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Open research questions in Geriatric Care and Nursing Homes

306 unresolved questions extracted from the limitations and future-work sections of 5,635 Geriatric Care and Nursing Homes papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • A notable limitation concerns the unequal distribu- tion across care settings: while the study included nurses from hospitals, nursing homes, and home-based nursing services, hospital-based nurses were substantially over- represented (n = 17), with only three participants from nursing homes.

    Structural determinants in quality of care for older adults: a nursing perspective on medical services - qualitative findings from focus group discussions in Germany · 2026 · DOI

  • The validation pathway is staged. First, the eight-week feasibility pilot described in Section 8: burden, completion rates, indicator clarity, score distributions, and the behaviour of the N/A logic in practice. Second, reliability work: inter-rater agreement between the carer and supervisor columns, and stability of the family instrument. Third — the substantive question — concurrent validity against the outcome layer: whether EI trajectories correlate over time with movement on ASCOT-Proxy-Resident or DEMQOL-Proxy administered at baseline and endpoint, which would test the leading-indicator claim that justifies the architecture’s existence. Fourth, calibration studies for weights, bands, and the divergence threshold. The author’s position is that the framework should be adopted only as far as this pathway supports; the paper’s purpose is to place the design and its rationale on the record so that the testing can be done by anyone, anywhere the design fits.

    A Shift-Level Architecture for Person-Centred Dementia Care: The Care Delivery Framework and Engagement Index · 2026 · DOI

  • ARTICLE IN PRESS ARTICLE IN PRESS 15 This review was strengthened by adherence to JBI methodological guidance, including systematic database and grey literature searches, independent dual screening, and structured data extraction, as well as use of qualitative content analysis and equity frameworks to guide synthesis. Mapping evidence across six publicly funded systems enabled identification of recurring patterns that would not be visible in single-country analyses, and inclusion of policy and programme documents extended coverage beyond peer-reviewed studies. The limitations primarily reflect the underlying evidence base. The database searches were conducted without language restrictions; however, the grey literature search used English-language search strings and relied on English language or translatable government websites, which may have constrained retrieval of non-English policy documents. The included evidence was unevenly distributed across countries and was weighted toward older and descriptive accounts; few outcome-focused studies were published after 2019, particularly for Canadian and Danish models. Because eligible sources were required to include older adults supported by an unpaid caregiver, the review may underrepresent the perspectives of older adults receiving home care without informal caregiver support. In accordance with JBI scoping review methodology, study quality was not appraised.

    Models of publicly funded home care for community-dwelling older adults across six high-income health systems: a scoping review · 2026 · DOI

  • Expected outcomes The review will identify key determinants of successful implementation, highlight gaps in the evidence, and provide actionable insights for LTC administrators, early childhood partners, and policymakers seeking to develop sustainable, equitable co-located childcare programs that benefit residents, children, and staff.

    Barriers and facilitators to implementing childcare in long-term care homes: A scoping review protocol and consultative exercise · 2026 · DOI

  • Background and ObjectivesSkilled nursing facility (SNF) hospitalization rates vary substantially across facilities serving comparable patient populations, yet the organizational factors underlying high performance remain poorly characterized.

    Faith Affiliation and Nursing Home Hospitalization Performance: Evidence from a National Stratified Sample · 2026 · DOI

  • This study is not intended to produce statistically generalisable findings. The sample size (n = 26) is modest and geographically concentrated in a single London borough. Participants were self-selecting and may reflect individuals more willing or able to narrate their experiences. Moreover, while the age range was broad, the sample may not fully represent the diversity of experiences across ethnicity, disability, or digital exclusion. However, the value of this research lies precisely in its attention to individual voice. Each narrative offers a window into how care is experienced in time, space, and memory, insights rarely captured by audit tools or standardised metrics. While limited in scale, the findings reveal emotional and relational patterns that resonate far beyond individual cases. They speak to structural vulnerabilities in the care system and to the universal human need for recognition, connection, and dignity in later life. As with most qualitative and narrative research, the aim here is not statistical generalisability but analytical transferability. The experiential concepts identified, such as waiting, relational continuity, narrative dignity, and temporal disruption, can inform comparative analysis and be applied to understanding home care contexts beyond this specific locality. These findings therefore offer interpretive insights that may resonate across diverse welfare regimes and ageing-in-place initiatives internationally. 12 International Journal of Ageing and Later Life Findings: Oral Histories of Domiciliary Care in Bexley, UK The thematic narrative analysis surfaced a nuanced and emotionally layered portrait of domiciliary care as experienced by older adults in Bexley, London, UK. Drawing on oral history interviews (Bornat 1989; Portelli 1991), the aim was not merely to extract data, but to co-produce situated accounts of care grounded in memory, emotion, and embodied experience. Participants narrated care not as a neutral service, but as a dynamic and relational encounter, shaped by temporality, loss, recognition, and the emotional geographies of the home. Each story represents more than an account of ageing or dependency; rather, it refracts broader themes of identity, dignity, vulnerability, and relational autonomy. Through these testimonies, the ways in which care is lived, negotiated, and at times resisted within the fragile intimacies of everyday life are illuminated. Temporal Disruption, Anticipation, and the Rhythm of Waiting For many participants, time itself was not simply a backdrop to care but a central component of how care was lived, negotiated, and emotionally absorbed.

    “Behind every visit is a life, my life”: Listening to home care recipients through oral history · 2026 · DOI

  • The invitation to participate in the study was sent to 42 persons, and as only 20 chose to participate, that needs to be considered when interpreting the results. Also, only two of the 20 panelists were men. This was certainly the case because healthcare sector is a female-dominated work field and most of the panelists worked in connec- tion to that field. The same gender distribution is also assumed to exist among people who did not consent to the study. On the other hand, the spread in terms of orga- nizational level was wide, from specialist assistant nurse to operational manager, and to different professions. Among the panelists, there were also a few people with an indirect connection to the field, such as those active within the Volunteer Center and case managers at the municipality. This spread among participants can be seen to balance the low response rate and gender distribution. Although some guidelines suggest a minimum of 30 participants for robust statistical analysis, Delphi litera- ture widely supports panel sizes between 15 and 30 when the focus is on specialized expertise rather than statisti- cal representativeness [35, 36]. However, the sample size of 20 in this study constitutes a limitation for the quan- titative analysis. In a panel of this size, each respondent accounts for 5% of the total variance, making descriptive Söderman et al. BMC Geriatrics (2026) 26:771 Page 10 of 11 statistics such as means and percentage thresholds sensi- tive to individual outliers. Consequently, the quantitative results should be interpreted as an indicator of consensus within this specific panel, rather than statistically gener- alized results. The panelists seem to have considered the topic of the study important, and it engaged them given that the response rate was 100% between the three response rounds. A few of the thematized statements about the older people’s conditions for remaining in ordinary hous- ing and working methods to support that achieved con- sensus according to the usual lowest level, i.e., 75% which is not a usual limit within the Delphi methodology, but on the other hand, the results showed that all the thema- tized aspects occur to some degree. This study was conducted in a smaller Swedish city, which means that it may not be transferable to all con- texts. However, this study is an important contribution as it raises the current issue of challenges and opportuni- ties for the aging population who wish to remain in their homes.

    Swedish stakeholders’ attitudes towards challenges and opportunities regarding support efforts to older persons’ conditions for living with a high quality of life in ordinary housing: a panel study · 2026 · DOI

  • Several limitations should be acknowledged. The single-site, retrospective design limits generalizability and prevents causal inference. The eight month study period may not capture seasonal variation in housing needs or CBO capacity. Administrative data lacked detailed demographic and clinical information, preventing analysis of health equity impacts and high risk subgroups. The small qualitative sample (n=7 staff) may not reflect all perspectives, and the study assessed referral connections rather than long-term housing outcomes. Finally, we could not assess member satisfaction or whether connected members ultimately received housing placements.

    Systematic Analysis of Housing Referral Outcomes in New York City's WholeYouNYC Social Care Network: Identifying Barriers to Service Connection · 2026 · DOI

  • Future research should include longitudinal evaluation following intervention implementation (12-18 months post-intervention), comparative analysis across New York City’s nine regional SCNs to identify best practices, and qualitative research with CBO partners and members to understand non response and engagement barriers. Analysis of member level demographic and clinical data would enable health equity assessment, and expansion to other service categories (food, transportation, benefits enrollment) would reveal whether identified bottlenecks are housing specific or generalizable across social care domains. Cost effectiveness analysis of workflow improvements and long-term housing stability outcomes would strengthen the business case for investing in social care coordination infrastructure.

    Systematic Analysis of Housing Referral Outcomes in New York City's WholeYouNYC Social Care Network: Identifying Barriers to Service Connection · 2026 · DOI

  • Based on the findings of this meta-analysis, which demonstrate a significant and consistent positive impact of personalized care approaches on the well-being of elderly residents in nursing homes, several evidence-based recommendations are proposed to enhance practice, policy, and future research. First, nursing homes are strongly encouraged to adopt and institutionalize person-centered and individualized care models as a core standard of service delivery rather than as optional or supplementary practices. This includes developing structured individualized care plans that reflect residents’ preferences, life histories, cultural backgrounds, and psychosocial needs. Care routines should be made flexible to allow residents greater autonomy in daily UKR Journal of Medicine and Medical Research (UKRJMMR). Published by UKR Publisher 45 activities, decision-making, and participation in meaningful engagements. and development Second, there is a critical need to strengthen staff in professional competencies personalized care. Training programs should focus on communication skills, empathy, relational care, and the practical application of person-centered approaches.

    Caring Beyond Routine: A Meta Analysis on The Impact of Personalized Care Approaches on The Well-Being of Elderly Residents in Nursing Homes · 2026 · DOI

  • Estimates of dementia prevalence in Indonesia widely vary between studies (9–28%), and little is known about the awareness and perception of dementia and the care networks around those living with (suspected) dementia.

    Dementia Care in Indonesia: Care Networks, Awareness & Perception · 2025 · DOI

  • OBJECTIVE: Australia has been undergoing a major aged care reform process since 2012 focused on consumer-oriented home and community-supported care, but little is known about the impact of these reforms on residential aged care delivery.

    The quality of residential aged care in the context of the Australian aged care reforms: A scoping review · 2024 · DOI

  • Yet, LTC homes lag behind other healthcare organizations in HIT adoption, and little is known about the factors that inform and shape LTC home managers' decisions.

    Factors Affecting Managers’ Technology Adoption Decisions in Long-Term Care Homes: A Canadian Exploratory Study Post–COVID-19 Pandemic · 2024 · DOI

  • Limited research exists on the effectiveness of the NV state statutes on ensuring habitability and access to essential services, and the characteristics of environmental hazards found in Clark County, NV renter-occupied units (ROUs).

    Environmental hazards and likelihood of mitigation in renter-occupied housing units in Clark County, Nevada · 2024 · DOI

  • Four key categories of outcomes were observed: (1) significantly improved engagement; (2) significantly improved mental health outcomes, including affect, depression, agitation, excessive eating and psychotropic medication prescriptions; (3) significantly improved feeding difficulty but mixed results regarding nutritional status; and (4) no significant changes in the activities of daily living and quality of life of individuals with dementia.

    The impact of montessori-based programmes on individuals with dementia living in residential aged care: A systematic review · 2023 · DOI

  • Despite this policy effort, the prevalence of SMI in NHs has continued to increase, and little is known about the mechanisms driving the heterogeneous and suboptimal administration of the PASRR program, absent routine evaluative efforts.

    Serious Mental Illness in Nursing Homes: Stakeholder Perspectives on the Federal Preadmission Screening Program · 2022 · DOI

  • Participants reported (1) establishing home health services is complex, requiring collaboration between many individuals and systems; (2) communication between medical teams and agencies is often reactive; (3) formal communication channels between medical teams and agencies are lacking; (4) aides are an important source of patient information; and (5) aides report important information, but rarely receive it.

    Improving Care Coordination Between Veterans Health Administration Primary Care Teams and Community Home Health Aide Providers: A Qualitative Study · 2022 · DOI

  • CLINICAL RELEVANCE: Many persons with dementia and their surrogates have limited knowledge about ACP; thus, more nurse-led ACP programs that reflect dementia stages may help them prepare for the situations in which persons with dementia lack decision-making capacity.

    Characteristics of Advance Care Planning Interventions Across Dementia Stages: A Systematic Review · 2021 · DOI

  • Speech-language pathologists (SLPs) are the most qualified individuals to educate CNAs about residents' communication behaviors; however, there is limited literature that outlines specific, evidence-based procedures for CNAs and residents in the LTC environment.

    Positive Culture Change in Long-Term Care: A Procedure to Enhance Speech-Language Pathologist–Certified Nursing Assistant Collaboration · 2019 · DOI

  • Access to state programs — such as Medicaid — that meet the needs of those living with intellectual or developmental disabilities and enable those with disabilities to live and work independently vary widely by state, according to the Case for Inclusion 2019 report released by United Cerebral Palsy and the ANCOR Foundation.

    Independent living, working varies widely by state · 2019 · DOI

  • Recent studies have reported that CBHH programs carry fewer costs and have greater patient satisfaction compared to equivalent traditional inpatient hospitalizations; however, studies on the organizational aspects of implementing CBHH are scarce.

    Management of Community-Based Home Hospitalization (CBHH) in Israeli Public Health System · 2019 · DOI

  • Because VHA has lagged behind Medicaid more generally in terms of investment in these types of services, additional strategies are warranted to achieve the important policy goal of deinstitutionalizing VHA care and returning veterans to their homes in the community.

    Barriers to a Timely Discharge From Short-Term Care in VA Community Living Centers · 2019 · DOI

  • In 2014, more than 800,000 older adults reside in assisted living communities (ALCs) in the United States, yet few studies have examined whether state licensure inspection and citation information can be used to help consumers infer quality in choosing facilities.

    Using Deficiency Data to Measure Quality in Assisted Living Communities: A Florida Statewide Study · 2019 · DOI

  • Despite this, the relationships between nursing staff coverage, care hours, and quality of resident care in LTC facilities are not well understood and have implications for policy-makers.

    Nursing Staff Time and Care Quality in Long-Term Care Facilities: A Systematic Review · 2019 · DOI

  • BACKGROUND AND OBJECTIVES: Despite acknowledged benefits of residents in nursing homes spending time outdoors, little is known about factors related to their use of outdoor space.

    Understanding the Barriers and Enablers to Using Outdoor Spaces in Nursing Homes: A Systematic Review · 2019 · DOI

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306 open questions have been extracted from the limitations and future-work passages of 5,635 Geriatric Care and Nursing Homes papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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