New guidelines help long-term care communities support residents’ intimacy and dignity

Practical framework offers staff clear guidance on consent, communication, and person-centered care

Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research

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Intimacy doesn’t disappear in long-term care, but clear guidance on how to support it often does. A new paper outlines a practical framework for how organizations can move from uncertainty and inconsistency to a structured, ethical approach that respects residents’ autonomy while protecting their safety. At the heart of the model is the creation of a dedicated Sexual Health Committee, a multidisciplinary team charged with developing policies, guiding staff, and helping communities navigate one of the most sensitive — and often avoided — aspects of care.

Entitled “Enhancing Sexual Well-Being in Long-Term Care: A Framework for Effective Guidelines,” and published in Annals of Long-Term Care, the framework begins by establishing a Sexual Health Committee that brings together professionals across disciplines to lead this work. The Sexual Health Committee’s mission is clear: to support healthy sexual expression for all residents, including those with cognitive impairment, within well-defined ethical and professional boundaries.

Those boundaries are explicit to ensure that resident rights are balanced with safety and professional standards.

The paper’s primary focus is on helping organizations build their own approach. The authors encourage organizations to adapt the Sexual Health Committee model and resulting guidelines to their specific population, culture, and resources.

It lays out a process other communities can follow, with three core pillars:

1. Ground the work in values, laws, and ethics.
   Before drafting policies, organizations are encouraged to define their cultural values and align them with state and local regulations, and the ethical codes of clinical and caregiving professions. This ensures that any guidelines are both compliant and consistent with the organization’s identity.
2. Develop clear, standardized policies and procedures.
   The Sexual Health Committee then translates those principles into practical guidance — creating written policies that address real-world situations, reduce ambiguity, and support consistent decision-making across staff.
3. Educate, apply, and adapt.
   Training is essential to making the framework work. Staff are taught how to apply the guidelines in practice, including how to assess consent and respond appropriately. The Sexual Health Committee also serves as an ongoing resource, helping teams navigate complex cases and refine policies over time.

“Intimacy and connection remain important parts of life, even in long-term care,” said Rachael F. Arielly, PsyD, a psychologist specializing in geropsychology at Hebrew Rehabilitation Center and a co-author of the paper. “This framework is designed to help organizations create thoughtful, consistent approaches that reflect their values, support residents, and give staff the guidance they need.”

For residents and families, these guidelines reflect a shift toward more person-centered care that recognizes sexual well-being as part of overall quality of life. By promoting healthy sexual expression and establishing clear, consistent guidelines, communities can better support residents’ rights while helping staff navigate complex situations in a way that is both respectful and appropriate.

In addition to Arielly, co-authors included Nathalie Huitema, PhD, a clinical sexologist and Certified Sexuality Educator, and Sarah J. Rogers, LICSW, a clinical social worker and certified sex therapist.

About Hebrew SeniorLife
Hebrew SeniorLife is a national leader working to create a world where aging is defined by possibility, not limitation. We care for more than 4,500 older adults each day across seven campuses throughout Greater Boston, and offer support for families in the aging journey. Our services include in-home care, outpatient therapies, an outpatient memory clinic, short- and long-term inpatient care, hospice, independent and assisted living, and affordable housing with services. We conduct influential research on aging at our Hinda and Arthur Marcus Institute for Aging Research, which has a grant portfolio of $87 million, and train future health care workers at the Lunder CareForce Institute. Hebrew SeniorLife is a Harvard Medical School affiliate. Follow us on our blog, Facebook, Instagram, and LinkedIn.

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Journal

Annals of Long-Term Care Clinical Care and Aging

DOI

10.25270/altc.2026.31.002 

Method of Research

Commentary/editorial

Subject of Research

People

Article Title

Enhancing Sexual Well-Being in Long-Term Care: A Framework for Effective Guidelines

 

New study gives voice to older homeless women navigating streets and shelters

Boston University

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For women in their 50s experiencing homelessness, daily life means far more than finding a place to sleep. It means navigating dangerous shelter environments, managing serious health conditions without adequate support, and fighting to maintain dignity in a system that was never designed for them. A new study by Boston University School of Social Work (BUSSW) Professor Judith Gonyea puts their experiences at the center.

Published in Frontiers in Global Women’s Health, the study was co-authored by Professor Gonyea and Kelly Melekis of the University of Vermont. Their research examines how older women experiencing homelessness navigate life on the streets and in emergency housing shelters, and how those environments affect their physical and emotional well-being, their sense of self-worth, and their path toward stable housing.

A Population Falling Through the Cracks

Women in their 50s experiencing homelessness occupy a particularly precarious position. Too young to qualify for federal old-age benefits and typically without minor-age children, they often fall between the targeted populations that safety net programs are designed to serve. At the same time, due to poor nutrition and harsh living conditions, many experience accelerated aging, presenting with chronic health conditions more commonly seen in housed women in their 70s and 80s.

Although one of the fastest-growing groups within the homeless population globally, older women experiencing homelessness have remained largely absent from research and policy conversations. This BUSSW study seeks to change that.

What the Research Found

Professor Gonyea and Melekis conducted in-depth interviews with 15 women in their 50s experiencing homelessness in an urban northeastern U.S. city. The majority identified as women of color. Trauma was nearly universal among participants, and most were managing significant physical and mental health challenges.

Five key themes emerged from the interviews, each reflecting how shelter environments intensify the daily struggles these women face. Participants described shelters as dehumanizing places where they were reduced to a bed number rather than recognized as individuals.

They reported feeling unsafe, often describing shelter life as akin to prison, requiring constant hypervigilance to protect themselves from bullying, theft and potential violence. Many found the harsh physical conditions of shelters, including bunk beds ill-suited to older bodies, limited privacy and inadequate resources, to be in direct conflict with their health needs. Rigid rules and protocols left women feeling stripped of control and autonomy. And the absence of stability and normalcy, from unpredictable daily schedules to compulsory daytime displacement onto the streets, wore heavily on their sense of self and hope for the future.

Despite these challenges, the women demonstrated remarkable resilience and resourcefulness, finding creative ways to maintain their appearance, preserve their belongings, and hold onto a sense of identity beyond homelessness.

Why This Matters

The findings point to an urgent need to transform both the physical and social environments of emergency housing shelters using trauma-informed and aging-responsive approaches. The authors call for shelters to move away from authoritarian, one-size-fits-all practices and toward models that recognize the distinct needs of older women, including those related to health, trauma, safety and dignity.

As the number of older adults experiencing homelessness continues to grow, Gonyea and Melekis state that older women must no longer be invisible in research, policy or practice. Their voices and their experiences must be part of the solution.

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Journal

Frontiers

DOI

10.3389/fgwh.2026.1697164 

Method of Research

Survey

Subject of Research

People

Article Title

Walk in our shoes: older homeless women's perceptions of the challenges of navigating streets and shelter life

 

Moderate UV light is best to boost the vitamin D content of edible mushrooms, McGill study finds

Up to half the world’s population suffers from a deficiency of this critical nutrient

McGill University

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Researchers at McGill University have discovered that moderate ultraviolet (UV) light exposure is best when the technique is used to enhance vitamin D₂ in edible mushrooms. Excessive exposure leads to nutrient degradation or a plateau effect, they found. The paper also provides quantitative guidance. 

The researchers’ work supports efforts to address vitamin D deficiency, which affects between 30 and 50 per cent of the world’s population, as well as enhance the nutritional value of mushrooms more broadly. 

“While many studies demonstrated that UV could improve mushroom nutrition, there hasn’t been a standardized or optimized set of conditions that researchers and industry can reliably follow,” said Valérie Orsat, Professor of Bioresource Engineering and study co-author.  

“Our findings highlight a clear gap: the need for species-specific and unified UV treatment guidelines. These should define safe and effective ranges that consistently enhance nutrients like vitamin D₂ without compromising quality attributes such as texture, colour or overall consumer appeal,” she said. 

Regulatory bodies like the U.K. Food Standards Agency and Food Standards Scotland have confirmed that UV-treated mushroom products are safe for consumption. Human studies have already shown that consuming UV-treated mushrooms can increase vitamin D levels, confirming their nutritional benefit. 

Meta-analysis fills in the gaps 

Previous research on this topic has shown significant variability in factors such as UV intensities, exposure times and treatment setups used across studies, often leading to inconsistent outcomes.  

In this study, the researchers conducted a meta-analysis of 22 studies published between 2020 and 2025. They gathered and analyzed key variables such as UV intensity, exposure time, dose, mushroom form (sliced or whole) and resulting vitamin D₂ levels, and applied a response surface analysis – a statistical modelling technique – to map how these variables interacted.  

This approach allowed them to identify the safe and optimal treatment zone, the conditions that maximized vitamin D₂ while maintaining mushroom quality, for each species. 

“In short, we moved beyond individual studies to build a data-driven, unified picture of what works best,” Orsat said. 

Blue and green light to be considered 

Soon, the team will begin exploring how different types of light, such as blue and green light, can be used individually or in combination with UV to enhance a broader range of desirable compounds found in mushrooms. 

“Future research is shifting toward a more integrated approach, using strategically programmed light treatment from cultivation through post-harvest and storage,” said Augustine Edet Ben, study co-author and a McGill PhD student. “The idea is to develop synergistic light treatments that not only boost vitamin D₂, but also improve other nutrients, bioactive compounds and overall quality through storage and retail display.” 

“Ultimately, this could lead to standardized, scalable light-based technologies for the mushroom industry, delivering safer, more nutritious and functionally enhanced products across the entire supply chain,” he said. 

About the study 

“UV-Induced Nutritional Transformation of Mushrooms: From Molecular Shifts to Health Outcomes,” by Augustine Edet Ben and Valerie Orsat, was published in Food Research International. 

The research was funded by the Natural Sciences and Engineering Research Council of Canada and the Fonds de Recherche du Québec - Nature et technologies. 

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Journal

Food Research International

DOI

10.1016/j.foodres.2025.118235 

Method of Research

Meta-analysis

Subject of Research

Not applicable

Article Title

UV-Induced Nutritional Transformation of Mushrooms: From Molecular Shifts to Health Outcomes

 

Dads are dying after their kids are born, and no one is tracking it

New study examines paternal mortality data in Georgia, finds 60% of deaths were preventable

Northwestern University

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• Majority of deaths resulted from potentially preventable causes like homicide, accidental injury, suicide

• While maternal deaths are closely tracked, paternal mortality is rarely examined

• Study includes Georgia data only 

• Studying these trends nationally is difficult because of how data is collected and de-identified

CHICAGO — It took the better part of a century for maternal mortality to be recognized, forgotten and finally recognized again as an urgent public health crisis in the United States. In contrast, research shows fathers — particularly men in their 20s through early 40s — die disproportionately from preventable causes such as suicide, overdose, homicide and accidental injury. Yet paternal mortality is rarely examined in connection to the transition to parenthood.

Northwestern University scientists are trying to change that.

A new Northwestern study examined all 130,267 babies born in Georgia in 2017 and tracked whether their fathers died at any point during the following five years, through 2022. Of those fathers who died within five years (796), 60% of the deaths were preventable, which the study authors call a “huge, missed opportunity.” These deaths resulted from homicide (143), accidental injury (142), suicide (102) or overdose (93), while 296 fathers died of natural causes.

The study will be published May 4 in JAMA Pediatrics. 

While maternal mortality review committees focus specifically and in depth on deaths of mothers in the first year of a child’s life, this is, to the researchers’ knowledge, the first study published in a major medical journal to examine paternal mortality in the years following a child’s birth.

“Our data show that fathers die frequently in the first years of their child’s life, and we have no systems in place to understand how we might prevent it,” said corresponding author Dr. Craig Garfield, professor of pediatrics and medical social sciences at Northwestern University Feinberg School of Medicine. “That’s a huge blind spot.”

The findings echo what maternal mortality research has long shown: Deaths around the transition to parenthood are shaped less by biology than by social vulnerability, and many are preventable — even as paternal deaths remain largely uncounted and unaddressed. Prior research has shown that paternal involvement is linked to better child and family health outcomes, while paternal absence is associated with a range of adverse outcomes for children.

Still, fatherhood appears to be protective

Despite fathers in the study dying disproportionately from preventable causes, the scientists found being a father was associated with lower death rates among all men in Georgia between 2017 and 2022. 

After age 20, the death rate for fathers is consistently lower compared to men who are not fathers. For example, among those aged 30 to 34, the death rate for Georgia fathers was 120 deaths per 100,000 men compared to Georgia non-fathers, whose death rate was 231 deaths per 100,000 men.

“Being a father appears to be protective in this particular group of men,” Garfield said. “We were surprised to see reduced mortality among men who are fathers. Whether that is due to changes in lifestyle or a new purpose or new roles and responsibilities, we don’t know, but it is certainly worth further study.”

More about the study

The scientists examined all births in Georgia between 2017 and 2022 and linked them to death records for fathers listed on birth certificates. They analyzed causes of death, overall mortality rates and whether fatherhood, itself, appeared to affect men’s risk of death.

Non‑natural deaths occurred more frequently among younger fathers. Medicaid‑paid births and unmarried status were linked to higher homicide risk. Fathers who died were more likely to have been older, non‑Hispanic Black, unmarried, living in rural areas and to have had Medicaid‑paid births. Higher education, Hispanic ethnicity and Tricare‑paid births were associated with fewer deaths.

Experiences in the hospital inspired the work

As a pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago, Garfield said he has encountered many situations in which mothers in the neonatal intensive care unit were coping with the death of their partner — whether from a shooting, a car accident or another sudden cause.

“In my experience, that happens more often than mothers dying,” Garfield said. “The death of any parent has enormous consequences for a child, and as a pediatrician, I care most about how a parent’s death impacts the child, especially in the early years.”

Despite publishing dozens of papers on fathers’ mental and physical health, Garfield said he could find little research examining fathers’ deaths in the years immediately following a child’s birth.

Why Georgia?

Examining paternal mortality at a national level is currently not possible. While birth and death data are collected at the state level, when that data is collected at the national level, personally identifiable information is removed and there is no way to determine individual cause of death, among many other important factors. Garfield and team had access to Georgia’s data through an existing project — the Pregnancy Risk Assessment Monitoring System for Dads (PRAMS for Dads survey) — which they created and first piloted in the state in 2018.

He hopes the findings will prompt other states to analyze their own data to better understand paternal mortality at a state level and work collectively to create a system to analyze this important national trend.  

“If we don’t measure it, we can’t change it,” Garfield said. “That affects thousands of children.”

Other Northwestern co‑authors include Clarissa D. Simon and Katy Bedjeti.

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Journal

JAMA Pediatrics

Article Title

Paternal Mortality During Early Childhood

Article Publication Date

4-May-2026

Cognitive decline and household firearm storage among older adults

JAMA Internal Medicine

About The Study: This study found that unsecure firearm storage was more common among those with subjective cognitive decline than among those without, although this observation may be driven by differences in storage status by sex, age, veteran status, and presence of children in the home. Existing clinical guidance recommends assessing firearm access and promoting secure storage for patients with cognitive symptoms; the results of this study suggest these recommendations are not yet reflected in household practices.

Corresponding Author: To contact the corresponding author, Kelsey M. Conrick, PhD, MPH, email kmc621@uw.edu.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamainternmed.2026.0505)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

Embed this link to provide your readers free access to the full-text article 

 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2026.0505?guestAccessKey=69f366a4-cab2-4659-9a08-2cfb54e0c79d&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=050426

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Journal

JAMA Internal Medicine

Hospital-based shootings in the US, 2000-2024

JAMA Network Open

About The Study: 

This systematic review found that hospital-based shootings in the U.S. have increased steadily over the past 25 years, representing an intersection between broader national trends in workplace and firearm violence. Large hospitals, those in the U.S. South, and hospitals in urban communities are particularly at-risk settings. These findings underscore the need for hospital-specific prevention strategies, including consideration of weapons screening technology, alongside broader societal efforts to address rising firearm violence.

Corresponding Author: To contact the corresponding author, Sarayna S. McGuire, MD, MS, email McGuire.Sarayna@mayo.edu.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2026.10552)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

Embed this link to provide your readers free access to the full-text article 

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2026.10552?guestAccessKey=1b34668e-afe8-4888-aa3d-dd05b3b83eff&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=050426

About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

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Journal

JAMA Network Open

GRIFT!

Nonprofit hospitals spend billions on management consultants with no clear effect

University of Chicago Medical Center

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In recent decades, management consulting firms have become a fixture in the American healthcare system, wielding outsized influence compared to most other economic sectors. Hospitals navigating challenging financial and regulatory landscapes may call on these specialists for advice on strategic planning, cost-cutting, reorganizations, or revenue-boosting initiatives.

A new paper published in JAMA is the first large-scale, empirical attempt to determine the scale and impact of hospital investment in management consultant services.

“This initial analysis suggests that consultants may deliver neither the dramatic efficiencies they promise nor the harms that critics sometimes fear,” said first author Joseph Dov Bruch, PhD, Assistant Professor of Public Health Sciences at the University of Chicago.

Bruch and his colleagues combed through IRS Form 990 filings, which (among other detailed financial disclosures) require nonprofits to describe their five largest external contracts costing over $100,000 each year. Using machine learning, the researchers identified hospital contracts with management consulting firms, compared 306 hospitals that initiated contracts with management consultants between 2010-2022 with a matched group of hospitals that did not, and then analyzed differences in finances, staffing, operations, and patient outcomes.

Over 20% of all nonprofit hospitals engaged management consultants during the study period. In total, the sector spent at least $7.8 billion on management consulting services over roughly a decade, with the average hospital spending $15.7 million — money that might otherwise be used for patient care, facility improvements, or community health programs.

“It’s not necessarily a waste, but we don’t have evidence of meaningful improvements,” said Bruch, who has spent years studying how nonprofit hospitals function in highly financialized markets.

Across metrics such as net patient revenue, operating margin, days of cash on hand, and even claims-based patient outcomes like readmission and mortality rates, there were no statistically significant or systematic changes linked to nonprofit hospitals hiring a management consulting firm. The only exception was a small increase in stroke readmissions — a slight negative effect.

The authors also point out that their current analysis was limited specifically to management consultants, but they recommend greater transparency and public accountability for how hospitals use tax-subsidized dollars on a broader level. When other types of consultants such as HR and IT consultants are included, the total sum spent by nonprofit hospitals reached more than $25 billion in the study period.

“Our study urges hospital executives toward greater caution about how money is spent on management consultants, and it demonstrates the need for additional research on how these contracts may or may not meaningfully impact health systems,” Bruch said.

In addition to informing hospital leaders and policymakers, Bruch says this research was motivated in part by his role as a mentor and adviser. As a health policy professor, he frequently fields questions from students considering healthcare management consulting as a career path.

“Students who genuinely want to make meaningful changes in the healthcare system ask me if management consultants can actually reduce inefficiencies, and whether I would personally encourage that type of professional pursuit,” Bruch said. “Answering those questions has been difficult because the evidence has been so limited. I’m hopeful more research on consultants will help people make more informed decisions about careers in healthcare.”

 

“Changes in Nonprofit Hospitals' Finances, Operations, and Quality of Care After Using Management Consultants” was published in JAMA in May 2026. Co-authors are Joseph Dov Bruch, Cal Chengqi Fang, Yan Bo Zeng, Avni Parthan & Ashvin D. Gandhi.

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Journal

JAMA

DOI

10.1001/jama.2026.5027 

Method of Research

Data/statistical analysis

Article Title

Changes in Nonprofit Hospitals' Finances, Operations, and Quality of Care After Using Management Consultants

Article Publication Date

4-May-2026