scholarly journals Vaccine access shrinks disparities between long-term care and community rates of COVID-19 mortality

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1028-1028
Author(s):  
Nicholas Resciniti ◽  
Daniel Kaplan ◽  
Joshua Sellner ◽  
Matthew Lohman
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Environmental Control ◽  
Incidence Rates ◽  
Community Dwelling ◽  
Disease Spread ◽  
Term Care ◽  
Incidence And Mortality ◽  
Vaccine Availability

Abstract This longitudinal secondary data analysis examines differences in COVID-19 incidence and mortality among long-term care facility (LTCF) residents with those living in the community in South Carolina (SC) throughout the pandemic, including the time of vaccine availability. Data came from the SC Department of Health and Environmental Control (SCDHEC). Descriptive statistics and trends for cases of infections and deaths were calculated. Cox proportional hazards were used to compare COVID-19 mortality in LTC residents to community dwelling older adults, controlling for age, gender, race, and pre-existing chronic health conditions. Until early January of 2021, significantly greater incidence rates of infection (116.2 per 10,000 per month) and hazard of death after infection (HR=1.83, 95% CI: 1.70-1.98) were experienced among LTC residents as compared to older adults in the community even after statewide mask mandates and visitation guidance. Since vaccine availability, COVID incidence rates among LTC residents fell by half (59.5 per 10,000 per month after vaccines), and the relative hazard of death compared to older adults in the community was diminished (HR=1.44, 95% CI:1.29-1.61). Reducing the gap between LTCF and community-wide infection and mortality rates suggests that vaccination against COVID-19 is correlated with reduced disease spread in the greater community and in LTCF. Results indicate that policies and regulations addressing LTC resident and staff vaccination may effectively protect the most vulnerable older adults and the workforce providing their care while mask mandates and visitation guidance do not.

Determinants of long-term care insurance applications in South Korea

2020 ◽  
Author(s):  
Sunhee Park ◽  
Heejung Kim ◽  
Chang Gi Park
Keyword(s):  
Older Adults ◽  
South Korea ◽  
Long Term Care ◽  
Community Dwelling ◽  
Care Needs ◽  
Term Care ◽  
Factors Affecting ◽  
Long Term Care Insurance ◽  
The Government

Abstract Background South Korea established universal long-term care insurance (LTCI) in 2008. However, actual requests for LTCI remain lower than government estimates because some eligible candidates never apply despite their strong care needs. This study aimed to examine factors affecting LTCI applications for older, community-dwelling Koreans. Methods Both individual- and community-level data were obtained from a national dataset from the Korea Health Panel Survey and the Korea National Statistical Office (N = 523). Data were analyzed using multilevel modeling. Results Only 16.4% of older adults in need of care applied for LTCI. Those who applied were more likely to be older, report poor self-rated health, receive care from non-family caregivers, and have caregivers experiencing high levels of caregiving burden. Regional differences in LTCI applications existed concerning the financial condition of one’s community. Conclusions Our study findings emphasize that Korean LTCI should implement both individual and community strategies to better assist older adults in properly acquiring LTCI. The government should make comprehensive efforts to increase access to LTCI in terms of availability, quality, cost, and information by collaborating with local centers.

scholarly journals EAST MEETS WEST: IMPROVING HEALTH AND LONG-TERM CARE FOR OLDER ADULTS IN THE U.S. AND CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S243-S244
Author(s):  
Bei Wu ◽  
Jie Hua Lu
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Long Term Care ◽  
Panel Discussion ◽  
Community Dwelling ◽  
Term Care ◽  
Spousal Caregiving ◽  
Pragmatic Clinical Trials ◽  
The U.S

Abstract As the number of older adults in the U.S. and China continues to increase, promoting healthy aging is essential for individuals, family, and society. Both countries face many similar issues due to their aging populations, including prolonging healthy life expectancy and providing quality of care. However, the change in demographics brings with it unique challenges for both the U.S and China. This forum invites scholars and researchers from these two countries to share their knowledge and insights on promoting healthy aging and improving care for older adults. This forum includes five presentations and one-panel discussion. Two presentations will focus on long-term care (LTC) in China, one is to forecast the needs of LTC in the next five decades, and the other is to evaluate the current LTC needs and discuss LTC policy. Using the data from the Health and Retirement Study, the third presentation aims to re-conceptualize spousal caregiving as a dyad-level phenomenon and provides a dynamic view of the spousal caregiving experiences. The last two presentations will focus on promoting healthy aging through clinical interventions. The fourth one is to evaluate the effectiveness of adaptive computer-based cognitive training among community-dwelling older adults in China. The last presentation provides some examples of using pragmatic clinical trials to improve the care of older adults in skilled nursing facilities in the U.S. After the five presentations, the three panelists will provide feedback to the presentations and share their views on healthy aging with the audience.

Reminiscence intervention for community-dwelling older adults without dementia: a literature review

2020 ◽  
Vol 25 (1) ◽  
pp. 40-44 ◽  
Author(s):  
Michele Shropshire
Keyword(s):  
Older Adults ◽  
Literature Review ◽  
Cognitive Abilities ◽  
Social Engagement ◽  
Cognitive Skills ◽  
Long Term Care ◽  
Community Dwelling ◽  
Positive Health ◽  
Term Care

The aim of the present integrative literature review is to summarise empirical evidence supporting the positive health benefits of reminiscence intervention for older adults without dementia who reside in community and long-term care settings. Reminiscence intervention may be used to improve cognitive ability in older adults by prompting them to share life stories and recall past events. Using Garrard's matrix method, 15 studies were identified and included in this review, with a total of 815 participants. The health outcomes of reminiscence intervention for older adults residing in the community and long-term care settings were improvements in depressive symptoms; greater wellbeing, peace and life satisfaction; and improvements in quality of life, social engagement, anxiety and cognitive skills/memory. Non-pharmacological approaches such as reminiscence intervention may contribute to a rich base for reformulating cognitive interpretations, increasing cognitive abilities, and improving social skills among older adults.

scholarly journals Clinical features and risk factors for mortality among long-term care facility residents hospitalized due to COVID-19 in Spain

2021 ◽  
Author(s):  
José-Manuel Ramos-Rincón ◽  
Máximo Bernabeu-Whittel ◽  
Isabel Fiteni-Mera ◽  
Almudena López-Sampalo ◽  
Carmen López-Ríos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Long Term Care ◽  
Functional Dependence ◽  
Care Facility ◽  
Community Dwelling ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

Abstract Background COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. Methods This is a cross-sectional analysis within a retrospective cohort of hospitalized patients≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. Results Of 6,189 patients≥75 years, 1,185 (19.1%) were LTCF residents and 4,548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs. 82.1 years), mostly female (61.6% vs. 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs. 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p<.001). Mortality risk factors in LTCF residents were severe functional dependence (aOR:1.79;95%CI:1.13-2.83;p=.012), dyspnea (1.66;1.16-2.39;p=.004), SatO2<94% (1.73;1.27-2.37;p=.001), temperature≥37.8ºC (1.62;1.11-2.38; p=.013); qSOFA index≥2 (1.62;1.11-2.38;p=.013), bilateral infiltrates (1.98;1.24-2.98;p<.001), and high C-reactive protein (1.005;1.003-1.007;p<.001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR:0.74,95%CI:0.62-0.87;p<.001). Conclusion Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.

scholarly journals Behavioral Health, Social Engagement, and Long-Term Care Services Use Among Community Older Adults: USA vs. Taiwan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 348-349
Author(s):  
Su-I Hou ◽  
Chien-Ching Li ◽  
Darren Liu
Keyword(s):  
Older Adults ◽  
Behavioral Health ◽  
Social Engagement ◽  
Long Term Care ◽  
Community Dwelling ◽  
Community Based ◽  
Term Care ◽  
Aging In Community ◽  
Community Dwelling Older Adults

Abstract As healthcare advances, older adults are living longer. While 90% of older adults prefer aging in their own homes and communities, it is important to examine key factors influencing healthy aging-in-community and community-based long-term care (LTC) services available in different countries. This symposium examines behavioral health, social engagement, and LTC services utilization among community-dwelling older adults in the USA and Taiwan. Lessons learned from older adults across countries will provide insights for tailored community-based LTC services and program development. Dr. Hou from The University of Central Florida (UCF) will highlight similarities and differences in behavioral health profiles and the topics that most interest community-dwelling older Americans participating in three aging-in-community programs in Central Florida. Dr. Wang from Case Western Reserve University will examine the impact of neighborhood social cohesion on mobility among community-dwelling older Americans aged 65 and older from the national Health and Retirement Study. Dr. Liu from National Cheng-Kung University in Taiwan will share results of healthy lifestyle on quality of life among community-dwelling older adults in southern Taiwan. Dr. Young from State University of New York at Albany will compare long-term care use among community-dwelling older adults with and without dementia in Central Taiwan. Finally, Drs. Cao and Hou from UCF will analyze home and community-based services in the USA versus Taiwan. This symposium will further discuss similarities and differences of key factors related to healthy aging-in-community, along with practical recommendations and lessons learned across countries and cultural environments to improve community-based long-term care services and programs.

scholarly journals Impact of urine and mixed incontinence on long-term care preference: a vignette-survey study of community-dwelling older adults

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicolas Carvalho ◽  
Sarah Fustinoni ◽  
Nazanin Abolhassani ◽  
Juan Manuel Blanco ◽  
Lionel Meylan ◽  
...  
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Community Dwelling ◽  
Survey Study ◽  
Term Care ◽  
Mixed Incontinence ◽  
Community Dwelling Older Adults

scholarly journals A Comparison of Long-Term Care Use by Community-Dwelling Older Adults With and Without Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 349-349
Author(s):  
Ya-Mei Chen ◽  
Kuo-Piao Chung ◽  
Hsiu-Hsi Chen ◽  
Yen-Po Yeh ◽  
Yuchi Young
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Community Dwelling ◽  
Term Care ◽  
Related Services ◽  
People With Dementia ◽  
Centered Care ◽  
Health Related ◽  
Community Dwelling Older Adults

Abstract Introduction. This study compares long-term care (LTC) use among community-dwelling older adults with and without dementia. Methods. Participants (n=14,483) were aged 65+ residents of Changhua County, Taiwan who qualified for LTC services. Data were collected (4/1/2017-10/26/2018) through health assessments. Multivariate logistic regression quantifies the study aim. Results. Preliminary results show that on average participants with dementia are older than people without dementia (81.1 vs. 80.5; p<.001), more females (13.4% vs. 8.0%; p<.001), higher mean ADL (12,4 vs. 9.8; p< .001) and IADL (21.4 vs. 17.8; p<.001), and lower mean comorbidity (2.5 vs. 2.8; p<.001). Multivariate regression results indicate people with dementia use twice the health-related LTC services than their counterpart (OR= 2.0; 95% CI 1.90–2.14). Discussion. People with dementia use more health-related LTC services. Future dementia studies should examine the pattern of non-health-related LTC services concomitant with health-related services, so that person-centered care can be tailored to foster aging-in-community.

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