions undermined the age-friendliness of the facility.

Risk of Hospitalization Among Assisted Living Residents Dually Enrolled in Medicare and Medicaid

Dec 1, 2024
WHAT THIS MEANS FOR YOU: This retrospective cohort study used Medicare data from 2008-2018 from 12,451 AL communities to examine the risk of hospitalization for Medicare-Medicaid dual eligibles. Out of 620,542 Medicare beneficiaries, the 1-year risk of hospitalization was higher for dually enrolled individuals. The risk was higher in high-dual AL communities than in low-dual AL communities for both dually enrolled (7.4%) and Medicare only (9.4%) individuals.

Risk of Hospitalization Among Assisted Living Residents Dually Enrolled in Medicare and Medicaid

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This retrospective cohort study used Medicare data from 2008-2018 from 12,451 AL communities to examine the risk of hospitalization for Medicare-Medicaid dual eligibles. Out of 620,542 Medicare beneficiaries, the 1-year risk of hospitalization was higher for dually enrolled individuals. The risk was higher in high-dual AL communities than in low-dual AL communities for both dually enrolled (7.4%) and Medicare only (9.4%) individuals.

Factors Associated with Transfer from Assisted Living Facilities to a Nursing Home: National Health Aging Trends Study 2011-2019

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This analysis used the National Health Aging Trends Study to identify factors associated with transfer from an AL community to a nursing home. Data from 970 AL residents over seven years showed that those with better baseline physical performance and college education were at lower risk of transfer. Residents who maintained physical less and had less difficulty with basic activities of daily living (ADLs) were also at lower risk of transfer.

Factors Associated with Transfer from Assisted Living Facilities to a Nursing Home: National Health Aging Trends Study 2011-2019

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This analysis used the National Health Aging Trends Study to identify factors associated with transfer from an AL community to a nursing home. Data from 970 AL residents over seven years showed that those with better baseline physical performance and college education were at lower risk of transfer. Residents who maintained physical less and had less difficulty with basic activities of daily living (ADLs) were also at lower risk of transfer.

Clinical and Sociodemographic Characteristics of New Residents of Assisted Living: A Nested Case-Control Study

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This nested case-control study in Ontario examined differences between community-dwelling and new AL residents to understand transitions to AL communitiess. New residents had higher rates of diagnosed dementia, mood disorders, cardiac arrhythmias, mild cognitive impairment, and falls than community-dwelling peers. New AL residents also had lower odds of having a spousal caregiver than a child caregiver. However, these residents also had higher rates of participation in activities of interest in the last seven days.

Clinical and Sociodemographic Characteristics of New Residents of Assisted Living: A Nested Case-Control Study

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This nested case-control study in Ontario examined differences between community-dwelling and new AL residents to understand transitions to AL communitiess. New residents had higher rates of diagnosed dementia, mood disorders, cardiac arrhythmias, mild cognitive impairment, and falls than community-dwelling peers. New AL residents also had lower odds of having a spousal caregiver than a child caregiver. However, these residents also had higher rates of participation in activities of interest in the last seven days.

Effects of a Meaning in Life Enhancement Program on Depression among Older Adult Residents of Assisted Living Facilities

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This quasi-experimental study of 60 older adults in 2 AL communities in Thailand examined the effects of a program to enhance meaning in life and reduce depression. The group that experienced the program, as opposed to routine nursing care, exhibited statistically lower depression scores from baseline and compared to the control group, which means the program may be effective; however, further testing is necessary.

Effects of a Meaning in Life Enhancement Program on Depression among Older Adult Residents of Assisted Living Facilities

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This quasi-experimental study of 60 older adults in 2 AL communities in Thailand examined the effects of a program to enhance meaning in life and reduce depression. The group that experienced the program, as opposed to routine nursing care, exhibited statistically lower depression scores from baseline and compared to the control group, which means the program may be effective; however, further testing is necessary.

The Relationship between Perceived Engagement in Meaningful Activity and Behavioral and Psychological Symptoms of Dementia among Assisted Living Residents

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This study of 71 residents with dementia in 5 AL communities assessed the relationship between engagement in meaningful activities and symptoms of dementia. Perceived engagement in meaningful activities was significantly associated with decreased agitation, but not apathy, depression, or irritability.

The Relationship between Perceived Engagement in Meaningful Activity and Behavioral and Psychological Symptoms of Dementia among Assisted Living Residents

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study of 71 residents with dementia in 5 AL communities assessed the relationship between engagement in meaningful activities and symptoms of dementia. Perceived engagement in meaningful activities was significantly associated with decreased agitation, but not apathy, depression, or irritability.

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.

Progress of Rehabilitation in Assisted Living for Mentally Ill According to STAX-SA Taxonomy

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This study used longitudinal data from a 2020-22 Finnish study of 340 health records of AL residents with mental illness to examine how residents moved through the AL supportive and health services system. Of the residents, 19% progressed to AL communities with fewer services, 79% remained stable, and 2% regressed into AL communities with more services. This means that rehabilitation may not be effectively implemented for these residents and needs to be improved.

Progress of Rehabilitation in Assisted Living for Mentally Ill According to STAX-SA Taxonomy

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study used longitudinal data from a 2020-22 Finnish study of 340 health records of AL residents with mental illness to examine how residents moved through the AL supportive and health services system. Of the residents, 19% progressed to AL communities with fewer services, 79% remained stable, and 2% regressed into AL communities with more services. This means that rehabilitation may not be effectively implemented for these residents and needs to be improved.

Association Between Organizational Context and Resident Pain in Assisted Living: A Repeated Cross-Sectional Study

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This repeated cross-sectional study linked survey data from COVID-19 waves 1 and 2 from 985 residents in 41 AL communities (wave 1) and 1134 residents in 42 AL communities (wave 2) to examine if organizational context was associated with resident pain. Overall pain prevalence decreased from 20.6% in wave 1 to 19.1% in wave 2, but it was non-significant.There were mixed results: better preparedness, room confinement, availability of a nurse practitioner, and staff shortages were associated with resident pain. Organizational context does therefore have an effect on resident pain, and future policy and management interventions should address these factors.

Association Between Organizational Context and Resident Pain in Assisted Living: A Repeated Cross-Sectional Study

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This repeated cross-sectional study linked survey data from COVID-19 waves 1 and 2 from 985 residents in 41 AL communities (wave 1) and 1134 residents in 42 AL communities (wave 2) to examine if organizational context was associated with resident pain. Overall pain prevalence decreased from 20.6% in wave 1 to 19.1% in wave 2, but it was non-significant.There were mixed results: better preparedness, room confinement, availability of a nurse practitioner, and staff shortages were associated with resident pain. Organizational context does therefore have an effect on resident pain, and future policy and management interventions should address these factors.

Residency in Long-Term Care Facilities: An Important Risk Factor for Respiratory Syncytial Virus Hospitalization

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This three-year prospective study in New York examined residential long-term care settings and risk associated with hospitalization due to respiratory syncytial virus (RSV), as compared with their community-dwelling peers. Residents in AL and NH settings were more likely to have dementia and congestive heart failure, creating intersections of risk factors for RSV. Residents of AL communities had 3-9 times higher, and residents of SNFs had 3-4 times higher, rates of RSV-associated hospitalizations than community dwelling residents. This study demonstrates the need for RSV vaccine recommendations in long-term care.

Residency in Long-Term Care Facilities: An Important Risk Factor for Respiratory Syncytial Virus Hospitalization

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This three-year prospective study in New York examined residential long-term care settings and risk associated with hospitalization due to respiratory syncytial virus (RSV), as compared with their community-dwelling peers. Residents in AL and NH settings were more likely to have dementia and congestive heart failure, creating intersections of risk factors for RSV. Residents of AL communities had 3-9 times higher, and residents of SNFs had 3-4 times higher, rates of RSV-associated hospitalizations than community dwelling residents. This study demonstrates the need for RSV vaccine recommendations in long-term care.

Staffing Patterns in Nursing Homes, Assisted Living Communities, and Memory Care Units: Variation Across Shifts

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This study used observational data from 678 nursing staff at NHs and 432 nursing staff at AL communities in Ohio to assess their direct care nursing staffing patterns. Both NHs and AL communities had better daytime staffing ratios than overnights, although NH staffing ratios were superior to those in AL communities. In AL and NH memory care units, staffing patterns were similar. As acuity increases in AL communities, more nursing staff will likely be required, especially on overnight shifts.

Staffing Patterns in Nursing Homes, Assisted Living Communities, and Memory Care Units: Variation Across Shifts

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This study used observational data from 678 nursing staff at NHs and 432 nursing staff at AL communities in Ohio to assess their direct care nursing staffing patterns. Both NHs and AL communities had better daytime staffing ratios than overnights, although NH staffing ratios were superior to those in AL communities. In AL and NH memory care units, staffing patterns were similar. As acuity increases in AL communities, more nursing staff will likely be required, especially on overnight shifts.

Barriers and Facilitators to Physical Activity Among Older Adults in Residential Aged Care Facilities: A Mixed Methods Systematic Review Using the Social Ecological Model

Nov 1, 2024
WHAT THIS MEANS FOR YOU: This systematic review examined 67 studies to understand barriers and facilitators to physical exercise for older adults in residential aged care facilities (RACFs). Out of those studies, 51 themes emerged (27 facilitators and 24 barriers), with intrapersonal factors being the most commonly cited barrier, and interpersonal factors being the most commonly cited facilitator, meaning that a multilevel approach is likely needed to address physical activity in residential care.

Barriers and Facilitators to Physical Activity Among Older Adults in Residential Aged Care Facilities: A Mixed Methods Systematic Review Using the Social Ecological Model

by Lea Efird-Green

WHAT THIS MEANS FOR YOU: This systematic review examined 67 studies to understand barriers and facilitators to physical exercise for older adults in residential aged care facilities (RACFs). Out of those studies, 51 themes emerged (27 facilitators and 24 barriers), with intrapersonal factors being the most commonly cited barrier, and interpersonal factors being the most commonly cited facilitator, meaning that a multilevel approach is likely needed to address physical activity in residential care.