P2-271: Dementia and disruptive behaviours in long-term care residents: A large-scale longitudinal survey in south west Germany

AbstractBackgroundFew studies have described the challenges experienced by long-term care facilities (LTCFs) following Hurricane Sandy. This study examined LTCF preparedness and experiences during and after the storm.MethodsA cross-sectional survey was conducted 2 years after Hurricane Sandy to assess LTCF demographics, preparation, and post-storm resources. Surveys were conducted at LTCFs located on the Rockaway Peninsula of New York City. All LTCFs located in a heavily affected area were approached.ResultsOf 29 facilities, 1 had closed, 5 did not respond, 9 declined to participate, and 14 participated, yielding a response rate of 50% for open facilities. Twenty-one percent of the facilities had preparations specifically for hurricanes. More than 70% of the facilities had lost electricity, heat, and telephone service, and one-half had evacuated. Twenty-one percent of the facilities reported not receiving any assistance and over one-half reported that relief resources did not meet their needs.ConclusionsMany LTCFs lacked plans specific to such a large-scale event. Since nearly all of the LTCFs in the region were affected, preexisting transportation and housing plans may have been inadequate. Future preparation could include hazard-specific planning and reliance on resources from a wider geographic area. Access to electricity emerged as a top priority. (Disaster Med Public Health Preparedness. 2018;12:194–200)

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Increasing the Frequency and Timeliness of Pain Assessment and Management in Long-Term Care: Knowledge Transfer and Sustained Implementation

Pain Research and Management ◽

10.1155/2016/6493463 ◽

2016 ◽

Vol 2016 ◽

pp. 1-13 ◽

Cited By ~ 4

Author(s):

Thomas Hadjistavropoulos ◽

Jaime Williams ◽

Sharon Kaasalainen ◽

Paulette V. Hunter ◽

Maryse L. Savoie ◽

...

Keyword(s):

Pain Assessment ◽

Large Scale ◽

Management Practices ◽

Long Term Care ◽

Future Research ◽

Clinical Practices ◽

Term Care ◽

Staff Members ◽

Before And After

Background. Although feasible protocols for pain assessment and management in long-term care (LTC) have been developed, these have not been implemented on a large-scale basis.Objective. To implement a program of regular pain assessment in two LTC facilities, using implementation science principles, and to evaluate the process and success of doing so.Methods. The implementation protocol included a pain assessment workshop and the establishment of a nurse Pain Champion. Quality indicators were tracked before and after implementation. Focus groups and interviews with staff were also conducted.Results. The implementation effort was successful in increasing and regularizing pain assessments. This was sustained during the follow-up period. Staff members reported enthusiasm about the protocol at baseline and positive results following its implementation. Despite the success in increasing assessments, we did not identify changes in the percentages of patients reported as having moderate-to-severe pain.Discussion. It is our hope that our feasibility demonstration will encourage more facilities to improve their pain assessment/management practices.Conclusions. It is feasible to implement regular and systematic pain assessment in LTC. Future research should focus on ensuring effective clinical practices in response to assessment results, and determination of longer-term sustainability.

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Perceptions Related to Nursing and Nursing Staff in Long-Term Care Settings during the COVID-19 Pandemic Era: Using Social Networking Service

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147398 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7398

Author(s):

Juhhyun Shin ◽

Sunok Jung ◽

Hyeonyoung Park ◽

Yaena Lee ◽

Yukyeong Son

Keyword(s):

Social Networking ◽

Nursing Staff ◽

Large Scale ◽

Long Term Care ◽

Social Networking Service ◽

Term Care ◽

Wide Range ◽

Role Of Nursing

Purpose: The purpose of this study was to investigate what opinions and perceptions people have about nursing and the role of nursing staff in nursing homes (NHs) on Social Networking Service (SNS) by analyzing large-scale data through social big-data analysis. Methods: This study investigated changes in perception related to nursing and nursing staff in NHs during the COVID-19 pandemic era using target channels (blogs, cafes, Instagram, communities, Twitter, etc.). Data were collected on the channel from 12 September 2019 to 11 September 2020, 6 months before and after 12 March 2020 when the COVID-19 pandemic was declared. Selected keywords included “nursing,” “nurse,” and “nursing staff,” and included words were “long-term care settings,” “geriatric hospital,” and “nursing home.” Text mining, opinion mining, and social network analysis were conducted. Results: After the COVID-19 pandemic, the frequency of keywords increased about 1.5 times compared to before. In March 2020 when the COVID-19 pandemic was declared, the negative phrase “be infected” ranked number one, resulting in a sharp 8% rise in the percentage of negative words in that month. The related words that have risen in rank significantly, or were newly ranked in the Top 30 after the pandemic, were related with COVID-19. Conclusion: The public began to realize the role of nursing staff in the prevention and management of mass infection in NHs and the importance of nursing staff after the pandemic. Further studies should examine the perceptions of those who have received nursing services and include a wide range of foreign channels.

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A Study on the Method to Secure Evacuation Safety of Long-term Care Hospitals for the Elderly through Actual Condition Surveys

Fire Science and Engineering ◽

10.7731/kifse.0632f241 ◽

2021 ◽

Vol 35 (6) ◽

pp. 45-52

Author(s):

Soo-Kyung Shin ◽

Young-Hoon Bae ◽

Jun-Ho Choi

Keyword(s):

Large Scale ◽

Long Term Care ◽

The Elderly ◽

Actual Condition ◽

Term Care ◽

Evacuation Plans ◽

Improvement Measures ◽

Evacuation Safety ◽

Fact Finding

In long-term care hospitals, there are many patients with reduced mobility and the fire compartment is difficult, so there is a high possibility of large-scale casualties in the event of a fire. Various studies have been conducted to reduce these risks, but studies on problems related to evacuation safety and improvement measures are lacking. Therefore, this study intends to examine the problems related to evacuation safety through a fact-finding survey targeting two hospitals and to suggest improvement measures. As a result, problems related to 1) maintenance of fire doors, 2) establishment of a horizontal evacuation plan, 3) evacuation mechanism, and 4) recognition and implementation of worker evacuation plans were derived, and improvement measures for each problem were suggested.

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Does Long-Term Care Substitute for Hospital Care? Evidence From the China Health and Retirement Longitudinal Survey

Innovation in Aging ◽

10.1093/geroni/igaa057.275 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 84-84

Author(s):

Wei Yang

Keyword(s):

Older People ◽

Inpatient Care ◽

Long Term Care ◽

Longitudinal Survey ◽

Substitution Effects ◽

Term Care ◽

Care Services ◽

The Poor ◽

The Rich

Abstract Publicly funded long-term care (LTC) support is shrinking in many countries despite continuing increases in the number of older people who need care. Evidence has shown that the LTC services have an impact on the efficient use of the resources in the health care sector by reducing rates of admission and associated costs through assisting older people with daily living. This paper seeks to examine whether and to what extent these services are substitutes. We use a fixed-effect instrumental variable GMM model to predict the effect of long-term care services on the utilisation of outpatient and inpatient care services. Data are drawn from China Health and Retirement Longitudinal Survey 2011, 2013 and 2015. Our findings suggest that LTC significantly reduces the use of outpatient care but not inpatient care. We have also found LTC use is concentrated among the rich, but the substitution effects are stronger among the poor compared to the rich. This indicates that the poor would benefit more from subsided LTC services. We urge the Chinese government to take action to develop its formal LTC system and to channel more resources to its LTC system, which will benefit the older population in general, and the poor in particular.

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Trajectories of end-of-life medical and long-term care expenditures for older adults in Japan: retrospective longitudinal study using a large-scale linked database of medical and long-term care claims

BMC Geriatrics ◽

10.1186/s12877-021-02215-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Emi Teraoka ◽

Susumu Kunisawa ◽

Yuichi Imanaka

Keyword(s):

End Of Life ◽

End Of Life Care ◽

Large Scale ◽

Long Term Care ◽

Medical Expenditures ◽

Life Care ◽

Healthcare Expenditures ◽

Term Care ◽

Factors Associated

Abstract Background An accurate understanding of the current state of end-of-life care is important for healthcare planning. The objectives of this study were to examine the trajectories of end-of-life medical and long-term care expenditures and associated factors. Methods This was a retrospective longitudinal study using a large-scale linked database of medical and long-term care claims—National Health Insurance, Advanced Elderly Medical Insurance, and long-term care insurance—covering Prefecture A in Japan. Patients aged ≥70 years who died between April 1, 2016, and March 31, 2017, were included (N = 16,084 patients; mean age = 85.1 ± 7.5 years; 7804 men (48.5%) and 8280 women (51.5%)). The outcome measures were medical expenditures (inpatient, outpatient, and prescription), long-term care expenditures, and total healthcare expenditures (the sum of medical and long-term care expenditures) during the 60 months before the date of death. We calculated each patient’s monthly medical and long-term care expenditures for 60 months before the date of death and applied group-based trajectory modeling to identify distinct trajectories. Factors associated with spending trajectories were examined via multinomial logistic regression analyses. Explanatory variables included age, sex, diseases, and the medical services used. Results We identified six distinct spending trajectories for the total healthcare expenditures: high persistent (45.6%), medium-to-high persistent (26.1%), early rise then high persistent (9.8%), late rise (6.4%), low persistent then very late rise (i.e., when spending starts increasing later than “late rise”; 6.4%), and progressive increase (5.7%). Factors associated with the high-persistent trajectory were chronic illnesses, various organ failures, neurodegenerative diseases, fractures, and tube feeding. The trajectory pattern of medical expenditures was similar to that of total healthcare expenditures; however, a different pattern was seen for long-term care expenditures. Conclusions Regarding combined medical and long-term care spending of the last 5 years, most patients belonged to a pattern in which the healthcare expenditures remained high, and a combination of multiple factors contributed to these patterns. This finding can offer healthcare providers a longer-term perspective on end-of-life care.

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A Conversation about Ageism: Time to Deinstitutionalize Long-Term Care?

University of Toronto Quarterly ◽

10.3138/utq.90.2.09 ◽

2021 ◽

Vol 90 (2) ◽

pp. 183-206

Author(s):

Rachel Herron ◽

Christine Kelly ◽

Katie Aubrecht

Keyword(s):

Older People ◽

Residential Care ◽

Large Scale ◽

Long Term Care ◽

Health Care Administrators ◽

Term Care ◽

Residential Care Facilities ◽

The Public ◽

Aging Studies

Ageism is arguably one of the least challenged forms of discrimination globally and manifests in many obvious and subtle ways. Situating our conversation within the context of COVID-19, we discuss peculiar and unchallenged forms of ageism in current times as well as the intersections with other forms of discrimination such as ableism, racism, sexism, and heterosexism. We highlight the limits of current understandings of ageism, specifically those that seek to identify positive aspects of ageism without appreciating how these forms of ageism reinforce inequalities among older adults. With regards to spatial manifestations of ageism, we explore the failure of critiques of institutionalization to include older people. Only in the context of “mass death” during COVID-19 has the public eye turned toward the problems of long-term residential care facilities as spaces of care, yet disabled, mad, and D/deaf people and allies have challenged the mass institutionalization of disabled people for decades, highlighting how physical and social segregation constitutes an obvious form of ableism. Institutions are notorious for their physical, spiritual, and emotional harms, but when it comes to residential long-term care for older people, especially older people living with dementia, responses to segregation and isolation have generally been ambivalent. Even aging studies scholars call for “transformation” but do not call for the elimination of large-scale institutions (e.g., Theurer et al.). We discuss this softer critique from aging studies, raising questions about whether institutionalized and segregated congregate living for older people is inherently discriminatory, and we consider the implications for families, health care administrators, researchers, and scholars working in the field of long-term residential care.

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Media Effects on Individual Worldview and Wellness for Long-Term Care Residents Amid the COVID-19 Virus

The Gerontologist ◽

10.1093/geront/gnaa095 ◽

2020 ◽

Author(s):

David Schroyer

Keyword(s):

Mental Health ◽

Adverse Effect ◽

Media Effects ◽

Large Scale ◽

Care Setting ◽

Long Term Care ◽

Health And Wellness ◽

Term Care ◽

The Impact

Abstract The following article serves as a means to highlight the need for increased scrutiny of the value and potentially adverse effect the 24-h news cycle has on individuals, particularly residents in a long-term care setting amid the COVID-19 pandemic or other large-scale catastrophic events. The work will emphasize what is currently known regarding the impact media plays on an individual, including mood, opinion, worldview, and overall mental health and wellness. The conclusion will focus on discussing current means of assessment with future recommendations for heightened evaluation in this already vulnerable population.

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