scholarly journals Dexamethasone and oxygen therapy in care home residents with diabetes: a management guide and algorithm for treatment: a rapid response action statement from the European Diabetes Working Party for Older People (EDWPOP) and European Geriatric Medicine Society (EuGMS)

2021 ◽  
Vol 33 (4) ◽  
pp. 895-900
Author(s):  
Alan James Sinclair ◽  
Stefania Maggi ◽  
Ahmed Hassan Abdelhafiz ◽  
Nicola Veronese ◽  
Leocadio Rodriguez-Manas ◽  
...  
Keyword(s):  
Older People ◽  
Oxygen Therapy ◽  
Long Term Care ◽  
Care Home ◽  
Geriatric Medicine ◽  
Working Party ◽  
Care Staff ◽  
Term Care ◽  
Practical Guidance

AbstractThis statement addresses the need to provide clinically relevant and practical guidance for long-term care staff working in care homes and other stakeholders engaged in the care of residents who require consideration for dexamethasone and oxygen therapy. It had been provided following a series of consensus discussions between the EDWPOP and the EuGMS in January and February 2021. Its main aim is to minimise morbidity and mortality from serious acute illnesses including COVID-19 requiring these treatments within the long-term care sector.

scholarly journals A systematic review and meta-analysis of the prevalence and associations of stress and burnout among staff in long-term care facilities for people with dementia

2018 ◽  
Vol 31 (08) ◽  
pp. 1203-1216 ◽  
Author(s):  
Harry Costello ◽  
Sebastian Walsh ◽  
Claudia Cooper ◽  
Gill Livingston
Keyword(s):  
Long Term Care ◽  
Meta Analysis ◽  
Care Home ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Care Staff ◽  
High Turnover ◽  
Term Care ◽  
People With Dementia

ABSTRACTBackground:Care home staff stress and burnout may be related to high turnover and associated with poorer quality care. We systematically reviewed and meta-analyzed studies reporting stress and burnout and associated factors in staff for people living with dementia in long-term care.Methods:We searched MEDLINE, PsycINFO, Web of Science databases, and CINAHL database from January 2009 to August 2017. Two raters independently rated study validity using standardized criteria. We meta-analyzed burnout scores across comparable studies using a random effects model.Results:17/2854 identified studies met inclusion criteria. Eight of the nine studies reporting mean Maslach Burnout Inventory (MBI) scores found low or moderate burnout levels. Meta-analysis of four studies using the 22-item MBI (n = 598) found moderate emotional exhaustion levels (mean 18.34, 95% Confidence Intervals 14.59–22.10), low depersonalization (6.29, 2.39–10.19), and moderate personal accomplishment (33.29, 20.13–46.46). All three studies examining mental health-related quality of life reported lower levels in carer age and sex matched populations. Staff factors associated with higher burnout and stress included: lower job satisfaction, lower perceived adequacy of staffing levels, poor care home environment, feeling unsupported, rating home leadership as poor and caring for residents exhibiting agitated behavior. There was preliminary evidence that speaking English as a first language and working shifts were associated with lower burnout levels.Conclusions:Most care staff for long-term care residents with dementia experience low or moderate burnout levels. Prospective studies of care staff burnout and stress are required to clarify its relationship to staff turnover and potentially modifiable risk factors.

scholarly journals Impact of a public policy restricting staff mobility between long-term care homes in Ontario, Canada during the COVID-19 pandemic

2020 ◽  
Author(s):  
Aaron Jones ◽  
Alexander G. Watts ◽  
Salah Uddin Khan ◽  
Jack Forsyth ◽  
Kevin A. Brown ◽  
...  
Keyword(s):  
Public Policy ◽  
Long Term Care ◽  
Care Home ◽  
Relative Difference ◽  
Care Staff ◽  
Care Homes ◽  
Term Care ◽  
Undirected Network ◽  
Before And After

AbstractObjectivesTo assess changes in the mobility of staff between long-term care homes in Ontario, Canada before and after enactment of public policy restricting staff from working at multiple homes.DesignPre-post observational study.Setting and Participants623 long-term cares homes in Ontario, Canada between March 2020 and June 2020.MethodsWe used anonymized mobile device location data to approximate connectivity between all 623 long-term care homes in Ontario during the 7 weeks before (March 1 – April 21) and after (April 22 – June 13) the policy restricting staff movement was implemented. We visualized connectivity between long-term care homes in Ontario using an undirected network and calculated the number of homes that had a connection with another long-term care home and the average number of connections per home in each period. We calculated the relative difference in these mobility metrics between the two time periods and compared within-home changes using McNemar’s test and the Wilcoxon rank-sum test.ResultsIn the period preceding restrictions, 266 (42.7%) long-term care homes had a connection with at least one other home, compared to 79 (12.7%) homes during the period after restrictions, a drop of 70.3% (p <0.001). The average number of connections in the before period was 3.90 compared to 0.77 in after period, a drop of 80.3% (p < 0.001). In both periods, mobility between long-term care homes was higher in homes located in larger communities, those with higher bed counts, and those part of a large chain.Conclusions and ImplicationsMobility between long-term care homes in Ontario fell sharply after an emergency order by the Ontario government limiting long-term care staff to a single home, though some mobility persisted. Reducing this residual mobility should be a focus of efforts to reduce risk within the long-term care sector during the COVID-19 pandemic.

scholarly journals Critical Contextual Elements in Facilitating and Achieving Success with a Person-Centred Care Intervention to Support Antipsychotic Deprescribing for Older People in Long-Term Care

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Lynn Chenoweth ◽  
Tiffany Jessop ◽  
Fleur Harrison ◽  
Monica Cations ◽  
Janet Cook ◽  
...  
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Direct Care ◽  
Care Staff ◽  
Care Homes ◽  
Term Care ◽  
Train The Trainer ◽  
People With Dementia ◽  
Contextual Elements

Antipsychotic and other tranquilising medicines are prescribed to help care staff manages behaviour in one-quarter of older people living in Australian long-term care homes. While these medicines pose significant health risks, particularly for people with dementia, reliance on their use occurs when staff are not educated to respond to resident behaviour using nonpharmacological approaches. The Halting Antipsychotic use in Long-Term care (HALT) single-arm study was undertaken to address this issue with 139 people 60 years and over with behaviours of concern for staff living in 24 care homes. A train-the-trainer approach delivered person-centred care education and support for 22 HALT (nurse) champions and 135 direct care staff, dementia management education for visiting general practitioners (GP) and pharmacists, use of an individualised deprescribing protocol for residents, and awareness-raising for the resident’s family. The HALT champions completed open-ended questionnaires and semistructured interviews to identify the contextual elements they considered most critical to facilitating, educating care staff, and achieving success with the study intervention. They reported that person-centred approaches helped care staff to respond proactively to resident behaviours in the absence of antipsychotic medicines; the champions considered that this required strong managerial support, champion empowerment to lead change, reeducation of care staff, and the cooperation of families and GPs.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

scholarly journals Association between multimorbidity patterns and disability among older people covered by long-term care insurance in Shanghai, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zijing Wang ◽  
Wenjia Peng ◽  
Mengying Li ◽  
Xinghui Li ◽  
Tingting Yang ◽  
...  
Keyword(s):  
Older People ◽  
Functional Disability ◽  
Long Term Care ◽  
Strong Association ◽  
Binary Logistic Regression ◽  
Term Care ◽  
Logistic Regression Models ◽  
Disease Pattern ◽  
Long Term Care Insurance

Abstract Background Functional disability and multimorbidity are common among older people. However, little is known about the relationship between functional disability and different multimorbidity combinations. We aimed to identify multimorbidity patterns and explore the associations between these patterns and functional disability. Methods We investigated a multi-stage random sample of 1871 participants aged ≥60 years and covered by long-term care insurance in Shanghai, China. Multimorbidity was defined as the simultaneous presence of two or more chronic diseases in an individual. Participants completed scales to assess basic and instrumental activities of daily living (BADL and IADL, respectively). Multimorbidity patterns were identified via exploratory factor analysis. Binary logistic regression models were used to determine adjusted associations between functional disability and number and patterns of multimorbidity. Results Multimorbidity was present in 74.3% of participants. The prevalence of BADL disability was 50.7% and that of IADL disability was 90.7%. There was a strong association between multimorbidity and disability. We identified three multimorbidity patterns: musculoskeletal, cardio-metabolic, and mental-degenerative diseases. The cardio-metabolic disease pattern was associated with both BADL (OR 1.28, 95%CI 1.16–1.41) and IADL (OR 1.41, 95%CI 1.19–1.68) disability. The mental-degenerative disease pattern was associated with BADL disability (OR 1.55, 95%CI 1.40–1.72). Conclusions Multimorbidity and functional disability are highly prevalent among older people covered by long-term care insurance in Shanghai, and distinct multimorbidity patterns are differentially associated with functional disability. Appropriate long-term healthcare and prevention strategies for older people may help reduce multimorbidity, maintain functional ability, and improve health-related quality of life.

Willingness of long‐term care staff to receive a COVID ‐19 vaccine: A single state survey

2020 ◽  
Author(s):  
Kathleen T. Unroe ◽  
Russell Evans ◽  
Lindsay Weaver ◽  
Dan Rusyniak ◽  
Justin Blackburn
Keyword(s):  
Long Term Care ◽  
Care Staff ◽  
Term Care ◽  
Single State ◽  
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