Long-term Care Placement of Dementia Patients and Caregiver Health and Well-being

COVID-19 has had a profound impact on long-term care (LTC) homes in Canada. But the measures put in place to control infection within LTC homes have also had devastating impacts on the health and well-being of residents through the effects on social connection. Here, we offer guiding principles to enable social connection and promote health and quality of life for LTC residents during COVID-19 and beyond. These principles were generated by a working group of the COVID-19 and Dementia Task Force, convened by the Alzheimer Society of Canada to identify the urgent and emerging issues raised by COVID-19 for Canadians with dementia.

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Art Activities in Long-Term Care: A Scoping Review

Canadian Journal of Occupational Therapy ◽

10.1177/00084174211064497 ◽

2021 ◽

pp. 000841742110644

Author(s):

Evelyne Durocher ◽

Janet Njelesani ◽

Emily Crosby

Keyword(s):

Occupational Therapy ◽

Scoping Review ◽

Long Term Care ◽

Occupational Therapists ◽

Well Being ◽

Term Care ◽

Therapeutic Benefits ◽

Art Activities ◽

Health And Well Being

Background: Outcomes of using art in therapy overlap with goals of occupational therapy with older adults in long-term care, which include improving and maintaining health and well-being through engagement in occupations. There is a lack of evidence about how art activities could complement or inform occupational therapy. Purpose: The purpose of this scoping review is to map existing literature about how art activities are used in long-term care. Methods: Six electronic databases were searched. Fourteen studies met inclusion criteria and were analyzed to identify patterns and discrepancies. Findings: The analysis suggests art activities can contribute to well-being by improving mood, promoting communication and reminiscence, and supporting the development and deepening of social relationships. Implications: Occupational therapists should consider incorporating art activities as these offer therapeutic benefits and can be adapted to individual strengths and preferred type and level of participation.

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EVALUATION OF ART ON THE BRAIN, A HEALTH APP FOR OLDER ADULTS, IN LONG-TERM CARE

Innovation in Aging ◽

10.1093/geroni/igz038.2977 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S808-S808

Author(s):

Elizabeth P Howard ◽

Tammy Retalic ◽

Jessica Rogan

Keyword(s):

Older Adults ◽

Long Term Care ◽

Well Being ◽

Personal Relationships ◽

Post Intervention ◽

Term Care ◽

Significant Difference ◽

The Brain ◽

Health And Well Being

Abstract ArtOn the Brain is a mobile application that incorporates art history education, play and socialization for older adults. This pilot project examined its health and social impact among long term care residents. A convenience sample of 48 residents, 60+ years, with borderline intact to moderate cognitive impairment were recruited. Residents with mild or better cognitive status used the app individually on a tablet while the remaining participated in therapist-led group sessions. One-hour intervention occurred twice weekly. Primary outcomes, health and well-being, were measured with 5Q-5D-5L and Warwick-Edinburgh Mental Well-being tools at baseline and after 6 weeks. Secondary outcomes were mood, cognition, function and overall satisfaction with activity options and personal relationships. Pre-post paired t-test analyses of data from EQ-5D-5L and Warwick tools did not show a significant difference. There were no notable declines with cognitive performance, functional ability and depression post-intervention. Four activity options and three personal relationship items had statistically significant improvements post-intervention. Activity options addressed engagement in enjoyable activities on weekends and evenings, and opportunity to, spend time with other like-minded residents and explore new skills, interests. Personal relationships items included engagement in activities helpful to others and having people to do things with. ArtOn the Brain is a novel application suitable for long term care residents. While 6 week intervention did not show improvement in overall health and well-being, there were significant improvements with residents’ reported engagement in activity options and improvement of personal relationships. Longitudinal evaluations are needed to examine changes in health status and well-being.

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Mental well‐being of staff in long‐term care facilities at risk

Geriatrics and Gerontology International ◽

10.1111/ggi.14260 ◽

2021 ◽

Author(s):

Chiaki Ura ◽

Tsuyoshi Okamura ◽

Akinori Takase ◽

Masaya Shimmei ◽

Yukan Ogawa

Keyword(s):

At Risk ◽

Long Term Care ◽

Well Being ◽

Term Care ◽

Care Facilities ◽

Mental Well Being

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Digital Technologies To Enhance Social Connectedness in Long-Term Care Facilities During COVID-19: A Review

Innovation in Aging ◽

10.1093/geroni/igaa057.3451 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 942-943

Author(s):

Shannon Freeman ◽

Aderonke Abgoji ◽

Alanna Koopmans ◽

Christopher Ross

Keyword(s):

Social Isolation ◽

Rural Areas ◽

Social Connectedness ◽

Long Term Care ◽

Care Facility ◽

Well Being ◽

Sufficient Information ◽

Term Care ◽

Care Facilities

Abstract A consequence of the strict visitor restrictions implemented by many Long-term Care Facilities (LTCFs), during the COVID-19 pandemic, was the exacerbation of loneliness and social isolation felt by older adult residents. While there had been a shift by some persons to utilize digital solutions to mitigate the effects of the imposed social isolation, many facilities did not have sufficient information regarding available solutions to implement institutional strategies to support social connectedness through digital solutions. To support our partners in evidence-based policy-making we conducted a scoping review to identify existing virtual technology solutions, apps, and platforms feasible to promote social connectedness among persons residing in a long-term care facility context during times of lockdown such as experienced during the COVID-19 pandemic. Initial identification of relevant literature involved a combination of keywords and subject headings searches within 5 databases (PubMed, CINAHL EBSCO, PsychINFO EBSCO, Embase OVIDSP, and Web of Science ISI). DistillerSR was used to screen, chart and summarize the data. There is growth in the availability of technologies focused on promoting health and well-being in later life for persons in long-term care facilities however a gap remains in widespread uptake. We will describe the breadth of technologies identified in this review and discuss how they vary in utility in smaller scale facilities common in rural areas. Of the technologies that can be used to mitigate the impacts of social isolation felt by long-term care residents, many “solutions” depend on stable highspeed internet, which remains a challenge in rural and northern areas.

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Informal carer in Portugal: moving towards political recognition in Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckz187.178 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

I Fronteira ◽

J Simoes ◽

G Augusto

Keyword(s):

Informal Care ◽

Long Term Care ◽

Well Being ◽

Oecd Countries ◽

Low Fertility ◽

Informal Carer ◽

Term Care ◽

System Perspective ◽

Informal Carers

Abstract Informal care represents around 80% of all long term care provided in EU countries. Nevertheless, the needs for this type of care are expected to increase in the coming years in all OECD countries. Portugal is among the OECD countries with the highest ageing index (21.5% of the population was older than 65 years in 2017) due to high life expectancy and low fertility rates. As this demographic trend establishes, Portugal is expected to have more than 40% of the population over 65 years in 2037, and the expected prevalence of dementia is 3%, in 2050. In 2015 there were 2.1% of people over 65 receiving long-term care, representing 52% of all long-term care users. Around 38% were receiving care at home. It is estimated that 287,000 people in Portugal depend on informal carers. The agenda towards the official recognition of informal cares has been push forward in the country. Since 2015, several recommendations have been issued by the Parliament as well as legislative initiatives and a proposal for a Status of the Informal Carer is currently under discussion. We analyse the process of formulation of this policy in terms of sectors and stakeholders involved, definition and scope of informal carer, rights and obligations, role of the person being cared for, formal protection (e.g., labor, social, financial, training) and implementation. Recognition of the informal carer is a sector wide approach. One of the main features is the economic, social and labor protection mainly through reconciliation between work life and caring activities and promotion of the carer’s well being. Notwithstanding, and from a health system perspective, community health teams are to be the focal point for informal carers, supporting and providing specific training whenever needed. Despite its relevance, informal care should not be professionalized and responsibility of care should not be shifted from health services to informal carers. Key messages Needs for informal care are expected to increase in the coming years in OECD countries. Recognition of the informal carer is a sector wide approach.

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#MoreThanAVisitor: Families as “Essential” Care Partners During COVID-19

The Gerontologist ◽

10.1093/geront/gnaa161 ◽

2020 ◽

Author(s):

Candace L Kemp

Keyword(s):

Family Involvement ◽

Long Term Care ◽

Research Policy ◽

Well Being ◽

Direct Care ◽

Negative Consequences ◽

Public Health Response ◽

Term Care ◽

Care Partners

Abstract The public health response to the current Coronavirus pandemic in long-term care communities, including assisted living, encompasses prohibiting visitors. This ban, which includes family members, has been criticized for being unfair, unhealthy, and unsafe. Against this backdrop, I examine the roles family play in residents’ daily lives and care routines. I argue that classifying family as “visitors” rather than essential care partners overlooks their critical contributions and stems from taken-for-granted assumption about gender, families, and care work, and I demonstrate why families are more than visitors. Policies that ban family visits also reflect a narrow understanding of health that focuses on mitigating infection risk, but neglects overall health and well-being. This policy further stems from a limited comprehension of care relations. Research shows that banning family visits has negative consequences for residents, but also families themselves, and direct care workers. I argue that identifying ways to better understand and support family involvement is essential and demonstrate the utility of the Convoys of Care model for guiding the reconceptualization of family in long-term care research, policy, and practice during and beyond the pandemic.

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FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

Innovation in Aging ◽

10.1093/geroni/igz038.576 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S161-S161

Author(s):

Rebecca L Mauldin ◽

Kathy Lee ◽

Antwan Williams

Keyword(s):

Long Term Care ◽

Federal Policy ◽

Care Facility ◽

Well Being ◽

The United States ◽

Term Care ◽

Long Term Care Facility ◽

Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

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