Ahead of print articles
JNHR, Volume 12, 2026
INCIDENT DEPRESSION IN RELATION TO CONTEXTUAL ISOLATION AMONG ESTABLISHED LONG-STAY RESIDENTS OF US NURSING HOMES
B.M. Jesdale, Y. Yuan, N.N. Nielsen, K.L. Lapane
Jour Nursing Home Res 2026;12:1-10
Show summaryHide summaryBACKGROUND: The U.S. Surgeon General recently put renewed focus on loneliness and isolation as fundamental determinants of health.
OBJECTIVE: To estimate the incidence of depression among established long-stay residents in relation to contextual isolation.
DESIGN: Retrospective cohort study.
SETTING: US nursing homes.
PARTICIPANTS: 490,523 residents who lived in the same home for at least one year between 2010 and 2019.
MEASUREMENTS: Using data from the Minimum Data Set 3.0, we identified residents who were newly diagnosed with depression. We assessed contextual isolation for each resident with regard to 31 socially salient characteristics relative to their co-residents.
RESULTS: The incidence proportion of diagnosed depression from 3-12 months was 21.3% among residents not contextually isolated, 21.0% among residents contextually isolated on a single characteristic, and 22.2% among residents contextually isolated on multiple characteristics. After adjustment for several potential effect modifiers (gender, age group, race/ethnicity, use of translation services), the 3-12 month incidence proportion was 8% higher among residents experiencing contextual isolation on multiple characteristics (95% confidence interval 6% to 10%).
CONCLUSION: Contextual isolation modestly increases the risk of newly diagnosed depression among long-stay residents after they have settled into the nursing home setting. Entry to a nursing home represents an opportunity to make new connections. Helping residents make novel connections may be particularly important for residents whose background or other socially salient characteristics leave them as outsiders to the mainstream of a given nursing home.
CITATION:
B.M. Jesdale ; Y. Yuan ; N.N. Nielsen ; K.L. Lapane ; (2026): Incident Depression in Relation to Contextual Isolation among Established Long-stay Residents of US Nursing Homes. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2026.1
BODY ODOUR IN INSTITUTIONALISED OLDER ADULTS: PERSPECTIVES OF FEMALE CAREGIVERS IN HONG KONG NURSING HOMES
H.Y.K. Tong, S.Y.C. Yue, J. Woo, H.H. Fung, Y. Cheng, H. Chen, A. Kleinman
Jour Nursing Home Res 2026;12:11-15
Show summaryHide summaryBACKGROUND: Body odour in older adults is a complex phenomenon that remains under-explored in nursing home and geriatric care settings. While age-related odour cues are biologically and socially significant, their implications for caregiving practice, resident dignity, and care quality require further investigation.
METHODS: A qualitative descriptive study was conducted between August and November 2023 in a licensed private nursing home in Hong Kong. Ten female caregivers were purposively sampled, and participated in individual semi-structured interviews covering four domains: odour perception, association with medical conditions, association with functional status, and management strategies. Caregivers rated separately the odour intensity (1-10) of residents with reference to the Katz Index of Independence in Activities of Daily Living. Data were analysed using deductive thematic analysis, and ratings were summarized descriptively.
RESULTS: Caregivers described residents’ body odour as noticeable with words such as “strong” or “musty”, yet did not express dehumanising or rejecting attitudes, reflecting professional habituation and emotional coping. Odour intensity was closely linked to functional dependency, particularly limitations in bathing and continence, and was interpreted as a clinical cue for conditions such as diabetes, chronic wounds, and poor oral hygiene. In the absence of formal training or institutional protocols, odour management relied on routine hygiene care and peer support. Caregivers also perceived that body odour contributed to stigma and ageist stereotypes among visitors and the wider community.
CONCLUSIONS: Frontline female caregivers in Hong Kong use body odour as a non-verbal indicator of health and functional status in older residents, despite limited organisational recognition or guidance. Findings support the integration of olfactory assessment and evidence-based odour management into geriatric training and care policies to promote dignified and age-inclusive care.
CITATION:
H.Y.K. Tong ; S.Y.C. Yue ; J. Woo ; H.H. Fung ; Y. Cheng ; H. Chen ; A. Kleinman ; (2026): Body Odour in Institutionalised Older Adults: Perspectives of Female Caregivers in Hong Kong Nursing Homes. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2026.2