Academic Publication

Challenges and Possibilities in Preventing Emerging Infectious Diseases in Long-Term Care: A Qualitative Descriptive Study

Oct 1, 2025

Background: Emerging infectious diseases pose significant risks to vulnerable populations, particularly older adults with underlying health conditions living in long-term care institutions. Yet, while the experiences of healthcare workers in managing these crises are invaluable, there remains limited research on the specific challenges they faced. Aim: To explore the experiences of long-term care workers-including nurses, […]

Challenges and Possibilities in Preventing Emerging Infectious Diseases in Long-Term Care: A Qualitative Descriptive Study

October 1, 2025 by Lea Efird-Green

Background: Emerging infectious diseases pose significant risks to vulnerable populations, particularly older adults with underlying health conditions living in long-term care institutions. Yet, while the experiences of healthcare workers in managing these crises are invaluable, there remains limited research on the specific challenges they faced. Aim: To explore the experiences of long-term care workers-including nurses, […]

Denture Care in Assisted Living: Best Practices and Clinical Importance for Resident Health

Sep 1, 2025

Oral health is a critical yet frequently underrecognized component of care in assisted living. Among residents, complete edentulism affects approximately one third, while partial edentulism remains highly prevalent, both conditions requiring the use of dentures for functional and nutritional support. Insufficient denture hygiene has been associated with significant adverse outcomes, including denture-related stomatitis, systemic fungal […]

Denture Care in Assisted Living: Best Practices and Clinical Importance for Resident Health

September 1, 2025 by Lea Efird-Green

Oral health is a critical yet frequently underrecognized component of care in assisted living. Among residents, complete edentulism affects approximately one third, while partial edentulism remains highly prevalent, both conditions requiring the use of dentures for functional and nutritional support. Insufficient denture hygiene has been associated with significant adverse outcomes, including denture-related stomatitis, systemic fungal […]

Person-Focused Interventions for Fall Risk Assessment, Fall Prevention and Fall Injury Prevention in Long-Term Care Facilities: A Scoping Review

Sep 1, 2025

Objective: Falls are a significant concern in long-term care facilities (LTCFs) as fall-related injuries can result in functional impairment, disability and death. Older adults living in LTCFs are at greater risk for falls than those in the community. Using scoping review methodology, we aimed to synthesise evidence examining intervention effects of person-focused interventions for risk […]

Person-Focused Interventions for Fall Risk Assessment, Fall Prevention and Fall Injury Prevention in Long-Term Care Facilities: A Scoping Review

September 1, 2025 by Lea Efird-Green

Objective: Falls are a significant concern in long-term care facilities (LTCFs) as fall-related injuries can result in functional impairment, disability and death. Older adults living in LTCFs are at greater risk for falls than those in the community. Using scoping review methodology, we aimed to synthesise evidence examining intervention effects of person-focused interventions for risk […]

Perception of Therapeutic Music in Community Settings

Sep 1, 2025

Background: Therapeutic music has been shown to reduce stress and anxiety, while boosting mood and overall well-being in numerous settings. Building on the success of Vanderbilt University Medical Center’s (VUMC) Therapeutic Music Program, and in collaboration with AARP Tennessee and the Blair School of Music at Vanderbilt, a community-based therapeutic music program was introduced, focusing […]

Perception of Therapeutic Music in Community Settings

September 1, 2025 by Lea Efird-Green

Background: Therapeutic music has been shown to reduce stress and anxiety, while boosting mood and overall well-being in numerous settings. Building on the success of Vanderbilt University Medical Center’s (VUMC) Therapeutic Music Program, and in collaboration with AARP Tennessee and the Blair School of Music at Vanderbilt, a community-based therapeutic music program was introduced, focusing […]

Long Fever Fever as a Long-Term Risk Factor for Mortality in Persons in Assisted Living Facilities

Sep 1, 2025

Background: The aging population and increasing use of assisted living facilities necessitate a better understanding of risk factors for adverse outcomes. Fever as a long-term risk factor in elderly populations remains understudied. Methods: We analyzed data from 16,523 veterans in assisted living facilities between 2012-2022, examining the relationship between fever (defined as temperature ≥100.4°F) and […]

Long Fever Fever as a Long-Term Risk Factor for Mortality in Persons in Assisted Living Facilities

September 1, 2025 by Lea Efird-Green

Background: The aging population and increasing use of assisted living facilities necessitate a better understanding of risk factors for adverse outcomes. Fever as a long-term risk factor in elderly populations remains understudied. Methods: We analyzed data from 16,523 veterans in assisted living facilities between 2012-2022, examining the relationship between fever (defined as temperature ≥100.4°F) and […]

Staff Satisfaction and Burnout in Assisted Living and Validity of the DCW Job Satisfaction Scale

Sep 1, 2025

Objectives: Professional caregivers (ie, direct care workers) provide the majority of support for long-term care residents. Unfortunately, they have consistently high turnover, which is associated with low job satisfaction and decreased care quality. Most research on this topic has been conducted in nursing homes; in contrast, this study investigated relationships between staff satisfaction, burnout, and […]

Staff Satisfaction and Burnout in Assisted Living and Validity of the DCW Job Satisfaction Scale

September 1, 2025 by Lea Efird-Green

Objectives: Professional caregivers (ie, direct care workers) provide the majority of support for long-term care residents. Unfortunately, they have consistently high turnover, which is associated with low job satisfaction and decreased care quality. Most research on this topic has been conducted in nursing homes; in contrast, this study investigated relationships between staff satisfaction, burnout, and […]

Mouth Care Without a Battle: Change in Assisted Living Staff Self-Efficacy and Attitudes

Sep 1, 2025

No abstract available

Mouth Care Without a Battle: Change in Assisted Living Staff Self-Efficacy and Attitudes

September 1, 2025 by Lea Efird-Green

No abstract available

Happy by Nature: Nature Connection as a Source of Psychological Well-Being in Assisted Living Facilities

Sep 1, 2025

Objectives: Contact with nature is a source of resilience and well-being, and nature-based interventions (NBIs) potentially support older adults’ health and self-efficacy. Health-related outcomes of NBIs depend not only on the surroundings and activity, but also on the perceived nature connection. Although NBIs are implemented in assisted living facilities (ALFs), the nature connection has not […]

Happy by Nature: Nature Connection as a Source of Psychological Well-Being in Assisted Living Facilities

September 1, 2025 by Lea Efird-Green

Objectives: Contact with nature is a source of resilience and well-being, and nature-based interventions (NBIs) potentially support older adults’ health and self-efficacy. Health-related outcomes of NBIs depend not only on the surroundings and activity, but also on the perceived nature connection. Although NBIs are implemented in assisted living facilities (ALFs), the nature connection has not […]

Obesity and Transition to Assisted Living Services in Older Adults: An Analysis from the National Health and Aging Trends Study

Sep 1, 2025

Background: The prevalence of obesity in older adults is increasing. Though body mass index (BMI) is often used as a measure of obesity, waist circumference (WC) may be a better reflection of obesity in older adults. While many factors contribute to transitioning to assisted living services (TALS), the relationship between obesity and TALS has demonstrated […]

Obesity and Transition to Assisted Living Services in Older Adults: An Analysis from the National Health and Aging Trends Study

September 1, 2025 by Lea Efird-Green

Background: The prevalence of obesity in older adults is increasing. Though body mass index (BMI) is often used as a measure of obesity, waist circumference (WC) may be a better reflection of obesity in older adults. While many factors contribute to transitioning to assisted living services (TALS), the relationship between obesity and TALS has demonstrated […]

Stand When You Can: Feasibility of a Multilevel, Multisite Sedentary Behavior Intervention in Assisted-Living Residences

Sep 1, 2025

Background/objectives: Prolonged sedentary time poses health risks for older adults, and residents in assisted living spend more time sedentary than peers who live independently. The purpose of this study was to examine the feasibility of Stand When You Can, a sedentary behavior intervention designed to encourage residents of assisted living to stand and move throughout […]

Stand When You Can: Feasibility of a Multilevel, Multisite Sedentary Behavior Intervention in Assisted-Living Residences

September 1, 2025 by Lea Efird-Green

Background/objectives: Prolonged sedentary time poses health risks for older adults, and residents in assisted living spend more time sedentary than peers who live independently. The purpose of this study was to examine the feasibility of Stand When You Can, a sedentary behavior intervention designed to encourage residents of assisted living to stand and move throughout […]

Delivering Engaging and Meaningful Activities for Older Adults in Long-Term Care Using Principles of Interpretation

Sep 1, 2025

Enjoyable, engaging, and meaningful group activities are critically needed and wanted by older adults, particularly by those living in long-term care communities (e.g., nursing homes and assisted living communities). While group activities are universally offered in long-term care settings, research has shown that participation rates are often moderate to low and that there is widespread […]

Delivering Engaging and Meaningful Activities for Older Adults in Long-Term Care Using Principles of Interpretation

September 1, 2025 by Lea Efird-Green

Enjoyable, engaging, and meaningful group activities are critically needed and wanted by older adults, particularly by those living in long-term care communities (e.g., nursing homes and assisted living communities). While group activities are universally offered in long-term care settings, research has shown that participation rates are often moderate to low and that there is widespread […]

Analgesic and Adjuvant Co-Prescribing in Australian and Finnish Residential Care Homes

Sep 1, 2025

Objective: To explore the co-prescribing of analgesic and/or adjuvant medications among residents of Australian and Finnish residential care homes. Method: Secondary cross-sectional analyses of prescribing data from residents of 12 Australian residential care homes in 2019 and 53 Finnish nursing homes and assisted living facilities in 2017-2018. Demographic characteristics and medication data were extracted from […]

Analgesic and Adjuvant Co-Prescribing in Australian and Finnish Residential Care Homes

September 1, 2025 by Lea Efird-Green

Objective: To explore the co-prescribing of analgesic and/or adjuvant medications among residents of Australian and Finnish residential care homes. Method: Secondary cross-sectional analyses of prescribing data from residents of 12 Australian residential care homes in 2019 and 53 Finnish nursing homes and assisted living facilities in 2017-2018. Demographic characteristics and medication data were extracted from […]

Developing and Implementing an Intervention to Increase Immunization Coverage Among Frontline Long-Term Care Staff

Sep 1, 2025

In the years following the COVID-19 pandemic, immunization coverage has declined among frontline post-acute and long-term care (PALTC) staff, such as nurses, certified nursing assistants, and kitchen staff. We took a novel approach to addressing these declines by engaging frontline staff in design of immunization-focused professional development by surveying a convenience sample of 200 frontline […]

Developing and Implementing an Intervention to Increase Immunization Coverage Among Frontline Long-Term Care Staff

September 1, 2025 by Lea Efird-Green

In the years following the COVID-19 pandemic, immunization coverage has declined among frontline post-acute and long-term care (PALTC) staff, such as nurses, certified nursing assistants, and kitchen staff. We took a novel approach to addressing these declines by engaging frontline staff in design of immunization-focused professional development by surveying a convenience sample of 200 frontline […]

Recruiting Sexual and Gender Minority Older Adults With and Without Dementia in Long-Term Care: Overcoming Barriers and Lessons Learned

Sep 1, 2025

Sexual and gender minority (SGM) older adults, including those in long-term care and living with cognitive impairment, are underrepresented in research. This study explored barriers and facilitators to recruiting SGM older adults using long-term services and supports (LTSS) into research. As part of a broader project on SGM policies in LTSS, we conducted qualitative interviews […]

Recruiting Sexual and Gender Minority Older Adults With and Without Dementia in Long-Term Care: Overcoming Barriers and Lessons Learned

September 1, 2025 by Lea Efird-Green

Sexual and gender minority (SGM) older adults, including those in long-term care and living with cognitive impairment, are underrepresented in research. This study explored barriers and facilitators to recruiting SGM older adults using long-term services and supports (LTSS) into research. As part of a broader project on SGM policies in LTSS, we conducted qualitative interviews […]

The Role of Aesthetics in Promoting Health-Related Quality of Life for Older Adults Transitioning to Long-Term Services and Support

Sep 1, 2025

The aesthetics of a home can promote healthy connections, well-being, and health-related quality of life (HRQoL) among older adults. Increased understanding of the meaning of aesthetics assigned by older adults transitioning to long-term services and supports (LTSS) is needed. Informed by the HRQoL conceptual framework, this study used cross-sectional data (n = 376) to examine […]

The Role of Aesthetics in Promoting Health-Related Quality of Life for Older Adults Transitioning to Long-Term Services and Support

September 1, 2025 by Lea Efird-Green

The aesthetics of a home can promote healthy connections, well-being, and health-related quality of life (HRQoL) among older adults. Increased understanding of the meaning of aesthetics assigned by older adults transitioning to long-term services and supports (LTSS) is needed. Informed by the HRQoL conceptual framework, this study used cross-sectional data (n = 376) to examine […]

Disproportionate Impact of Respiratory Syncytial Virus (RSV) Among Older Adults in Long-Term Care Settings

Sep 1, 2025

Objectives: The full burden of respiratory syncytial virus (RSV) infection in the long-term care facility (LTCF) population is not well defined. This study aimed to quantify the burden of RSV infection, hospitalization, and in-hospital death in older adults residing in LTCFs compared with those in the community. Design: Retrospective cohort study. Setting and participants: Monroe […]

Disproportionate Impact of Respiratory Syncytial Virus (RSV) Among Older Adults in Long-Term Care Settings

September 1, 2025 by Lea Efird-Green

Objectives: The full burden of respiratory syncytial virus (RSV) infection in the long-term care facility (LTCF) population is not well defined. This study aimed to quantify the burden of RSV infection, hospitalization, and in-hospital death in older adults residing in LTCFs compared with those in the community. Design: Retrospective cohort study. Setting and participants: Monroe […]

Primary Palliative Care in Assisted Living and Residential Care: A Metasynthesis

Aug 1, 2025

Assisted living (AL) and residential care (RC) settings are experiencing substantial growth as older adults with lower care needs seek alternatives to nursing homes. Despite this trend, there is a lack of skilled nursing care to support palliative care (PC) in these environments. Primary PC delivered by AL staff has emerged as a potential model […]

Primary Palliative Care in Assisted Living and Residential Care: A Metasynthesis

August 1, 2025 by Lea Efird-Green

Assisted living (AL) and residential care (RC) settings are experiencing substantial growth as older adults with lower care needs seek alternatives to nursing homes. Despite this trend, there is a lack of skilled nursing care to support palliative care (PC) in these environments. Primary PC delivered by AL staff has emerged as a potential model […]

Review of State Regulations Related to Environmental Sanitation in Long-Term Care Facilities

Aug 1, 2025

Background: We examined how state regulations for long-term care facilities address environmental sanitation. Methods: State regulations for nursing homes and assisted living facilities across all 50 US states and the District of Columbia were sourced from government Web sites. We searched using key terms about environmental sanitation and then quantified our findings to answer 4 […]

Review of State Regulations Related to Environmental Sanitation in Long-Term Care Facilities

August 1, 2025 by Lea Efird-Green

Background: We examined how state regulations for long-term care facilities address environmental sanitation. Methods: State regulations for nursing homes and assisted living facilities across all 50 US states and the District of Columbia were sourced from government Web sites. We searched using key terms about environmental sanitation and then quantified our findings to answer 4 […]

Emergency Department Care Coordination Program for Assisted Living Residents with Dementia: A Qualitative Study

Aug 1, 2025

Importance: Care transitions to the emergency department (ED) from assisted living centers (ALCs) for residents may include incomplete or inaccurate information during transfer. These transitions can be especially difficult for vulnerable populations, including persons living with dementia (PLWD). Objective: To assess perceptions of complex care managers (CCMs) implementing a care coordination program designed to improve […]

Emergency Department Care Coordination Program for Assisted Living Residents with Dementia: A Qualitative Study

August 1, 2025 by Lea Efird-Green

Importance: Care transitions to the emergency department (ED) from assisted living centers (ALCs) for residents may include incomplete or inaccurate information during transfer. These transitions can be especially difficult for vulnerable populations, including persons living with dementia (PLWD). Objective: To assess perceptions of complex care managers (CCMs) implementing a care coordination program designed to improve […]

Real-Time Fatigue and Physical Activity of Older Adults in Assisted Living: Feasibility of Ecological Momentary Assessment

Aug 1, 2025

Background: Fatigue is associated with decreased physical activity (PA) among older adults in assisted living (AL), but the direction of the relationship is unclear and may differ with mobility status. Objective: This study (1) assessed the feasibility and acceptability of measuring real-time fatigue and PA using ecological momentary assessment (EMA) and (2) described the temporal […]

Real-Time Fatigue and Physical Activity of Older Adults in Assisted Living: Feasibility of Ecological Momentary Assessment

August 1, 2025 by Lea Efird-Green

Background: Fatigue is associated with decreased physical activity (PA) among older adults in assisted living (AL), but the direction of the relationship is unclear and may differ with mobility status. Objective: This study (1) assessed the feasibility and acceptability of measuring real-time fatigue and PA using ecological momentary assessment (EMA) and (2) described the temporal […]

“There Should Be a Nurse on Call”: Complex Care Needs of Low-Income Older Adults in Medicaid-Supported Assisted Living

Aug 1, 2025

Background: In the United States, nearly 1 million older adults reside in assisted living facilities, which aim to provide support for safe, autonomous living. However, low-income residents, especially those in Medicaid-supported facilities, experience unmet medical and social complex care needs and limited serious illness communication due to limited resources. Objective: The objective of this study […]

“There Should Be a Nurse on Call”: Complex Care Needs of Low-Income Older Adults in Medicaid-Supported Assisted Living

August 1, 2025 by Lea Efird-Green

Background: In the United States, nearly 1 million older adults reside in assisted living facilities, which aim to provide support for safe, autonomous living. However, low-income residents, especially those in Medicaid-supported facilities, experience unmet medical and social complex care needs and limited serious illness communication due to limited resources. Objective: The objective of this study […]

Anxiety Among Workers in Institutions for Older Adults During the COVID-19 Pandemic

Aug 1, 2025

Objective: The present study examined the factors that predict anxiety in workers of institutions for older adults in Puerto Rico during the COVID-19 pandemic. Methods: Nine hundred nursing home and assisted living workers were assessed via self-administered questionnaires. Data were collected online from October 2020 to February 2021, during Puerto Rico’s third COVID-19 wave peak. […]

Anxiety Among Workers in Institutions for Older Adults During the COVID-19 Pandemic

August 1, 2025 by Lea Efird-Green

Objective: The present study examined the factors that predict anxiety in workers of institutions for older adults in Puerto Rico during the COVID-19 pandemic. Methods: Nine hundred nursing home and assisted living workers were assessed via self-administered questionnaires. Data were collected online from October 2020 to February 2021, during Puerto Rico’s third COVID-19 wave peak. […]

Yearlong Evaluation of Fall Risk Determinants Among 40 Older Adults in Two Residential Assisted Living Facilities

Aug 1, 2025

BACKGROUND Falls among the elderly, the second leading cause of death from unintentional injury globally, represent significant social and economic challenges. We evaluated the relationship between physical activity, physical performance, falls, and cognitive functioning at 1 year in 40 older adults living in 2 residential assisted living facilities in 2 communities in Wisconsin, USA. MATERIAL […]

Yearlong Evaluation of Fall Risk Determinants Among 40 Older Adults in Two Residential Assisted Living Facilities

August 1, 2025 by Lea Efird-Green

BACKGROUND Falls among the elderly, the second leading cause of death from unintentional injury globally, represent significant social and economic challenges. We evaluated the relationship between physical activity, physical performance, falls, and cognitive functioning at 1 year in 40 older adults living in 2 residential assisted living facilities in 2 communities in Wisconsin, USA. MATERIAL […]