Telehealth has great potential for providing timely and comprehensive care to community-dwelling older adults while reducing their barriers to healthcare access. The purpose of this study is to understand how older adults with chronic diseases access healthcare services in their community and evaluate the impact of telehealth on access to care from a self-reported survey conducted in British Columbia. About a quarter of older adult participants reported barriers to healthcare access in their community. Participants frequently reported financial barriers to healthcare access regardless of telehealth use. In addition, telehealth users more frequently reported a lack of necessary healthcare services in their community and physical barriers to access to care. Although the findings did not demonstrate a significant difference in access to care between telehealth users and nonusers, telehealth was identified as a meaningful care delivery tool for older adults with barriers to healthcare access. Further efforts are needed to implement a valid tool for ongoing evaluation and optimization of telehealth and integrate telehealth into clinical and community programs to reduce physical and financial barriers to healthcare access for community-dwelling older adults with chronic illnesses. / Graduate

Technology development in the sub-field of older adult care has always been on the back-burner compared to other healthcare areas. But with increasing life expectancy, this is poised to change. With the increasing older adult population, the current older adult care facilities and personnel are struggling to keep up with demand. Research conducted in the Netherlands [1] found 33,000 older adults were awaiting admission into a home for the elderly showing that demand far exceeds availability. This huge demand for older adult care has resulted in a decrease in the quality of care being provided. A recent study involving older adults aged 65 and above [2] compared the quality of care given to older adults in nursing homes in the UK and found it to be inadequate. While it is true that giant strides have been made in the field of personal health and fitness [3], we have to acknowledge that these technologies have not found widespread adoption in the elderly communities for a number of reasons which include lack of education, cognitive impediments, low-income and techno-phobia [4]. We believe that older adult care technologies should be approached from a different perspective in order to maximize outcomes. Inventions in the health care space are a moving target and a significant degree of technical aptitude and interest is required to keep up with these changes. My research work will be focused on developing a distributed system infrastructure that will enable large-scale monitoring of vital signals and early detection of emergency situations in nursing homes and assisted living communities. This new approach will increase automation in nursing homes leading to a reduction in running cost and an increase in capacity

No / Reducing hospital admissions of older adults with ambulatory care sensitive conditions is a government priority. Yet relatively little is known about current health care practice in UK nursing homes. We studied approaches to developing understanding of current health care practices in UK nursing homes using a methodology of data-extraction from retrospective care home records combined with key informant interviews. Older adults with an exacerbation of one of 4 ambulatory sensitive conditions that warranted decision making around admission to hospital or continued primary-care led nursing home care were 178 identified and recruited for participation. Care home records were examined using a proforma for data-extraction. These data were combined with care-plans to construct a brief care narrative. The relevant progress notes/daily record of care-given at the time of the decision making were used to construct a visual time-line of events. For those participants who consented, the key multiple stake holders in care were identified: non-professional carers, care-home workers, caring professionals and care-managers. These data were used to generate supplementary trigger questions and topics for semi-structured interviews. This enabled questions raised by the care record to be identified and explored. Implications of the findings for practice and research will be discussed. / NIHR