scholarly journals A Profile of Black and Latinx Older Adults Receiving Care in Nursing Homes: 2011-2017

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 241-241
Author(s):  
Andrew Dick ◽  
Bei Wu ◽  
David Grabowski ◽  
Mansi Agarwal ◽  
Gayani Perera ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Racial And Ethnic Disparities ◽  
Current Trends ◽  
Services And Supports

Abstract Between the years 1999-2008, a substantial increase in nursing home use occurred among Black and Latinx older adults, while white older adults’ use of nursing homes decreased. These disparate trends suggested potential racial and ethnic disparities in options for preferred long-term services and supports (LTSS) settings. Over the last decade, several initiatives have been put in place to support LTSS needs in the community. However, it is unclear whether Black and Latinx older adults are continuing to use nursing home services at disproportionate rates. We used LTCfocus data for 2011-2017 to explore current trends in nursing home use and access among Black and Latinx older adults in light of these current initiatives. Our findings reveal a continued rise in Black and Latinx older adults’ use of nursing homes while white older adults’ use continues to decline. More notably, there has been a decline in nursing homes servicing these minority groups.

scholarly journals RACIAL DISPARITIES IN COMMUNITY- AND INSTITUTION-BASED LONG-TERM SERVICES AND SUPPORTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S779-S780
Author(s):  
Chanee D Fabius
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Health Outcomes ◽  
Racial Disparities ◽  
Nursing Home Residents ◽  
Home Health ◽  
Services And Supports ◽  
The Impact

Abstract Long-term services and supports (LTSS) are services provided to individuals with functional limitations and chronic conditions who need assistance to perform daily activities such as bathing, dressing, preparing meals, and administering medications, and can be provided in community settings via services such as home health, as well as institutions such as nursing homes. Racial disparities are persistent across systems of LTSS, with older adults of color receiving lower quality care and experiencing worse health outcomes than their white counterparts. Given the increasing diversity of the aging population, and the need to ensure equity in quality and health outcomes in LTSS, there is a greater need for more understanding of how experiences of care vary across multiple settings for diverse groups of older adults and the people who help them. This symposium will feature 5 presentations that provide novel insight regarding racial disparities in community- and institution-based LTSS. We focus on racial differences in functional needs and disparities among those receiving home health services and living in nursing homes. Individual presentations will describe 1) race and gender differences in physical functioning needs of older adults; 2) disparities in home health quality across racially diverse and low income geographic areas; 3) racial disparities in nursing home residents overtime; 4) racial and ethnic disparities in rates of 30-day rehospitalization from skilled nursing facilities among Medicare Fee-For-Service and Medicare Advantage patients; and 5) the impact of the unequal burden of care provided to minority nursing home residents by staff of color.

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.

scholarly journals High-Minority Nursing Homes Disproportionately Affected by COVID-19 Deaths

2021 ◽  
Vol 9 ◽  
Author(s):  
Robert Weech-Maldonado ◽  
Justin Lord ◽  
Ganisher Davlyatov ◽  
Akbar Ghiasi ◽  
Gregory Orewa
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Ethnic Disparities ◽  
Nursing Facilities ◽  
Term Care ◽  
The Face ◽  
Facility Level ◽  
The Relationship ◽  
Racial Ethnic

Racial/ethnic disparities in healthcare have been highlighted by the recent COVID-19 pandemic. Using the Centers for Medicare and Medicaid Services' Nursing Home COVID-19 Public File, this study examined the relationship between nursing home racial/ethnic mix and COVID-19 resident mortality. As of October 25, 2020, high minority nursing homes reported 6.5 COVID-19 deaths as compared to 2.6 deaths for nursing homes that had no racial/ethnic minorities. After controlling for interstate differences, facility-level resident characteristics, resource availability, and organizational characteristics, high-minority nursing homes had 61% more COVID-19 deaths [Incidence Rate Ratio (IRR) = 1.61; p < 0.001] as compared to nursing facilities with no minorities. From a policy perspective, nursing homes, that serve primarily minority populations, may need additional resources, such as, funding for staffing and personal protective equipment in the face of the pandemic. The COVID-19 pandemic has sharpened the focus on healthcare disparities and societal inequalities in the delivery of long-term care.

scholarly journals Trends in racial and ethnic disparities in coronavirus disease 2019 (COVID-19) outcomes among nursing home residents

2021 ◽  
pp. 1-7
Author(s):  
Yue Li ◽  
Xueya Cai ◽  
Yunjiao Mao ◽  
Zijing Cheng ◽  
Helena Temkin-Greener
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Ethnic Minority ◽  
Negative Binomial ◽  
Nursing Home Residents ◽  
Ethnic Disparities ◽  
Relative Increase ◽  
Racial And Ethnic Disparities ◽  
Rate Ratios ◽  
Racial And Ethnic Minority

Abstract Objectives: To evaluate trends in racial and ethnic disparities in weekly cumulative rates of coronavirus disease 2019 (COVID-19) cases and deaths in Connecticut nursing homes. Design: Longitudinal analysis of nursing-home COVID-19 reports and other databases. Multivariable negative binomial models were used to estimate disparities in COVID-19 incidence and fatality rates across nursing-home groups with varying proportions of racial and ethnic minority residents, defined as low-, medium-, medium-high-, and high-proportion groups. Trends in such disparities were estimated from week 1 (April 13) to week 10 (ending on June 19, 2020). Setting: The study was conducted across 211 nursing homes. Results: The average number of cases ranged from 6.1 cases per facility for the low-proportion group to 11.7 cases per facility for the high-proportion group in week 1, and from 26.7 to 58.5 cases per facility in week 10. Compared to the low-proportion group, the adjusted incidence rate ratios (IRRs) for the high-proportion group were 1.18 (95% confidence interval [CI], 0.77–1.80; P > .10) in week 1 and 1.54 (95% CI, 1.05–2.25; P < .05) in week 10, showing a 30% (95% CI, 5%–62%) relative increase (P < .05). The average weekly number of COVID-19–related deaths ranged from 0 to 0.3 deaths per facility for different groups in week 1, and from 7.6 to 13.3 deaths per facility in week 10. Adjusted disparities in fatalities similarly increased over time. Conclusions: Connecticut nursing homes caring for predominately racial and ethnic minority residents tended to have higher COVID-19 incidence and fatality rates. These across-facility disparities increased during the early periods of the pandemic.

scholarly journals Nurse-Patient Interaction and Self-Transcendence: Assets for a Meaningful Life in Nursing Home Residents?

2019 ◽  
Author(s):  
Gørill Haugan ◽  
Britt Moene Kuven ◽  
Wenche Mjanger Eide ◽  
Siw Eriksen Tåsen ◽  
Eva Rinnan ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Meaning In Life ◽  
Nursing Home Residents ◽  
Well Being ◽  
Nursing Home Care ◽  
Patient Interaction ◽  
Self Transcendence

Abstract Background. Today, we face a shift to an older population worldwide and its consequences; a noteworthy part of older adults will need 24-hours nursing home care at the end of life. Finding new and alternative approaches to increase wellbeing among nursing home residents is highly warranted. Knowledge about nurse-patient-interaction, self-transcendence and meaning-in-life seems vital in order to guide clinical practice in how to best and efficiently boost wellbeing among older adults in nursing homes. Methods In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH patients representing 27 NHs responded to the nurse-patient interaction, self-transcendence, and the purpose-and-meaning-in-life scales. Inclusion criteria were: (1) municipality authority’s decision of long-term NH care; (2) residential time three months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations (five hypotheses) between the latent constructs were tested by means of structural equation modelling (SEM) using Stata 15.1. Results The SEM-model yielded a good fit (χ2=146.824, p=0.021, df=114, χ2 /df=1.29 RMSEA=0.040, p-close 0.811, CFI=0.97, TLI=0.96, and SRMR=0.063), showing significant relationships between the constructs of nurse-patient interaction, inter- and intra-personal self-transcendence and meaning-in-life. Nurse-patient interaction significantly relates with both inter- and intra-personal self-transcendence and meaning in NH patients. Self-transcendence revealed a fundamental influence on perceived meaning, while nurse-patient interaction demonstrated a significant influence on meaning, mediated by self-transcendence Conclusion According to the rapidly growing number of people over 65 in the world, and the growing segment of people 80-100, the present results are significant in their suggestions that nurse-patient-interaction is a crucial resource in relation to nursing home residents’ wellbeing. Knowledge of how nurse-patient-interaction, self-transcendence and meaning relate to each other among older adults in NHs is important for researchers, nurses, caregivers, nursing educators, and clinicians. Health professionals in nursing homes should learn how to competently use the nurse-patient interaction as a health promoting asset for self-transcendence, meaning and thus well-being. Nursing home nurses should be given more time for interacting with the residents, continuity and mutuality in nurse-patient relationships should be prioritized and facilitated.

scholarly journals COVID-19, Policy, and Nursing Homes: A Health and Aging Policy Fellows Symposium

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 58-58
Author(s):  
Nancy Kusmaul ◽  
Toni Miles ◽  
Lori Frank
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
State Government ◽  
Long Term Care ◽  
Extended Period ◽  
Federal State ◽  
Term Care ◽  
State And Local

Abstract COVID-19 significantly impacted older adults, particularly those in long term care. This symposium focuses on policy, and how policies drove many of the outcomes older adults in care experienced during 2020. We begin with a case study of one nursing home describing their operations, how those were impacted by policies at the local, state and federal levels, and operational factors that proved uncontrollable. From there we look more broadly at a national effort as implemented in one state which leveraged clinical and regulatory experts to partner with nursing homes and disseminate emerging and evidence based practice cohorts to address the realities of the COVID-19 pandemic over an extended period. Then we move from the federal to two state level projects. One looks at the experience of embedding advanced practice nurses (APRNs) into long term care facilities in one state over a five year period including during COVID-19. The final presentation describes hands on support provided by one state government to nursing homes and assisted livings during COVID-19, including the coordination of staff testing and the implementation of the use of the antigen testing machines issued through federal policy. We conclude with a discussion of the interplay of federal, state, and local policy on nursing home experiences in COVID-19 and recommendations for more effective policy interventions.

scholarly journals Developmental Evaluation of an Established Advisory Board

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 789-790
Author(s):  
Rachel Lessem
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Research Evaluation ◽  
Advisory Board ◽  
Community Members ◽  
Aging Research ◽  
Design And Implementation ◽  
Working Together ◽  
Services And Supports

Abstract CJE SeniorLife developed the PCORI-funded Bureau of Sages, a research advisory board of nursing home community members and older adults, who live at home and receive long term services and supports (LTSS). Bureau members share experiences, build knowledge, and develop skills for working together to provide voice to the direction, design, and implementation of aging research. The PCORI-funded Sages in Every Setting project developed four additional bureaus, expanding and diversifying a pool of researchers, providers, and older adults living with LTSS who have the knowledge, skills, and opportunity to collaborate in research. Evaluation results reveal that the Sage Model is translatable into new settings; partners were able to adapt the provided resources; researchers receive useful input from bureaus to improve their work; and, participation in a research advisory board is a benefit to its members. In addition, we will share challenges to establishing and expanding the Sage Model. Part of a symposium sponsored by the Patient/Person Engagement in Research Interest Group.

scholarly journals Utilization and Expenditures of High-Need, High-Cost Older Adults With Disabilities

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 158-158
Author(s):  
Cleanthe Kordomenos ◽  
Molly Knowles ◽  
Micah Segelman ◽  
Sarita Karon
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Inpatient Care ◽  
Nursing Home Care ◽  
Community Based ◽  
Adults With Disabilities ◽  
Care Models ◽  
Patterns Of Utilization ◽  
Services And Supports

Abstract The factors that lead people to have high needs for care can vary greatly, with implications for the best approaches to serving their needs. One high need group of interest is older adults with disabilities and multiple comorbidities. There is variation in need within this group. Of particular interest is the subset that is both high need and high cost (HNHC). We present work describing Medicare and Medicaid utilization and expenditures for this high need group and the HNHC subset. Over 7.6 million people were identified as high need; 13.6% of them also were defined as HNHC. Patterns of utilization differed between these groups, with the HNHC group more likely to use inpatient care and nursing home care, but less likely to use community-based long-term services and supports. These findings have implications for the development of care models that might best meet the needs of this population.

scholarly journals Addressing Systemic Factors Related to Racial and Ethnic Disparities among Older Adults in Long-Term Care Facilities

2021 ◽  
Author(s):  
Rebecca L. Mauldin ◽  
Shellye L. Sledge ◽  
Ebonie K. Kinney ◽  
Sarah Herrera ◽  
Kathy Lee
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Ethnic Disparities ◽  
The United States ◽  
Racial And Ethnic Disparities ◽  
Structural Racism ◽  
Term Care ◽  
Care Facilities ◽  
Systemic Factors

Disparities in older adults’ care and experiences in long-term care facilities (LTCFs) such as nursing homes and assisted living/residential care communities reflect disparities in the broader society. Various policies and institutional practices related to economic opportunity, education, housing, health care, and retirement financing have created and maintain inequitable social structures in the United States. This chapter describes racial and ethnic disparities among older adults in LTCFs in the United States and the systemic factors associated with those disparities. It presents a conceptual framework for understanding the role of structural racism in the racial and ethnic inequities experienced by LTCF residents. In the framework, structural racism directly contributes to racial and ethnic inequities among LTCF residents through LTCF-related policies and practices. Structural racism also indirectly causes disparities among LTCF residents through health and economic disparities. The chapter describes current efforts that address the effects of structural racism within LTCFs and concludes with practice and policy recommendations to redress racial and ethnic disparities among LTCF residents.

scholarly journals A CHANGING INDUSTRY IN A CHANGING WORLD: LONG-TERM SERVICES WHERE ARE YOU GOING?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S771-S771
Author(s):  
Robert A Applebaum ◽  
Matt Nelson ◽  
Jane Straker ◽  
A Katherine Harrington ◽  
John R Bowblis
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
User Characteristics ◽  
Term Care ◽  
Residential Care Facilities ◽  
The Future ◽  
Services And Supports ◽  
Home Industries

Abstract From its name to the type and setting of care provided, the world of long-term services and supports has changed dramatically in the last two decades. Using 26 years of longitudinal data from the state of Ohio this presentation describes how the long-term services system is different from the one that existed in the early 1990’s. Data come from 13 biennial surveys of Ohio nursing homes and residential care facilities (95% response rate) and comprehensive resident and home care participant data on user characteristics and utilization rates. Findings show large changes in where services are provided and who receives services. For example, Ohio, as has most other states, has changed the ratio of its older population using Medicaid long-term care, going from 91% nursing home users in 1993, to more than half using home and community-based services in 2017. At the same time the sheer number of admissions to Ohio nursing homes increased from 70,000 to more than 220,000 and Medic are admissions increasing from 30,000 to 145,000, painting a picture of today’s nursing home as a short-term care provider. These massive changes indicate an industry in transition. What will this mean for the future of the home care and nursing home industries? What will tomorrow’s system of long-term services and supports look like? Building on more than two decades of findings the presentation will tackle the question of where long-term services is going in the future.

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