Preparedness in Long-Term Care: A Novel Approach to Address Gaps in Evacuation Tracking

2016 ◽  
Vol 11 (1) ◽  
pp. 28-30
Author(s):  
Emilie Y Prot ◽  
Bruce Clements
Keyword(s):  
Disaster Preparedness ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Initial Response ◽  
Term Care ◽  
Medical Needs ◽  
Novel Approach ◽  
Major Disaster ◽  
Disaster Preparedness And Response

AbstractWith an aging population, the number of elderly individuals residing in long-term care (LTC) facilities will continue to grow and pose unique challenges to disaster preparedness and response. With this rapidly growing vulnerable population, it becomes imperative to identify enhanced and novel preparedness strategies and measures. LTC residents not only have complicated medical needs, including the timing of dispensing multiple medications, but frequently have cognitive and mobility deficits as well. In nearly every major disaster, elderly populations have suffered disproportionate morbidity and mortality. This is often due to elderly evacuees getting overlooked in the chaos of an initial response. Instituting measures to rapidly recognize this population in a crowd during an evacuation will reduce their risk. This commentary reviews the LTC facility evacuation challenges of the 2013 explosion of the West Fertilizer Company plant in West, Texas, and offers a novel solution of mandating the wearing of pink vests by all nursing home residents in case of an evacuation. The pink vests quickly alert disaster rescue and response workers of LTC residents with special needs. (Disaster Med Public Health Preparedness. 2017;11:28–30)

scholarly journals Improving Long-Term Care Facility Disaster Preparedness and Response: A Literature Review

2016 ◽  
Vol 11 (1) ◽  
pp. 140-149 ◽  
Author(s):  
J. Rush Pierce ◽  
Sarah K. Morley ◽  
Theresa A. West ◽  
Percy Pentecost ◽  
Lori A. Upton ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Long Term Care ◽  
Care Facility ◽  
Disaster Planning ◽  
Patient Characteristics ◽  
Careful Consideration ◽  
Term Care ◽  
Medical Needs

AbstractLong-term care facilities (LTCFs) and their residents are especially susceptible to disruptions associated with natural disasters and often have limited experience and resources for disaster planning and response. Previous reports have offered disaster planning and response recommendations. We could not find a comprehensive review of studied interventions or facility attributes that affect disaster outcomes in LTCFs and their residents. We reviewed articles published from 1974 through September 30, 2015, that studied disaster characteristics, facility characteristics, patient characteristics, or an intervention that affected outcomes for LTCFs experiencing or preparing for a disaster. Twenty-one articles were included in the review. All of the articles fell into 1 of the following categories: facility or disaster characteristics that predicted preparedness or response, interventions to improve preparedness, and health effects of disaster response, most often related to facility evacuation. All of the articles described observational studies that were heterogeneous in design and metrics. We believe that the evidence-based literature supports 6 specific recommendations for facilities, governmental agencies, health care communities and academia. These include integrated and coordinated disaster planning, staff training, careful consideration before governments order mandatory evacuations, anticipation of the increased medical needs of LTCF residents following a disaster, and the need for more outcomes research. (Disaster Med Public Health Preparedness. 2017;11:140–149)

scholarly journals CNAs’ Ratings of Nursing Home Residents’ Pain: The Role of CNA and Resident Traits

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 381-381
Author(s):  
Emily Behrens ◽  
Hyunjin Noh ◽  
A Lynn Snow ◽  
Patricia Parmelee
Keyword(s):  
Long Term Care ◽  
Pain Catastrophizing ◽  
Nursing Home Residents ◽  
Cognitive Status ◽  
Pain Rating ◽  
Sources Of Information ◽  
Term Care ◽  
Rating Accuracy ◽  
Lower Accuracy

Abstract Long-term care residents with and without cognitive impairment may experience undertreatment of persistent pain (Fain et. al, 2017). Certified nursing assistants (CNAs) are important sources of information about resident pain as they provide the majority of residents’ hands-on care. Therefore, assessing the accuracy of CNAs’ pain assessments and potential influencing factors may provide insight regarding the undertreatment of pain. Informed by prior research, this study examined resident pain catastrophizing and cognitive status as predictors of CNAs’ pain assessment accuracy. CNA empathy was examined as a moderating variable. Analyses confirmed a relationship between pain catastrophizing and CNA pain rating accuracy (R^2 = .205, p < .01), reflecting lower accuracy of ratings for residents higher in catastrophizing. Hypotheses predicting a relationship between resident cognitive status and CNA pain rating accuracy and moderating effects of empathy were disconfirmed. Challenges of conducting research in long-term care are discussed.

Community Long Term Care Ombudsman Program Disaster Assistance: Ready, Willing or Able?

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
H. Wayne Nelson ◽  
Bo Kyum Yang ◽  
F. Ellen Netting ◽  
Erin Monahan
Keyword(s):  
Hurricane Katrina ◽  
Disaster Preparedness ◽  
Long Term Care ◽  
Disaster Mitigation ◽  
Term Care ◽  
Disaster Assistance ◽  
Disaster Experience ◽  
Public Crisis ◽  
Disaster Training

AbstractThe high elder care death toll of Hurricane Katrina in 2005, pushed the federally mandated Long-Term Care Ombudsman Program (LTCOP) into the unsought and unforeseen realm of disaster preparedness. This new role was an extension of the LTCOP’s historic resident’s rights investigative case advocacy. To assess if, how, and to what extent local ombudsmen adapted to this new function, 102 local LTCOP leaders completed a telephone survey based on the CMS Emergency Planning Checklist. This assessed their own and their programs’: (a) readiness to help facilities reduce disaster threats to residents, (b) familiarity with relevant disaster laws, rules, and resources; (c) readiness to help residents through the disaster cycle; and (d) levels of disaster training and/or their plans to provide such training to their staff and LTC stakeholders. Forty-two respondents (41.13%) had experienced a public disaster but over half or those responding (n = 56, 54.90%) felt fairly to somewhat prepared to help in a public crisis. After being ready to work away from their office during a crisis ($\overline{x}$ = 4.14, SD = 1.00) respondents felt most prepared “to assist during nursing home emergency closure and evacuation” ($\overline{x}$ = 3.86, SD = 1.09). t-tests revealed that respondents with a disaster experience were significantly more prepared in all assessed dimensions than as those without disaster experience. The study highlights the training needs of ombudsmen in high risk areas to better prepare them for disaster mitigation in nursing homes.

Combating Coronavirus Disease-2019 Outbreak in Long-Term Care Facilities for Frail Older Adults: Preventive Measures and Palliative Care Go Hand-in-Hand

2021 ◽  
pp. 082585972110393
Author(s):  
Hon Wai Benjamin Cheng
Keyword(s):  
Palliative Care ◽  
Long Term Care ◽  
Care Delivery ◽  
Nursing Home Residents ◽  
Respiratory Illness ◽  
Term Care ◽  
The People ◽  
Care Facilities ◽  
Novel Coronavirus

While the whole population is at risk from infection with the coronavirus, older people—often frail and subject to multimorbidity—are at the highest risk for the severe and fatal disease. Despite strict infection control and social distancing measures, frail adults in long-term care facilities may be at particular risk of transmission of respiratory illness. Treatment decisions are often complex attributed to the heterogeneity of this population with regards to different geriatric domains such as functional status, comorbidity, and poly-pharmacy. While measures must be taken to prevent the novel coronavirus from spreading through these facilities, it is also essential that residents with coronavirus disease 2019 (COVID-19) have access to the symptom management and support they want and deserve. What most nursing home residents want during the course of their illness is to be able to stay in their facilities, to be surrounded by the people they love most, and to feel relief from their physical and emotional pain. By addressing the limited access to hospice and palliative care delivery in nursing homes, we can prevent unnecessary suffering and pain from COVID-19 as well as lay the groundwork for improving care for all residents moving forward.

scholarly journals Why Nursing Home Residents Use Social Network Systems: An Attachment Perspective

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1037
Author(s):  
I.-Chiu Chang ◽  
Kuei-Chen Cheng ◽  
Cheng-Yi Chiang ◽  
Chang-Kuo Hu
Keyword(s):  
Social Network ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Care Facility ◽  
Network Systems ◽  
Term Care ◽  
Long Term Care Facility ◽  
Network Platform ◽  
Labor Resources

Most long-term care facilities can offer residents’ with sufficiently material and physical care, but psychological support may not be always provided due to the tight financial budget or labor resources. Residents’ isolation and loneliness then become a big issue, especially for the residents. Social network systems (SNS) have been proved to be a more effective information transmission channel for thoughts, perspectives, and information sharing than traditional channels such as microblogging, e-mails, or telephones. This study conducted a quasi-experiment to identify factors that influence residents’ intention of using SNS and the impacts of SNS on them in a long-term care facility. The results showed that residents’ attached motivation of personal interacting is a significant factor that influences their intention to use the social network platform. Meanwhile, both the loneliness and depression scales of the participants were decreased significantly.

scholarly journals The Interplay Between Infection Risk Factors of SARS-CoV-2 and Prognosis: A Cross-Sectional Study from a Cohort of Long-Term Care Nursing Home Residents

2021 ◽  
Author(s):  
Laura Soldevila ◽  
Núria Prat ◽  
Miquel À. Mas ◽  
Mireia Massot ◽  
Ramon Miralles ◽  
...  
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Risk Of Infection ◽  
Cross Sectional ◽  
Term Care ◽  
Facility Size ◽  
Care Nursing ◽  
Pcr Test

Abstract Background: Covid-19 pandemic has particularly affected older people living in Long-term Care settings. Methods: We carried out a cross-sectional analysis of a cohort of Long-term care nursing home residents between March first and June thirty, 2020, who were ≥ 65 years old and on whom at last one PCR test was performed. Socio-demographic, comorbidities, and clinical data were recorded. Facility size and community incidence of SARS-CoV-2 were also considered.Results: A total of 8021 participants were included from 168 facilities. Mean age was 86.4 years (SD = 7.4). Women represented 74.1%. SARS-CoV-2 infection was detected in 27.7% of participants, and the overall case fatality rate was 11.3% (24.9% among those with a positive PCR test). Epidemiological factors related to risk of infection were larger facility size (pooled aOR 1.73; P < .001), higher community incidence (pooled aOR 1.67, P = .04), leading to a higher risk than the clinical factor of low level of functional dependence (aOR 1.22, P = 0.03). Epidemiological risk factors associated with mortality were male gender (aOR 1.75; P < .001), age (pooled aOR 1.16; P < .001), and higher community incidence (pooled aOR 1.19, P = < .001). There was evidence of clustering for facility and health area when considering the risk of infection and mortality (P < .001). Conclusions: Our results suggest a complex interplay between structural and individual factors regarding Covid-19 infection and its impact on mortality in nursing-home residents.

The vulnerability of nursing home residents to the Covid-19 pandemic

2020 ◽  
Vol 23 (2-3) ◽  
pp. 57-60 ◽  
Author(s):  
Edward H Wagner
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Nursing Assistants ◽  
Nursing Home Care ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.

scholarly journals TRENDS IN OPIOID USE IN LONG-TERM CARE NURSING HOME RESIDENTS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S709-S709
Author(s):  
Hemalkumar B Mehta ◽  
Yong-Fang Kuo ◽  
Jordan Westra ◽  
Mukaila Raji ◽  
James S Goodwin
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Opioid Use ◽  
Severe Dementia ◽  
Term Care ◽  
Dementia Patients ◽  
Moderate Dementia ◽  
Long Acting

Abstract We examined opioid use in long-term care nursing home residents with dementia. This retrospective cohort study used Minimum Data Set linked Medicare data, 2011-2016, and included long-term care episodes for residents 65+ years who survived 100+ days each year (592,211 episodes for 256,207 residents). Cognitive status at first annual assessment was classified as none/mild, moderate and severe impairment. Overall opioid use, prolonged opioid use (prescription supply 90+ days) and long-acting opioid use were identified from Medicare part D. Descriptive statistics were used to describe opioid use by cognitive impairment. Cochrane Armitage trends test was used to determine trends in opioid use. 114,622 (19%) patients had severe and 129,257 (22%) had moderate dementia. Overall opioid (none/mild=15.4%, moderate=13.9%, severe=9%), prolonged opioid (none/mild=5.2%, moderate=4.5%, severe=3.2%) and long-acting opioid use (none/mild=1.1%, moderate=0.9%, severe=0.3% ) were lower in patients with advanced dementia. Opioid use was significantly higher in females and Whites and varied by states. Substantial increase was found in overall opioid and prolonged opioid use from 2011 to 2016, with greater increase in none/mild and moderate dementia patients. For example, prolonged opioid use increased by 69% in none/mild and 71% in moderate dementia patients compared to 52% in severe dementia patients (p&lt;0.0001). Long-acting opioid use decreased, with a greater decline in none/mild (69%) and moderate (71%) dementia patients compared to severe dementia patients (58%) (p&lt;0.0001). Contrary to decreasing opioid use in community setting, overall and prolonged opioid use increased in nursing home residents. Future studies should identify the reasons behind increased use.

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