scholarly journals COVID-19 Response In U.S. Assisted Living Settings: Key Stakeholder Perspectives

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 57-58
Author(s):  
Sarah Dys ◽  
Jaclyn Winfree ◽  
Paula Carder ◽  
Sheryl Zimmerman ◽  
Kali Thomas
Keyword(s):  
Assisted Living ◽  
Policy Development ◽  
State Level ◽  
Unintended Consequences ◽  
Direct Care ◽  
Health Priorities ◽  
Regulatory Requirements ◽  
Policy Practice ◽  
Stakeholder Perspectives ◽  
Policy Development Process

Abstract Unique regulatory requirements and scope of services within assisted living (AL) pose distinctive challenges to COVID-19 response. To identify COVID-19 issues specific to AL, we recruited stakeholders with expertise in AL operations, policy, practice, and research (n=42) to participate in remote interviews between July and September 2020. Using thematic analysis, we derived the following overarching themes: 1) Policymakers lack an understanding of the AL context; 2) AL administrators were left to coordinate guidelines with little support; 3) AL organizations faced limited knowledge of and disparate access to resources; 4) State-level regulatory requirements conflicted with COVID-19 guidelines resulting in confusion; and 5) AL operators struggled to balance public health priorities with promoting their residents’ wellbeing. To develop evidence-informed policy and avoid unintended consequences, AL operators, direct care workers, residents, and clinicians practicing in these settings should have opportunities to provide feedback through the policy development process, both state and national.

scholarly journals Delivering Person-Centered Care During a Pandemic: Stakeholder Perspectives

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 269-270
Author(s):  
Katherine Abbott ◽  
Kirsten Corazzini
Keyword(s):  
Family Involvement ◽  
Health Care Providers ◽  
Assisted Living ◽  
Direct Care ◽  
Care Providers ◽  
Improvement Project ◽  
Stakeholder Perspectives ◽  
Person Centered Care ◽  
Centered Care ◽  
The Impact

Abstract Person-centered care (PCC) is an approach to care that both nursing homes (NH) and assisted living (AL) communities strive to provide. PCC is a philosophy that recognizes knowing the person and honoring individual preferences. However, when COVID-19 emerged, the NH and AL environments were ground zero for infection spread and disproportionate numbers of deaths among residents. As a result, many practices changed dramatically in efforts to reduce the transmission of COVID-19 in these communities. The purpose of this symposium is to discuss several projects that can speak to the impact of the pandemic on stakeholder efforts to provide PCC. First, Dr. Roberts presents feedback from residents and family members on the challenges COVID-19 created for family involvement in care conferences. In the second study, Dr. Behrens examines focus group data from direct-care nurses on their perceptions of delivering PCC related to risk of harm to staff and residents. The third study presents the voices of activities professionals who were implementing a PCC quality improvement project to communicate resident preferences, which illustrates both the importance of PCC during the pandemic, but also the challenges implementing during the pandemic. Fourth, the Kansas PEAK 2.0 program used provider feedback to direct and inform program responses through components such as consistent staffing. Finally, Dr. Zimmerman presents qualitative data from over 100 AL administrators, medical, and mental health care providers on their experiences pivoting during COVID-19. Our discussant will explore the implications of these studies in terms of the future of PCC in residential settings.

scholarly journals Issues in the Hong Kong Applied Learning Trials

2018 ◽  
Vol 3 (1) ◽  
pp. 62 ◽  
Author(s):  
Richard G. Bagnall ◽  
Linnie Wong Koon Lin
Keyword(s):  
Hong Kong ◽  
General Education ◽  
School Leadership ◽  
Policy Development ◽  
Unintended Consequences ◽  
Applied Learning ◽  
Policy Makers ◽  
Policy Development Process ◽  
Critical Issues ◽  
Academic Recognition

This paper presents critical issues in the conceptualisation and positioning of applied learning (APL) in Hong Kong trials. It draws on a critical review of official documentation and interviews with participants involved in the 2003-09 developmental trials of APL policy: policy makers, APL provider leadership personnel, school leadership personnel, APL teachers and course coordinators, and APL students. Analysis of the documentation and interview data revealed five critical limiting issues of the way APL was promulgated in and through the policy development process: (1) its de-vocationalisation; (2) its under-theorisation; (3) its limited academic recognition; (4) its lack of vocational recognition; and (5) its poor standing. Those issues suggested the importance of the following considerations in APL policy development: a clear and consistent prioritisation of vocational and general education goals; a strongly theory-driven approach; academic credit equivalence into general educational qualifications; the dual recognition of APL in both general secondary and vocational education qualifications; and sensitivity to the unintended consequences of policy developments.

scholarly journals Coronavirus Disease 2019 Regulatory Response in United States-Assisted Living Communities: Lessons Learned

2021 ◽  
Vol 9 ◽  
Author(s):  
Sarah Dys ◽  
Jaclyn Winfree ◽  
Paula Carder ◽  
Sheryl Zimmerman ◽  
Kali S. Thomas
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Long Term Care ◽  
Well Being ◽  
Unintended Consequences ◽  
Lessons Learned ◽  
Social Model ◽  
Health Priorities ◽  
Term Care

Coronavirus disease 2019 (COVID-19) has disproportionately affected residents, their families, staff, and operators of congregate care settings. Assisted living (AL) is a type of long-term care setting for older adults who need supportive care but not ongoing nursing care and emphasizes a social model of care provision. Because AL is a type of long-term care, it has at times been referenced along with nursing homes in discussions related to COVID-19 but not recognized for its different care practices that pose unique challenges related to COVID-19; in that manner, it has largely been left out of the COVID-19 discourse, although ~812,000 older adults live in AL. To identify COVID-19 issues specific to AL, stakeholders with expertise in AL operations, policy, practice, and research (n = 42) were recruited to participate in remote interviews between July and September 2020. Using a thematic analysis, we derived the following overarching themes: (1) Policymakers are disconnected from and lack an understanding of the AL context; (2) AL administrators were left to coordinate, communicate, and implement constantly changing guidelines with little support; (3) AL organizations faced limited knowledge of and disparate access to funding and resources; (4) state-level regulatory requirements conflicted with COVID-19 guidelines resulting in uncertainty about which rules to follow; and (5) AL operators struggled to balance public health priorities with promoting their residents' quality of life and well-being. To develop evidence-informed policy and avoid unintended consequences, AL operators, direct care workers, residents, and clinicians practicing in these settings should have opportunities to provide feedback throughout the policy development process, both state and national.

scholarly journals Financing Long-Term Services and Supports: Opportunities for Overcoming Historical Roadblocks to Reform

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 717-717
Author(s):  
Edward Miller ◽  
Pamela Nadash ◽  
Marc Cohen
Keyword(s):  
Affordable Care Act ◽  
Policy Development ◽  
State Level ◽  
Government Action ◽  
Policy Window ◽  
Adoption And Implementation ◽  
Opportunities For Learning ◽  
State Budgets ◽  
Services And Supports

Abstract This presentation documents the continuing failure to tackle the problem of financing long-term services and supports (LTSS)—a failure most recently seen in the only national legislation ever enacted to comprehensively address LTSS costs: the Community Living Assistance Services and Supports (CLASS) Act. The CLASS Act was included in the Affordable Care Act, but was repealed in 2013. Subsequently, policy experts and some Democrats have made proposals for addressing the LTSS financing crisis. Moreover, significant government action is taking place at the state level, both to relieve financial and emotional burdens on LTSS recipients and their families and to ease pressure on state budgets. Lessons from these initiatives could serve as opportunities for learning how to overcome roadblocks to successful policy development, adoption, and implementation across states and for traversing the policy and political tradeoffs should a policy window open once again for addressing the problem of LTSS financing nationally.

scholarly journals From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Fixed Effects ◽  
Nursing Home Residents ◽  
Direct Care ◽  
Multiple Perspectives ◽  
Person Centered Care ◽  
Fixed Effects Panel Regression ◽  
Centered Care ◽  
The Impact

Abstract Advancing our knowledge related to honoring nursing home resident preferences is a cornerstone of person-centered care (PCC). While there are multiple approaches to providing PCC, we focus on resident preferences as assessed via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In this symposium, we explore the perspectives of a variety of stakeholders including nursing home residents, staff, and the impact of preference-based care on provider level regulatory outcomes. First, we present a comparative study of preference importance among n=317 African America and White nursing home residents that found more similarities than differences between the two groups. Second, a content analysis of the responses from n=196 interviews with nursing home residents details the barriers and facilitators connected to their levels of satisfaction with their preferences being fulfilled. Third, perspectives from n=27 direct care workers explore the concept of pervasive risk avoidance to the delivery of PCC. Fourth, systems-level practices, such as shift assignments and provider schedules are identified as barriers to successfully fulfilling resident preferences from the perspectives of n=19 staff within assisted living. Our final presentation utilizes a fixed-effects panel regression analysis with n=551 Ohio nursing home providers to explore the impact of PELI use on regulatory outcomes such as substantiated complaints and deficiency scores reported in the CMS Nursing Home Compare data. Discussant Dr. Kristi Williams will integrate findings, highlighting implications for policy, practice, and future directions. Research in Quality of Care Interest Group Sponsored Symposium.

scholarly journals 12-month incidence, prevalence, persistence, and treatment of mental disorders among individuals recently admitted to assisted living facilities in Maryland

2013 ◽  
Vol 25 (5) ◽  
pp. 721-731 ◽  
Author(s):  
Quincy M. Samus ◽  
Chiadi U. Onyike ◽  
Deirdre Johnston ◽  
Lawrence Mayer ◽  
Matthew McNabney ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Assisted Living ◽  
Cognitive Disorders ◽  
Cognitive Disorder ◽  
Incidence Rates ◽  
Direct Care ◽  
Care Staff ◽  
Care Practice ◽  
Longitudinal Impact ◽  
Incidence Prevalence

ABSTRACTBackground: To estimate the 12-month incidence, prevalence, and persistence of mental disorders among recently admitted assisted living (AL) residents and to describe the recognition and treatment of these disorders.Methods: Two hundred recently admitted AL residents in 21 randomly selected AL facilities in Maryland received comprehensive physician-based cognitive and neuropsychiatric evaluations at baseline and 12 months later. An expert consensus panel adjudicated psychiatric diagnoses (using DSM-IV-TR criteria) and completeness of workup and treatment. Incidence, prevalence, and persistence were derived from the panel's assessment. Family and direct care staff recognition of mental disorders was also assessed.Results: At baseline, three-quarters suffered from a cognitive disorder (56% dementia, 19% Cognitive Disorders Not Otherwise Specified) and 15% from an active non-cognitive mental disorder. Twelve-month incidence rates for dementia and non-cognitive psychiatric disorders were 17% and 3% respectively, and persistence rates were 89% and 41% respectively. Staff recognition rates for persistent dementias increased over the 12-month period but 25% of cases were still unrecognized at 12 months. Treatment was complete at 12 months for 71% of persistent dementia cases and 43% of persistent non-cognitive psychiatric disorder cases.Conclusions: Individuals recently admitted to AL are at high risk for having or developing mental disorders and a high proportion of cases, both persistent and incident, go unrecognized or untreated. Routine dementia and psychiatric screening and reassessment should be considered a standard care practice. Further study is needed to determine the longitudinal impact of psychiatric care on resident outcomes and use of facility resources.

Examining the Washington State Breastfeeding-Friendly Policy Development Process Using the Advocacy Coalition Framework

2016 ◽  
Vol 21 (3) ◽  
pp. 659-669 ◽  
Author(s):  
Lesley E. Steinman ◽  
Victoria Bradford ◽  
Emilee Quinn ◽  
Jennifer J. Otten ◽  
Jennifer McNamara ◽  
...  
Keyword(s):  
Policy Development ◽  
Development Process ◽  
Washington State ◽  
Advocacy Coalition Framework ◽  
Advocacy Coalition ◽  
Policy Development Process

scholarly journals Systemic Challenges Facing Public Procurement Policy Development in Tanzania: An Institutional Analysis

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Bakari Maligwa Mohamed
Keyword(s):  
Policy Development ◽  
Process Model ◽  
Structural Changes ◽  
Public Procurement ◽  
Institutional Analysis ◽  
Analysis Data ◽  
The Public ◽  
Procurement Policy ◽  
Policy Development Process ◽  
Development Data

Public procurement policy is vital for effective, efficient, economic, and transparent functioning of the public procurement system. Policy development is a political decision making platform. This paper tries to do an institutional analysis dwelling on the identification of the relevant systemic challenges and the related issues facing public procurement policy development in Tanzania. The paper utilises institutional and Delphi policy analyses to analyse systemic challenges facing public procurement policy development. Data for this paper were collected through Delphi in-depth interviews and documentary reviews and analysis. Data analysis were done by thematic and Delphi policy analyses. Analyses of data and evidences show that, Tanzania has been evidenced to have no public procurement policy. The public procurement policy development process has been halted for at least four years since 2012 due systemic challenges. The identified and analysed relevant systemic challenges facing public procurement policy development, inter alia, were: neglected politics and lack of political willingness; unrealistic policy process model; failure to achieve the desired qualities of policy development and difficult in achieving the policy qualities and therefore failure to make progress; and incoherent and incomplete institutional and structural changes that led to the emergence of new institutional and structural challenges.

A Study of the Alcohol Policy Development Process in the United States: Theory, Goals, and Methods

2004 ◽  
Vol 31 (4) ◽  
pp. 591-626 ◽  
Author(s):  
Thomas K. Greenfield ◽  
Norman Giesbrecht ◽  
Lee Ann Kaskutas ◽  
Suzanne Johnson ◽  
Lynn Kavanagh ◽  
...  
Keyword(s):  
United States ◽  
Policy Development ◽  
Development Process ◽  
The United States ◽  
Alcohol Policy ◽  
Policy Development Process

Policy, practice and racism: social cohesion in action

2018 ◽  
Author(s):  
Zanib Rasool
Keyword(s):  
Social Cohesion ◽  
Policy Development ◽  
Policy Issue ◽  
Structural Inequality ◽  
Scarce Resources ◽  
Policy Practice ◽  
Ethnic Minority Women ◽  
Internal Conflicts ◽  
Key Policy ◽  
Policy Impacts

This chapter considers some questions related to policy development, as policy impacts all areas of community life. In particular, it explores the concept of social cohesion in neighbourhoods, which is currently a key policy issue. The context for this includes internal conflicts between groups competing for the same scarce resources, structural inequality, housing and environment neglect, crime, and disorder, creating segregation and a culture of ‘us and them’. Moreover, this chapter finds that arts methodology is a tool for ethnic minority women and young people to negotiate boundaries and hostile territories and to engage in policy questions on community cohesion through photography, portraits, and poetry.

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