scholarly journals Going Virtual When The Doors Close: Addressing Geriatric Workforce Training Needs During A Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 106-107
Author(s):  
Linda Edelman ◽  
Gail Towsley ◽  
Timothy Farrell

Abstract The focus of our Geriatric Workforce Enhancement Program (GWEP) is to enhance long-term services and support (LTSS) and primary care healthcare workforce capacity through interprofessional education (IPE) and to increase patient, family, and caregiver engagement. When it became evident that LTSS settings, schools, and communities were going to be adversely impacted by the COVID-19 pandemic for the unforeseeable future, our GWEP quickly pivoted to address new challenges and initiate technology to continue our programs. In this symposium, we describe four programs implemented or revised during the COVID-19 pandemic. We utilized CARES (Coronavirus Aid, Relief and Economic Security) funding to develop a 3-part Project ECHO on utilizing telehealth in LTSS settings. We pivoted quarterly Fireside Chats – community-based educational programs held at partnering LTSS settings for older adults and caregivers – to bi-weekly and now monthly webinars addressing topics relevant to COVID-19 and combatting social isolation. Because students could no longer attend an in-person IPE course introducing them to long-term care, we revised the course to be online with a partnering nursing home participating in an interactive mock care conference. Finally, a 2-semester undergraduate Honors College project-based course introducing students to successful aging utilized virtual activities to expose students to the challenges of hospice care during a pandemic. With these adaptations, as well as activities that advocated for, and supported, LTSS settings and older adults, our GWEP program was able to continue to provide education and support to the setting and individuals most impacted by COVID-19.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 107-108
Author(s):  
Megan Thomas Hebdon ◽  
Christina Wilson ◽  
Catherine Bernier-Carney ◽  
Jacqueline Telonidis ◽  
Susan Chase-Cantarini

Abstract The Utah Geriatric Education Consortium seeks to enhance healthcare provider workforce capacity. The purpose of our interprofessional education (IPE) in Long Term Care (LTC) course is to enhance students’ understanding of team-based care for older adults, presenting avenues for career opportunities. The course was offered via distance learning technology to adapt to the COVID-19 pandemic. Health sciences students (n=55) enrolled in the course and completed pre- and post-course work asynchronously. The course also included a two-hour virtual session in partnership with a LTC interprofessional team with a resident case study and discussion using the 4M’s Framework. We will discuss the a) COVID-19 course adaptations, b) IPE case study using the 4M’s Framework to help students conceptualize older adult care, and c) student pre- and post-course discussion responses demonstrating their prior experience with older adults and course impact on their views about caring for older adults in LTC settings.


2020 ◽  
pp. 1-2
Author(s):  
R.A. Merchant

Older adults at home, intermediate and long-term care (ILTC) setting including nursing home and hospice care are vulnerable to COVID-19 infection with increased morbidity and mortality. Singapore is one of the fastest aging countries in Asia where 14.4% of population is above 65 years old and this will double by 2030 (1). About 16000 older adults live in long-term care facilities and many more attend different types of day care facilities (2). Many of the residents are frail, with underlying dementia and / or multimorbidity and often present atypically causing a delay in diagnosis. In many countries, COVID-19 has spread amongst nursing home residents with mortality ranging from 24% in Hungary to 82% in Canada (3). It is known that 56% of residents may test positive while in pre-symptomatic stage, and many countries have put in initiatives to decrease the risk of spread in care homes (4). COVID-19 pandemic has highlighted the importance of communication and collaboration amongst ILTC providers which in many countries are run by non-governmental organization’s, healthcare providers, regional and national healthcare leaders.


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.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 733-734
Author(s):  
Lindsay Peterson ◽  
David Dosa ◽  
Patricia D’Antonio

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chan Mi Park ◽  
Wonsock Kim ◽  
Hye Chang Rhim ◽  
Eun Sik Lee ◽  
Jong Hun Kim ◽  
...  

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.


2021 ◽  
pp. 089801012110253
Author(s):  
Verónica G. Walker ◽  
Elizabeth K. Walker

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.


2021 ◽  
pp. 1-16
Author(s):  
Katherine Fasullo ◽  
Erik McIntosh ◽  
Susan W. Buchholz ◽  
Todd Ruppar ◽  
Sarah Ailey

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