The long-term psychological effects of traumatic wartime experiences on older adults

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

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35 Social Contact Mode and 15-Year Episodic Memory Trajectories in Older Adults with and Without Hearing Loss: the Elsa Study

Age and Ageing ◽

10.1093/ageing/afab029.14 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i7-i11

Author(s):

S Rafnsson ◽

A Maharani ◽

G Tampubolon

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Social Network ◽

Episodic Memory ◽

Social Interactions ◽

Social Contact ◽

Sensitivity Analyses ◽

Impaired Hearing ◽

Contact Mode

Abstract Introduction Frequent social contact benefits cognition in later life although evidence is lacking on the potential importance of the modes chosen by older adults for interacting with others in their social network. Method 11,513 participants in the English Longitudinal Study of Ageing (ELSA) provided baseline information on hearing status and social contact mode and frequency of use. Multilevel growth curve models compared episodic memory (immediate and delayed recall) at baseline and long-term in participants who interacted frequently (offline only or offline and online combined), compared to infrequently, with others in their social network. Results Frequent offline (β = 0.29; p < 0.05) and combined offline and online (β = 0.76; p < 0.001) social interactions predicted better episodic memory after adjustment for multiple confounding factors. We observed positive long-term influences of combined offline and online interactions on memory in participants without hearing loss (β = 0.48, p = 0.001) but not of strictly offline interactions (β = 0.00, p = 0.970). In those with impaired hearing, long-term memory was positively influenced by both modes of engagement (offline only: β = 0.93, p < 0.001; combined online and offline: β = 1.47, p < 0.001). Sensitivity analyses confirmed the robustness of these findings. Conclusion Supplementing conventional social interactions with online communication modes may help older adults, especially those living with hearing loss, sustain, and benefit cognitively from, personal relationships.

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Vulnerable Older Adults in Disasters: Effects of Hurricane Irma on Nursing Homes and Assisted Living

Innovation in Aging ◽

10.1093/geroni/igaa057.2607 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 733-734

Author(s):

Lindsay Peterson ◽

David Dosa ◽

Patricia D’Antonio

Keyword(s):

Older Adults ◽

Assisted Living ◽

Gulf Coast ◽

Secondary Data ◽

Morbidity And Mortality ◽

Term Care ◽

The Face ◽

Qualitative Methodologies ◽

Hurricane Irma

Abstract Preparedness of residents in long-term care (LTC) in the face of hurricane emergencies is a contested and largely unanswered question. Our prior work involving the U.S. Gulf Coast hurricanes of 2005-08 showed that exposure to various storms on nursing home (NH) residents resulted in significantly more deaths than reported by health care officials. This work also highlighted that evacuation of NH residents, compared to sheltering in place, was independently associated with morbidity and mortality. Hurricane Irma struck Florida on Sept. 10, 2017, prompting the evacuation of thousands of NH and assisted living community (ALC) residents. This symposium will discuss the effects of Hurricane Irma on vulnerable older adults residing in NHs and ALCs using mixed quantitative and qualitative methodologies. The first presentation will discuss morbidity and mortality of NH residents exposed to Hurricane Irma and will stratify by long stay/short stay status and hospice enrollment. The second presentation will discuss improvements and continued barriers to NH preparedness based on interviews with 30 administrators following Hurricane Irma. Using a novel methodology to identify residents of ALCs using secondary data sources, the third presentation will document AL resident morbidity and mortality risk following Hurricane Irma. The final presentation will highlight results of interviews with 70 stakeholders from small and large ALCs concerning the hurricane experiences of residents, including those with dementia. This symposium offers a multi-faceted view of a disaster’s effects on LTC residents across Florida, including novel data from the NH environment and lesser-examined ALCs.

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Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

BMC Geriatrics ◽

10.1186/s12877-021-02049-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chan Mi Park ◽

Wonsock Kim ◽

Hye Chang Rhim ◽

Eun Sik Lee ◽

Jong Hun Kim ◽

...

Keyword(s):

Older Adults ◽

Primary Outcome ◽

Long Term Care ◽

Functional Decline ◽

Tube Feeding ◽

Term Care ◽

Pneumonia Severity ◽

Frailty Assessment ◽

Nasogastric Tube Feeding

Abstract Background Pneumonia is a major cause of morbidity and mortality in older adults. The role of frailty assessment in older adults with pneumonia is not well defined. Our purpose of the study was to investigate 30-day clinical course and functional outcomes of pneumonia in older adults with different levels of frailty. Methods A prospective cohort was conducted at a university hospital in Seoul, Korea with 176 patients who were 65 years or older and hospitalized with pneumonia. A 50-item deficit-accumulation frailty index (FI) (range: 0–1; robust < 0.15, pre-frail 0.15–0.24, mild-to-moderately frail 0.25–0.44, and severely frail ≥ 0.45) and the pneumonia severity CURB-65 score (range: 0–5) were measured. Primary outcome was death or functional decline, defined as worsening dependencies in 21 daily activities and physical tasks in 30 days. Secondary outcomes were intensive care unit admission, psychoactive drug use, nasogastric tube feeding, prolonged hospitalization (length of stay > 15 days), and discharge to a long-term care institution. Results The population had a median age 79 (interquartile range, 75–84) years, 68 (38.6 %) female, and 45 (25.5 %) robust, 36 (47.4 %) pre-frail, 37 (21.0 %) mild-to-moderately frail, and 58 (33.0 %) severely frail patients. After adjusting for age, sex, and CURB-65, the risk of primary outcome for increasing frailty categories was 46.7 %, 61.1 %, 83.8 %, and 86.2 %, respectively (p = 0.014). The risk was higher in patients with frailty (FI ≥ 0.25) than without (FI < 0.25) among those with CURB-65 0–2 points (75 % vs. 52 %; p = 0.022) and among those with CURB-65 3–5 points (93 % vs. 65 %; p = 0.007). In addition, patients with greater frailty were more likely to require nasogastric tube feeding (robust vs. severe frailty: 13.9 % vs. 60.3 %) and prolonged hospitalization (18.2 % vs. 50.9 %) and discharge to a long-term care institution (4.4 % vs. 59.3 %) (p < 0.05 for all). Rates of intensive care unit admission and psychoactive drug use were similar. Conclusions Older adults with frailty experience high rates of death or functional decline in 30 days of pneumonia hospitalization, regardless of the pneumonia severity. These results underscore the importance of frailty assessment in the acute care setting.

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Older Adults Diagnosed With Schizophrenia in Long-term Care Facilities: Life Course Theory for Holistic Nursing Research and Practice

Journal of Holistic Nursing ◽

10.1177/08980101211025372 ◽

2021 ◽

pp. 089801012110253

Author(s):

Verónica G. Walker ◽

Elizabeth K. Walker

Keyword(s):

Older Adults ◽

Life Course ◽

Health Beliefs ◽

Long Term Care ◽

Life Course Theory ◽

Nursing Research ◽

Term Care ◽

Holistic Nursing ◽

Care Facilities

Older adults diagnosed with schizophrenia (OADWS) often enter long-term care facilities with unique challenges related to trauma and stress experienced throughout their life course. Health care workers often report that when they work with this population, they feel unprepared due to limited training. In this article, life course theory is presented as a lens for holistic nursing research and as a way for nurses to adapt interventions already used with cognitively impaired older adults (e.g., those diagnosed with Alzheimer's disease) for OADWS in long-term care. It is hoped that these ideas will facilitate discussion of ways to inform training for holistic long-term care of OADWS. Holistic principles of nursing addressed with life course theory as a lens include the following: (a) accounting for strengths and challenges; (b) honoring experiences, values, and health beliefs; (c) viewing interrelationships with the environment; and (d) nurturing of peace, wholeness, and healing.

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Feasibility and Enjoyment of Exercise Video Games in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1838 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 559-559

Author(s):

Sara Freed ◽

Briana Sprague ◽

Lesley Ross

Keyword(s):

Older Adults ◽

Video Games ◽

Game Design ◽

Long Term Effects ◽

Short Term ◽

Qualitative And Quantitative ◽

Before And After ◽

Xbox Kinect ◽

Game Developers

Abstract Interventions using exercise video games, or exergames, have shown short-term cognitive and physical benefits to older adults, though long-term effects are less promising. Enjoyment of exergames may promote exergame use after the intervention period, though little work has examined older adults’ views of exergames before and after gameplay experience. We invited 20 older adults between 65 and 84 years of age (M=73.30, SD=5.95) to play two Xbox Kinect games, Just Dance and Kinect Sports Rivals, for twenty minutes. In our presentation, we will present qualitative and quantitative findings of this pilot study, including findings that older adults reported that they were not likely to play similar exergames in the future and that they did not find the exergames to be more fun compared to other ways of exercising. We will discuss implications for game design and research relevant to game developers, manufacturers, and researchers. Part of a symposium sponsored by Technology and Aging Interest Group.

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