scholarly journals COVID-19 in Assisted Living: Evidence on Policies, Provider Experiences, and Resident Mortality

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 57-57
Author(s):  
Kali Thomas ◽  
Lindsay Schwartz
Keyword(s):  
Health Care Providers ◽  
Assisted Living ◽  
Long Term Care ◽  
Healthcare Providers ◽  
Care Providers ◽  
Term Care ◽  
Key Stakeholders ◽  
National Organizations ◽  
Poor Outcomes

Abstract The devastating effects of Coronavirus disease 2019 (COVID-19) among older adults residing in long-term care settings has been well documented. Assisted living settings in the U.S. have 811,000 residents; most are 80 years or older, and many have one or more chronic illnesses, making them highly susceptible to poor outcomes if exposed to COVID-19. This symposium highlights five studies that focus on various levels of COVID-19 response in assisted living: national organizations, states, assisted living operators and healthcare providers, and residents. The first study compares the sometimes conflicting guidance provided by national long-term care industry-related organizations and recommends assisted living-specific actions for the future. The second study describes the state regulatory response to COVID-19 in assisted living, identifying the themes and implications for the function of the care networks of assisted living residents. The third study presents findings from interviews with key stakeholders, including policymakers and industry leaders, that reflect on the challenges responding to changing recommendations and policies. The fourth study reports results from a survey with administrators and medical and mental health care providers who treat their residents that illustrates the care practices that were implemented in response to COVID-19 in assisted living. The fifth presentation documents the national excess assisted living resident mortality that was attributable to COVID-19. This symposium culminates with a leading assisted living industry expert reflecting on providers’ experiences and posing areas to consider when preparing for and responding to future pandemic events in assisted living settings.

scholarly journals COVID-19 Perspectives of Assisted Living and Health Care Providers in Seven States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 271-271
Author(s):  
Philip Sloane ◽  
Johanna Hickey ◽  
Kali Thomas ◽  
Julia Thorp ◽  
Meredith Poole ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Assisted Living ◽  
Infection Prevention ◽  
Long Term Care ◽  
Patient Access ◽  
Care Providers ◽  
Psychosocial Needs ◽  
Term Care

Abstract Thirty percent of COVID-19 deaths in long-term care were in assisted living (AL), indicating challenges providing care. This project recruited AL administrators and medical and mental health care providers in a seven-state stratified random sample of 250 communities; it asked what was most challenging responding to COVID-19, what was successful, how to have better dealt with COVID-19, and how others could have helped. The most common challenge was addressing residents’ psychosocial needs, explained as “No contact - no hugging. The seniors require touch. It's something we've always done, and we can't do; we're required not to do it.” Successes included infection prevention, and in hindsight, administrators discussed staffing. Related to external entities, one commented, “Come in the building and see what we're doing. Don't sit behind a freaking screen and act like you know what we're doing.” Providers stressed patient access to care and social isolation. Implications will be discussed.

scholarly journals Is Long-Term Care Person Centred? A Case Study

2021 ◽  
Author(s):  
Katarina Young
Keyword(s):  
Long Term Care ◽  
Direct Care ◽  
Care Providers ◽  
Term Care ◽  
Study Approach ◽  
Key Stakeholders ◽  
Direct Care Providers ◽  
Government Legislation

In Ontario long-term care (LTC) settings, person-centred care (PCC) is promoted by government legislation, accreditation organizations and professional practice guidelines aiming to integrate this approach. However, there is currently no standardized approach to providing PCC in LTC. The purpose of this study was to examine public policies on PCC in Ontario and explore how they are interpreted and translated into practice in LTC. A qualitative case study approach was used to examine the perspectives of key stakeholders at one LTC facility in Ontario. Focus groups were conducted with residents, family members, direct care providers and managers. Through content analysis, findings were organized into four categories showcasing both overlapping and differential understandings of PCC in practice: 1) conceptualization, 2) barriers, 3) facilitators, and 4) evaluation. Identified tensions between policy and the delivery of PCC highlight systemic issues that must be addressed to enable equitable person-centred LTC rooted in resident-identified priorities.

scholarly journals Visual process maps to support implementation efforts: a case example

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Jennifer Kononowech ◽  
Zach Landis-Lewis ◽  
Joan Carpenter ◽  
Mary Ersek ◽  
Robert Hogikyan ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Process Mapping ◽  
Care Providers ◽  
Term Care ◽  
Goals Of Care ◽  
Process Maps ◽  
Time Burden ◽  
Centered Care

Abstract Background Process mapping is often used in quality improvement work to examine current processes and workflow and to identify areas to intervene to improve quality. Our objective in this paper is to describe process maps as a visual means of understanding modifiable behaviors and activities, in this case example to ensure that goals of care conversations are part of admitting a veteran in long-term care settings. Methods We completed site visits to 6 VA nursing homes and reviewed their current admission processes. We conducted interviews to document behaviors and activities that occur when a veteran is referred to a long-term care setting, during admission, and during mandatory VA reassessments. We created visualizations of the data using process mapping approaches. Process maps for each site were created to document the admission activities for each VA nursing home and were reviewed by the research team to identify consistencies across sites and to identify potential opportunities for implementing goals of care conversations. Results We identified five consistent behaviors that take place when a veteran is referred and admitted in long-term care. These behaviors are assessing, discussing, decision-making, documenting, and re-assessing. Conclusions Based on the process maps, it seems feasible that the LST note and order template could be completed along with other routine assessment processes. However, this will require more robust multi-disciplinary collaboration among both prescribing and non-prescribing health care providers. Completing the LST template during the current admission process would increase the likelihood that the template is completed in a timely manner, potentially alleviate the perceived time burden, and help with the provision of veteran-centered care.

Forensic Issues in Long-Term Care Psychiatry

2017 ◽  
Author(s):  
Marshall B. Kapp
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
Psychiatric Treatment ◽  
Health Assessment ◽  
The United States ◽  
Assisted Living Facilities ◽  
Nursing Facilities ◽  
Care Providers ◽  
Term Care

This chapter focuses on medical-legal issues that may arise in the context of identifying psychiatric needs and providing psychiatric care for older persons in long-term care institutional settings, specifically residents of nursing facilities and assisted living facilities. Following general observations about the present regulatory climate in the United States governing nursing facilities and assisted living facilities, the chapter explores mental health assessment requirements for residents of those venues. Key legal responsibilities and restrictions regarding the psychiatric treatment of those residents are then discussed, as well as several areas of concern about potential exposure to litigation and liability on the part of long-term care providers. Finally, some of the most salient future legal and policy challenges confronting those who plan, fund, provide, and evaluate long-term care institutional psychiatric services are noted.

scholarly journals EVENT-SPECIFIC EMOTIONAL EXPRESSION OF PERSONS WITH DEMENTIA IN LONG-TERM CARE: PRELIMINARY RESULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S420-S420
Author(s):  
Kyung Hee Lee ◽  
Ji Yeon Lee ◽  
Bora Kim ◽  
Marie Boltz
Keyword(s):  
Health Care Providers ◽  
Emotional Expression ◽  
Long Term Care ◽  
Well Being ◽  
Emotional Expressions ◽  
Care Providers ◽  
Personal Care ◽  
Term Care ◽  
Meal Time

Abstract Although dementia-related language, comprehension, and memory deficits occur fairly early stage in dementia, persons with dementia retain the ability to express their emotion even in the late stage of disease. However, health care providers do not know how to interpret emotional expressions that could be utilized as important signals of underlying needs and care preferences in persons with dementia. The purpose of this study was to explore the event-specific emotional expressions of persons with dementia in long-term care over a 6-month period. This was a longitudinal study using repeated observations. Emotional expressions were videotaped when three specific events (personal care, meal time, and activity) occurred at baseline, month 3 and month 6. A total of nine observations was made for each participant. We enrolled 13 participants so far; ten participants were completed 6 month follow up. The mean score of MMSE at baseline was 4.38; that of ADL was 16.62. On average, persons with dementia showed 9.93 episodes of positive emotional expression (PEE) per minute and 1.81 episodes of negative emotional expression (NEE) per minute. We found between person variations for both PEE and NEE. PEE and NEE were different by three types of events. Specifically, persons with dementia showed more PEE with activity than personal care and meal time and more NEE with personal care than the other two events. This study will provide better understanding of event-specific emotional expressions, and inform the development of emotion-oriented interventions programs to improve the psychological well-being of persons with dementia.

Intercultural Collaboration: An Approach to Long Term Care for Urban American Indians

2003 ◽  
Vol 4 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Levanne R. Hendrix
Keyword(s):  
American Indian ◽  
American Indians ◽  
Health Care Providers ◽  
Long Term Care ◽  
Extended Family ◽  
Care Providers ◽  
Indian Culture ◽  
Term Care ◽  
Urban American Indians

Most long term care of older urban American Indians is provided in the community by family, extended family, or fictive kin, and American Indians are rarely found in long term care facilities. An approach to American Indian elderly requires some understanding of Indian ways in order to be effective therapeutically and acceptable to the older Indian. Multiple interviews, a focus group, and a survey conducted in an urban Indian community revealed the consistent perception by American Indian elderly and their families that health care providers lacked information, understanding, and respect for Indian culture.

scholarly journals Linking Incidents in Long-Term Care Facilities to Worker Activities

2017 ◽  
Vol 65 (10) ◽  
pp. 457-466
Author(s):  
Rose McCloskey ◽  
Cindy Donovan ◽  
Alicia Donovan
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Occupational Injury ◽  
Worker Safety ◽  
Care Providers ◽  
Cross Sectional ◽  
Term Care ◽  
Care Facilities ◽  
The Impact

This article reports on a study examining staff activities being performed when incidents were reported to have occurred. The risk for injury among health care providers who engage in patient handling activities is widely acknowledged. For those working in long-term care, the risk of occupational injury is particularly high. Although injuries and injury prevention have been widely studied, the work has generally focused on incident rates and the impact of specific assistive devices on worker safety. The purpose of this study was to examine reported staff incidents in relation to staff activities. A multicenter cross-sectional exploratory study used retrospective data from reported staff incidents (2010, 2011, and 2012) and prospective data from 360 hours of staff observations in five long-term care facilities during 2013. Descriptive statistics were used to analyze data. A total of 898 staff incidents were reviewed from the facilities. Incidents were most likely to occur in resident rooms. Resident aides were more likely to be engaged in high-risk activities than other care providers. Times when staff incidents were reported to have occurred were not associated with periods of high staff-to-resident contact. Safe handling during low and moderate risk activities should be promoted. Education on what constitutes a reportable incident and strategies to ensure compliance with reporting policies and procedures may be needed to ensure accuracy and completeness of incident data.

scholarly journals Keperawatan Pasien Berpenyakit Kronis

2014 ◽  
Vol 1 (2) ◽  
pp. 45-50
Author(s):  
Elly Nurachmah
Keyword(s):  
Chronic Illness ◽  
Health Care Providers ◽  
Nursing Practice ◽  
Long Term Care ◽  
Care Providers ◽  
Term Care ◽  
Caring Behavior ◽  
Pathological Alteration ◽  
Factors Influencing

Keperawatan merupakan falsafah mendasar praktik keperawatan. Dikembangkan oleh Watson (1985), keperawatan terdiri atas 10 faktor karatif yang menganjurkan perawat memberikan asuhan keperawatan paripurna kepada para pasien  sehubung dengan kondisi penyakit mereka, termasuk pasien berpenyakit kronis. Penyakit kronis ialah penyakit yang karena cirri-cirinya membutuhkan perawatan jangka panjang. Biasanya disebabkan oleh perubhan patologi yang “irreversible” dimana mengarahkan kemampuan seseorang karena kegagalan fungsi tubuh. Penyakit kronis menciptakan banyak masalah tidak hanya pada individu dan keluarga tetapi juga pada pemberi pelayanan kesehatan termasuk perawat. Mereka harus “hidup” dengan pasien dari hari ke hari dan mengatasinya. Mereka berada pada status kematian yang datangnya tidak dapat diperkirakan dengan tepat. Perawat merasa putus asa terhadap prognosa penyakit menyebabkan mereka sulit merawat pasien berpenyakit kronis. Hal ini juga merupakan salah satu alasan mengapa perawat tidak mampu memperlihatkan perilaku merawat seperti yang dikatakan Watson. Artikel ini mencoba menguraikan teori merawat berdasarkan kasih sayang, factor yang mempengaruhi perawat dalam merawat, dan alasan pemberian perawatan pada pasien berpenyakit kronis dengan menggunakan sikap merawat yang tepat. Caring is a fundamental philosophy of nursing practice. It was developed by Watson (1985). It consist of ten carrative factors that allow nurses to provide a comprehensive nursing care to patients regardless of their condition of illness including patients with chronic illness. Chronic illness is a variety of illness that because of its characteristic needs long term care. It is usually caused by non-reversible pathological alteration that lead to incapacity of a person due to impairment of body function. Chronic illness has created many problems not only for individuals and families but also for health care providers including nurses. They have to “live” with the patient day to day and cope with it. Following the chronicity of disease, death will come unpredictably. Nurses feel a sense of hopelessness with regard to the prognosis that make them difficult to care for individuals with chronic illness. This is also one of the reasons why nurses are unable to demonstrate caring behavior as stated by Watson. This article attempts to describe about theory of caring, factors influencing nurses caring behavior, and reasons to provide care to patients with chronic illness using appropriate caring behavior.

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