Morbidity and mortality associated with influenza exposure in long-term care facilities for dependant elderly people

Abstract Objective: to identify the factors associated with the institutionalization of the elderly. Method: a case-control, population-based study was performed with 387 elderly people. The study considered cases of elderly people (n=191) living in long-term care facilities, and a control group (n=196) who lived in homes in urban areas of the city. Both groups were identified from the records of the Family Health Strategy and were randomly selected. Institutionalization was considered a dependent variable, and sociodemographics, clinical factors, functional status, and cognitive impairment were considered independent variables. Comparison between groups was analyzed using the Chi-squared and Pearson tests and the logistic regression model was used in adjusted analysis, with measurements of effect expressed as odds ratio with a 95% confidence interval. Variables with p≤0.20 were considered for entry in the multiple model. Results: variables that remained associated with institutionalization in multiple analysis were: not having a partner (OR=9.7), not having children (OR=4.0), presenting cognitive impairment (OR=11.4), and depending on others to perform basic activities of daily living (OR=10.9). Conclusion: cognitive impairment and dependency for basic activities of daily living were more strongly associated with institutionalization. Home care strategies and preventive actions for risk factors should be stimulated to delay the referral of elderly people to Long Term Care Facilities for the Elderly, and to develop strategies that allow the elderly to remain socially active.

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COVID-19 morbimortality in long-term care facilities in the state of Bahia, Brazil

Geriatrics Gerontology and Aging ◽

10.53886/gga.e0210053 ◽

2021 ◽

Vol 15 ◽

Author(s):

Meirelayne Borges Duarte ◽

Isabela Lôbo Duarte ◽

Lucas Maia Scardino Faria ◽

Mônica Hupsel Frank ◽

Helena Patáro de Oliveira Novaes ◽

...

Keyword(s):

Ecological Study ◽

Long Term Care ◽

Global Analysis ◽

Case Fatality ◽

The State ◽

Morbidity And Mortality ◽

Term Care ◽

Care Facilities ◽

Stratified Analysis

OBJECTIVE: To describe coronavirus disease 2019 (COVID-19) morbidity and mortality in long-term care facilities (LTCFs) in the state of Bahia, Brazil. METHODS: This is an ecological study involving identified and active LTCFs in Bahia, monitored by the Intersectoral Monitoring Commission of LTCFs. Data analysis included COVID-19 incidence among older residents and workers and COVID-19 hospitalization, fatality, and mortality rates among older residents. In addition to a global analysis of data from Bahia, a stratified analysis compared (i) the East macroregion with the rest of Bahia, and (ii) private LTCFs with philanthropic ones. RESULTS: Our sample consisted of 175 LTCFs, more than half located in the East macroregion (n = 99). Most facilities declared themselves as philanthropic (n = 94) or private (n = 59). From April/2020 to June/2021, COVID-19 incidence was 30.71% among residents and 19.86% among LTCF workers. Considering older residents, mortality was 3.57% and fatality was 11.63%. Incidence was lower in the East macroregion, for older residents (relative risk [RR] = 0.77; 95% confidence interval [CI] 0.68–0.87) and LTCF workers (RR = 0.70; 95%CI 0.59–0.83). The hospitalization rate due to COVID-19 was 19.97%, being higher in private LTCFs (RR = 1.61; 95%CI 1.30–2.00). CONCLUSIONS: This study reveals that COVID-19 morbidity and mortality in LTCFs in Bahia were consistent with the wide ranges described in the literature, although case fatality was lower than expected. This demonstrates the importance of strategies to coordinate, identify, assess, and target support for LTCFs, highlighting the need for stronger public policies.

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A rapid systematic review of measures to protect older people in long-term care facilities from COVID-19

BMJ Open ◽

10.1136/bmjopen-2020-047012 ◽

2021 ◽

Vol 11 (10) ◽

pp. e047012

Author(s):

Kate Frazer ◽

Lachlan Mitchell ◽

Diarmuid Stokes ◽

Ella Lacey ◽

Eibhlin Crowley ◽

...

Keyword(s):

Systematic Review ◽

Nursing Homes ◽

Older People ◽

Outcome Measures ◽

Long Term Care ◽

Morbidity And Mortality ◽

Secondary Outcome ◽

Term Care ◽

Care Facilities

ObjectivesThe global COVID-19 pandemic produced large-scale health and economic complications. Older people and those with comorbidities are particularly vulnerable to this virus, with nursing homes and long term care facilities (LTCF) experiencing significant morbidity and mortality associated with COVID-19 outbreaks. The aim of this rapid systematic review was to investigate measures implemented in LTCF to reduce transmission of COVID-19 and their effect on morbidity and mortality of residents, staff and visitors.SettingLong-term care facilities.ParticipantsResidents, staff and visitors of facilities.Primary and secondary outcome measuresDatabases (PubMed, EMBASE, CINAHL, Cochrane Databases and repositories and MedRXiv prepublished database) were systematically searched from inception to 27 July 2020 to identify studies reporting assessment of interventions to reduce transmission of COVID-19 in nursing homes among residents, staff or visitors. Outcome measures include facility characteristics, morbidity data, case fatalities and transmission rates. Due to study quality and heterogeneity, no meta-analysis was conducted.ResultsThe search yielded 1414 articles, with 38 studies included. Reported interventions include mass testing, use of personal protective equipment, symptom screening, visitor restrictions, hand hygiene and droplet/contact precautions, and resident cohorting. Prevalence rates ranged from 1.2% to 85.4% in residents and 0.6% to 62.6% in staff. Mortality rates ranged from 5.3% to 55.3% in residents.ConclusionsNovel evidence in this review details the impact of facility size, availability of staff and practices of operating between multiple facilities, and for-profit status of facilities as factors contributing to the size and number of COVID-19 outbreaks. No causative relationships can be determined; however, this review provides evidence of interventions that reduce transmission of COVID-19 in LTCF.PROSPERO registration numberCRD42020191569.

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Social adaptation of elderly persons in long-term care facilities

Social'naja politika i social'noe partnerstvo (Social Policy and Social Partnership) ◽

10.33920/pol-01-2101-09 ◽

2021 ◽

pp. 54-57

Author(s):

Olga Nikolaevna Startseva

Keyword(s):

Elderly People ◽

Long Term Care ◽

Social Institutions ◽

Social Adaptation ◽

Elderly Persons ◽

Term Care ◽

The Social ◽

Care Facilities ◽

The Creation

The article presents modern approaches to the social adaptation of elderly people in inpatient social institutions as part of the creation of a long-term care system.

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Ethnic elderly people in long-term care facilities of the dominant culture: implications for social work practice and education

International Social Work ◽

10.1177/002087288602900306 ◽

1986 ◽

Vol 29 (3) ◽

pp. 227-236 ◽

Cited By ~ 5

Author(s):

Michael J. MacLean ◽

Rita Bonar

Keyword(s):

Social Work ◽

Elderly People ◽

Long Term Care ◽

Work Practice ◽

Social Work Practice ◽

Dominant Culture ◽

Term Care ◽

Care Facilities

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The silent deaths of the elderly in long-term care facilities during the Covid-19 pandemic: The role of forensic pathology

Medico-Legal Journal ◽

10.1177/0025817220930552 ◽

2020 ◽

Vol 88 (2) ◽

pp. 66-68 ◽

Cited By ~ 1

Author(s):

Fabrizio Cordasco ◽

Carmen Scalise ◽

Matteo Antonio Sacco ◽

Carlo Filippo Bonetta ◽

Angelica Zibetti ◽

...

Keyword(s):

Elderly People ◽

Long Term Care ◽

Close Contact ◽

Public Health Problem ◽

The Elderly ◽

Global Public Health ◽

Term Care ◽

Care Facilities ◽

Underlying Diseases

The Covid-19 pandemic is currently a major global public health problem. We know that the elderly and people with chronic diseases contract the infection more easily and they develop clinically more serious and often lethal forms. To date, the reasons for this have been generically attributed to old age and underlying diseases. Most Covid-19 deaths occurred in long-term care facilities because the residents are elderly people with chronic illness living in close contact. Therefore, facilities have become epidemic outbreaks. Forensic knowledge is very limited because an autopsy is rarely performed. Post-mortem investigations can help increase knowledge about Covid-19 and identify any undiagnosed pathologies in life. Therefore, forensic investigations play a role in protecting a frail population. Autopsies should be encouraged on elderly people who died of Covid-19.

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Gerontological contributions to the care of elderly people in long-term care facilities

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2017-0357 ◽

2018 ◽

Vol 71 (suppl 2) ◽

pp. 912-919 ◽

Cited By ~ 1

Author(s):

Vanessa da Silva Antonio Coimbra ◽

Rose Mary Costa Rosa Andrade Silva ◽

Fabiana Lopes Joaquim ◽

Eliane Ramos Pereira

Keyword(s):

Elderly People ◽

Long Term Care ◽

Care Facility ◽

Self Esteem ◽

Term Care ◽

Long Term Care Facility ◽

Care Facilities ◽

Methodological Approaches ◽

Care Of Elderly

ABSTRACT Objective: To analyze Brazilian scientific productions from the last 11 years which show the contributions of nursing to elderly people in long-term care facilities. Method: This is an integrative literature review. The search took place in the Virtual Health Library (VHL) in the BDENF and LILACS databases and the SCIELO virtual library, between June and October 2016, using the keyword long-term care facility and the descriptors nursing and geriatrics. Results: Eleven studies were selected, published 2005 and 2016, with various methodological approaches that enabled discussion of the proposed objective. Conclusion: The contributions of nursing to institutionalized elderly people were linked to health promotion measures, as well as simple interventions, such as listening, interacting, offering recreation and helping in psychoaffective relationships. These activities contributed to raising the self-esteem of the individuals.

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