scholarly journals Fostering Continuity of Care for Massachusetts Long-Term Care Residents on Medication for Opioid Use Disorder

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 53-53
Author(s):  
Rosanna Bertrand ◽  
Chiara Moore ◽  
Katherine Fillo ◽  
Katherine Saunders ◽  
Stephanie Baker ◽  
...  
Keyword(s):  
Older Adults ◽  
Best Practices ◽  
Prescription Drugs ◽  
Long Term Care ◽  
Continuum Of Care ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Term Care ◽  
The Continuum

Abstract In 2016, the CDC estimated that 2.1 million Americans had Opioid Use Disorder (OUD); about 1.8 million related to prescribed painkillers. Older adults are especially susceptible; SAMHSA estimates that 2.7 million older adults will misuse prescription drugs by 2020. The Massachusetts Department of Public Health (MDPH) issued a 2016 Circular Letter advising long-term care facility (LTCF) administrators that, if otherwise eligible for admission, facilities are expected to admit individuals diagnosed with OUD, and provide medication for OUD (MOUD) as prescribed. Yet, many facilities express concern for admitting residents with OUD. The MDPH and their partners are conducting a multi-faceted training/technical support (TS) program to foster best practices across the continuum of care, targeting LTCF. The 15-month program consists of in-person learning sessions, a comprehensive toolkit, on-site TS, weekly contact, and a peer-to-peer webinar. Pre-training data indicated that 24 of 42 recruited LTCFs had not admitted residents with OUD. Although licensed LTCF practitioners can obtain a waiver to prescribe certain MOUD, only 4 of the 28 LTCF medical directors interviewed had done so. Subject matter experts led topic-specific discussions in the first learning session to educate on OUD/MOUD, dispel myths, make community connections, and provide resources. Almost all participants agreed that the session met the objectives of understanding OUD as a chronic disease, recognizing the stigma of OUD, gaining knowledge of MOUD treatments, and obtaining strategies to enhance best practices across the continuum of care. All items on the pre/post-session assessments indicated a significant increase in understanding (37% versus 60%, respectively).

LGBTQ Older Adults in Long-Term Care Settings: An Integrative Review to Inform Best Practices

2021 ◽  
pp. 1-16
Author(s):  
Katherine Fasullo ◽  
Erik McIntosh ◽  
Susan W. Buchholz ◽  
Todd Ruppar ◽  
Sarah Ailey
Keyword(s):  
Older Adults ◽  
Best Practices ◽  
Long Term Care ◽  
Integrative Review ◽  
Term Care

scholarly journals Evidence-based Recommendations to Inform Best Practices for LGBTQ Older Adults in Long-term Care Settings

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 851-851
Author(s):  
Katherine Fasullo ◽  
Erik McIntosh ◽  
Todd Ruppar ◽  
Sarah Ailey ◽  
Susan Buchholz
Keyword(s):  
Older Adults ◽  
Best Practices ◽  
Best Practice ◽  
Long Term Care ◽  
Guideline Development ◽  
Care Staff ◽  
Evidence Based ◽  
Term Care ◽  
Care Facilities

Abstract Lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults are more likely to live alone and have less familial support, which disproportionately contributes to a reliance on long-term care facilities as they age. Best-practice guidelines supported by scholarly literature to care for LGBTQ older adults in long-term care settings do not exist. This review synthesizes literature about LGBTQ older adults in long-term care facilities and provides recommendations for best practice guideline development. Four electronic databases were searched in June 2019 for studies conducted between 2000 – 2019 related to caring for LGBTQ older adults in long-term care settings. An integrative literature review was completed on the twenty eligible studies. Findings showed that LGBTQ participants fear discrimination in long-term care leading to the invisibility of their identities. They recognize a need for increased staff training and the importance of community networks and facility preferences. Long-term care staff have mixed experiences with inclusive practices and complex views of LGBTQ older adults. They experience training deficits and have a need for more expansive training modalities. The recommendations offered by both LGBTQ participants and long-term care staff are to revise policies and forms as well as provide widespread training and education. LGBTQ participants recommend that their unique identities be recognized within long-term care while long-term care staff recommend leadership involvement to change culture and practice. This review provides evidence-based recommendations to promote equitable healthcare to the LGBTQ older adult population and calls to attention the need for long-term care settings to uniformly follow best-practices.

The Continuum of Care

2018 ◽  
pp. 71-90 ◽  
Author(s):  
Kwong Yuen Liu ◽  
Bonnie H. Y. Wong ◽  
Maria Chu ◽  
William Y. W. Leung
Keyword(s):  
Long Term Care ◽  
Continuum Of Care ◽  
Geriatric Care ◽  
Term Care ◽  
Language And Culture ◽  
Community Agencies ◽  
Canadian Population ◽  
Chinese Canadian ◽  
The Continuum

This chapter examines the continuum of care in use at the Yee Hong Centre for Geriatric Care in Toronto, Ontario, Canada. The service continuum is a response to the needs of a diverse Chinese Canadian population, where services in the appropriate language and culture are limited. Within the funding context, service coordination for seniors within Ontario can be characterized as fragmented, with over-use of acute care hospitalization and long-term care institutionalization. Community agencies must find a way to adapt to changing systems as the Ontario government moves away from institutionalization and toward community care. This chapter explores challenges that are faced by a socially-minded organization within a medically-minded funding system. It also addresses ways to cope with the constraints.

Uitbraak COVID-19 in de verpleeghuiszorg

2020 ◽  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Informal Caregivers ◽  
Rapid Review ◽  
Daily Routine ◽  
Term Care ◽  
Care Facilities

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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