Jean Krampe

Using Technology to Enhance Aging in Place

Integrated sensor networks have been installed in apartments of residents at TigerPlace, a retirement community helping residents age in place. Motion and bed sensor events have been logged continuously for over two years in some apartments. Using data from the sensor network, we have been investigating potential correlations to health events, such as falls, emergency room visits, and hospitalization, to identify patterns in the sensor data which might have offered some clues to predict the events. The long-term goal is to generate alerts that notify care givers of changes in a residents condition so they could intervene and prevent or delay adverse health events. In this paper, two case studies are presented. In each case, the sensor network detected changes in the residents condition that were not detected by traditional health care assessment.

Dance-Based Therapy in a Program of All-inclusive Care for the Elderly: An Integrative Approach to Decrease Fall Risk

BackgroundLoss of balance and diminished gait are major fall risk factors in older persons. Literature suggests that physical activity based on dance may improve balance and gait. The aim of this pilot study was to determine whether dance-based therapy affects the balance/gait of community-based frail seniors. Conceptual FrameworkThe Roy Adaptation Model and Environmental Press Theory were used as joint frameworks. ParticipantsEleven participants were recruited from a Program of All-inclusive Care for the Elderly (PACE). Inclusion criteria were (1) Mini-Mental State Examination score of 23 or more, (2) attending PACE on Monday, Wednesday, and Friday, and (3) able to stand with or without assistance. MethodsA Lebed Method dance intervention was conducted using a longitudinal design 3 times a week for 6 weeks. Functional Reach and Timed Get Up and Go were measured at baseline, 6 weeks after the start of the intervention, and 6 weeks postintervention and repeated to estimate the persistence of the effect. ConclusionsGraphs were compared looking for functional trends; postintervention interviews were conducted with each subject. ImplicationsDance therapy results in positive functional trends, suggesting that further study using dance-based therapy will be useful to decrease fall risks in older persons.

Exploring the Effects of Dance-Based Therapy on Balance and Mobility in Older Adults:

Balance and mobility are a common concern among older adults. This pilot randomized controlled study examines the effect of dance-based therapy to increase balance and mobility in 27 participants with mean age 85 years (±7.5) from a single aging-in-place facility in the Midwest. Multidirectional reach, velocity, step length differential, and a Functional Ambulation Profile were measured before and after 18 sessions of low-impact dance-based therapy. Although a Wilcoxon rank sum test showed no significance, effect size analyses suggest that dance-based therapy was mildly or moderately effective in several components of balance and mobility. Additional research is needed with a full-scale trial.

Development of an online orientation course for preceptors in a dedicated education unit program.

The dedicated education unit (DEU) is an emerging model of nursing education. Instead of an instructor-led clinical group, students are partnered with a unit staff nurse for precepted learning. These experiences in learning typically begin with early clinical courses. Precepting nursing students in a DEU is different from precepting newly hired staff nurses and traditional clinical students. This article describes the DEU model implemented at one university, the challenges associated with preparing staff nurses to precept nursing students, the development of a face-to-face DEU preceptor orientation, and progression to an innovative online orientation course.

Nighttime Restfulness During Daytime Dance Therapy An Exploratory Study Using Bed Sensors

Dance-based therapy has the potential to slow the progression of functional limitations in older adults. The purpose of this study was to explore the feasibility of measuring the impact of dance-based therapy on the nighttime restfulness patterns of older adults in an aging-in-place facility using passive bed sensors. A secondary data analysis of the continuous 2-month nighttime bed sensor data was reviewed for measurable change during a dance study. A measurable variation in nighttime restfulness level was detected between the dancers and nondancers, and no high or very high restlessness was detected during this period for the dance-based therapy group. Although these exploratory variations are modest, the findings suggest that bed sensors can be used to measure nighttime restfulness following a therapeutic dance intervention. More research is needed in this emerging area.

Does dance-based therapy increase gait speed in older adults with chronic lower extremity pain: A feasibility study

A decreased gait speed in older adults can lead to dependency when the individuals are no longer able to participate in activities or do things for themselves. Thirty-seven senior apartment residents (31 females; Mean age=80.6 years; SD=8.9) with lower extremity pain/stiffness participated in a feasibility and preliminary efficacy study of 12 weeks (24 sessions). Healthy-Steps dance therapy compared to a wait-list control group. Small improvements in gait speed ([ES]=0.33) were noted for participants completing 19-24 dance sessions. Improvements in gait speed measured by a 10 Meter Walk Test (0.0517 m/s) exceeded 0.05 m/s, a value deemed to be meaningful in community dwelling older adults. These feasibility study findings support the need for additional research using dance-based therapy for older adults with lower extremity pain.

Dance mobility: a somatic and dance programme for older adults in New Zealand

This article describes the significance of Dance Mobility™, a new community dance programme that follows a New Zealand partnership research project, designed for older adults with diverse motor skill levels and dance experiences. The programme includes high-functioning older adults, some with sensory or balance impairments and others with Parkinsons disease. We discuss the benefits and challenges of facilitating a once-weekly dance practice model and the ways the programme affects individuals’ sensorial states of well-being and awareness. Somatic practices are introduced as integral to Dance Mobility™ teaching methods and dance activities. We include observations and comparisons with dance embodiment theories, cross-disciplinary goals of gerontology and exercise science/rehabilitation research to debate benefits and limitations of dance for older adults, and adaptive methods of the Dance Mobility™ approach. Somatic research is needed to build evidence-based conclusions that advance older adults’ feelings of well-being and safeguard their motivations to continue moving freely.

A model of risk reduction for older adults vulnerable to nursing home placement.

Because of the cost of nursing home care and desire of older adults to stay in their homes, it is important for health care providers to understand the factors that place older adults at risk for nursing home placement. This integrative review of 12 years of research, as published in 148 articles, explores the risk factors for nursing home placement of older adults. Using the framework of the vulnerable populations conceptual model developed by Flaskerud and Winslow (1998), we explored factors related to resource availability, relative risks, and health status. Important factors include socioeconomic status, having a caregiver, the availability and use of home- and community-based support services, race, acute illness particularly if hospitalization is required, medications, dementia, multiple chronic conditions, functional disability, and falls. Few intervention studies were identified. Development of evidence-based interventions and creation of policies to address modifiable risk factors are important next steps.

Shall we skype dance? Connecting nursing students with older adults via skype for dance-based therapy.

Clinical training sites are scarce and require resourceintensive coordination to accommodate student needs and minimize clinical partner burden. Nurse educators can explore and replicate medicine’s successes using innovative technology such as telehealth in nursing education. The purpose of this article was to report a process used to introduce nursing students to a group of older adults using video call technology during a dance-based therapy session. To the authors’ knowledge, this is the first time Skype has been used to facilitate a clinical experience with second-year nursing students and older adults.

Building Evidence: Fuze Versus Skype for Dance-Based Therapy With Older Adults and Nursing Students.

KEY POINTS: Innovative telehealth programs for older adults can provide cost-effective therapeutic activities and engage nursing students. Video conferencing software needs feasibility testing. Fuze has the potential to connect two locations for a dancebased therapy session with better audio and visual quality than Skype. T he use of telehealth has greatly increased in the last decade. Although used effectively today in medicine, opportunities for nurse-led programs are still emerging. Likewise, the evidence of the clinical benefits of synchronous video conferencing communication tools is not known. Potential technology for healthcare must be initially evaluated for feasibility. This article reports a program evaluation of Fuze video conferencing software (Fuze, Cambridge, MA) connecting nursing students with an older adult population during a therapeutic dance-based activity. To our knowledge, this is the first time Fuze has been used in this capacity. This program evaluation builds on lessons learned following a therapeutic dance-based project using Skype (Microsoft, Redmond,WA) with nursing students and older adults. Recommendations for improving dance-therapy sessions via Skype were the need for (1) audio improvements, (2) visual improvements, and (3) greater engagement between the older adults and nursing students.