scholarly journals THE EXTREME FACE OF SOCIAL ISOLATION: A COHORT STUDY OF UNBEFRIENDED INDIVIDUALS IN LONG-TERM CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S532-S533
Author(s):  
Stephanie Chamberlain ◽  
Wendy Duggleby ◽  
Pamela B Teaster ◽  
Janet Fast ◽  
Carole Estabrooks
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Health Outcomes ◽  
Social Isolation ◽  
Long Term Care ◽  
Poor Health ◽  
Term Care ◽  
Data Set ◽  
Family Contact

Abstract Even though social isolation is a significant predictor of poor health and mortality in older adults, very little is known about social isolation in long-term care (LTC) settings. The aim of this study was to describe the prevalence, demographic characteristics, health outcomes, and disease diagnoses of residents without family contact in Alberta LTC homes. Using data collected between April 2008 and March 2018, we conducted a retrospective cohort study using the Resident Assessment Instrument, Minimum Data Set, (RAI-MDS 2.0) data from 34 LTC facilities in Alberta. We identified individuals who had no contact with family or friends. Using descriptive statistics and binary logistic regression, we compared the characteristics, disease diagnoses, and functional status of individuals who had no contact with family and individuals who did have contact with family. We identified a cohort of 25,330 individuals, of whom 945 had no contact with family or friends. Different from residents who had family, the cohort with no contact was younger (81.47 years, SD=11.79), and had a longer length of stay (2.71 years, SD=3.63). For residents who had contact with family, residents with no contact had a greater number of mental health diagnoses, including depression (OR: 1.21, [95% CI: 1.06-1.39]), bipolar disorder (OR: 1.80, [95% CI: 1.22-2.68]), and schizophrenia (OR: 3.9, [95% CI: 2.96-5.14]). Interpretation: Residents without family contact had a number of unique care concerns, including mental health issues and poor health outcomes. These findings have implications for the training of staff and LTC services available to these vulnerable residents.

Mental health disorder, pain, and pain treatment among long-term care residents: Evidence from the Minimum Data Set 3.0

2018 ◽  
Vol 23 (9) ◽  
pp. 1146-1155 ◽  
Author(s):  
Penny L. Brennan ◽  
Mark A. Greenbaum ◽  
Sonne Lemke ◽  
Kathleen K. Schutte
Keyword(s):  
Mental Health ◽  
Long Term Care ◽  
Pain Treatment ◽  
Mental Health Disorder ◽  
Minimum Data Set ◽  
Term Care ◽  
Data Set ◽  
Minimum Data

scholarly journals Characteristics of Socially Isolated Residents in Long-Term Care: A Retrospective Cohort Study

2020 ◽  
Vol 6 ◽  
pp. 233372142097532
Author(s):  
Stephanie A. Chamberlain ◽  
Wendy Duggleby ◽  
Pamela B. Teaster ◽  
Carole A. Estabrooks
Keyword(s):  
Cohort Study ◽  
Functional Status ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Assessment Instrument ◽  
Term Care ◽  
Data Set ◽  
Socially Isolated

Objectives: To identify socially isolated long-term care residents and to compare their demographic characteristics, functional status, and health conditions to residents who are not isolated. Methods: We conducted a retrospective cohort study using the Resident Assessment Instrument, Minimum Data Set, 2.0 (RAI-MDS) data, from residents in 34 long-term care homes in Alberta, Canada (2008–2018). Using logistic regression, we compared the characteristics, conditions, and functional status of residents who were socially isolated (no contact with family/friends) and non-socially isolated residents. Results: Socially isolated residents were male, younger, and had a longer length of stay in the home, than non-socially isolated residents. Socially isolated residents lacked social engagement and exhibited signs of depression. Discussion: Socially isolated residents had unique care concerns, including psychiatric disorders, and co-morbid conditions. Our approach, using a single item in an existing data source, has the potential to assist clinicians in screening for socially isolated long-term care residents.

scholarly journals Digital Technologies To Enhance Social Connectedness in Long-Term Care Facilities During COVID-19: A Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 942-943
Author(s):  
Shannon Freeman ◽  
Aderonke Abgoji ◽  
Alanna Koopmans ◽  
Christopher Ross
Keyword(s):  
Social Isolation ◽  
Rural Areas ◽  
Social Connectedness ◽  
Long Term Care ◽  
Care Facility ◽  
Well Being ◽  
Sufficient Information ◽  
Term Care ◽  
Care Facilities

Abstract A consequence of the strict visitor restrictions implemented by many Long-term Care Facilities (LTCFs), during the COVID-19 pandemic, was the exacerbation of loneliness and social isolation felt by older adult residents. While there had been a shift by some persons to utilize digital solutions to mitigate the effects of the imposed social isolation, many facilities did not have sufficient information regarding available solutions to implement institutional strategies to support social connectedness through digital solutions. To support our partners in evidence-based policy-making we conducted a scoping review to identify existing virtual technology solutions, apps, and platforms feasible to promote social connectedness among persons residing in a long-term care facility context during times of lockdown such as experienced during the COVID-19 pandemic. Initial identification of relevant literature involved a combination of keywords and subject headings searches within 5 databases (PubMed, CINAHL EBSCO, PsychINFO EBSCO, Embase OVIDSP, and Web of Science ISI). DistillerSR was used to screen, chart and summarize the data. There is growth in the availability of technologies focused on promoting health and well-being in later life for persons in long-term care facilities however a gap remains in widespread uptake. We will describe the breadth of technologies identified in this review and discuss how they vary in utility in smaller scale facilities common in rural areas. Of the technologies that can be used to mitigate the impacts of social isolation felt by long-term care residents, many “solutions” depend on stable highspeed internet, which remains a challenge in rural and northern areas.

scholarly journals Evidence for Publicly Reported Quality Indicators in Residential Long-Term Care: A Systematic Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 181-181
Author(s):  
Franziska Zúñiga ◽  
Magdalena Osinska ◽  
Franziska Zuniga
Keyword(s):  
New Zealand ◽  
Quality Indicators ◽  
Long Term Care ◽  
Grey Literature ◽  
Public Reporting ◽  
Assessment Instrument ◽  
Term Care ◽  
Data Set ◽  
Residential Long Term Care

Abstract Quality indicators (QIs) are used internationally to measure, compare and improve quality in residential long-term care. Public reporting of such indicators allows transparency and motivates local quality improvement initiatives. However, little is known about the quality of QIs. In a systematic literature review, we assessed which countries publicly report health-related QIs, whether stakeholders were involved in their development and the evidence concerning their validity and reliability. Most information was found in grey literature, with nine countries (USA, Canada, Australia, New Zealand and five countries in Europe) publicly reporting a total of 66 QIs in areas like mobility, falls, pressure ulcers, continence, pain, weight loss, and physical restraint. While USA, Canada and New Zealand work with QIs from the Resident Assessment Instrument – Minimal Data Set (RAI-MDS), the other countries developed their own QIs. All countries involved stakeholders in some phase of the QI development. However, we only found reports from Canada and Australia on both, the criteria judged (e.g. relevance, influenceability), and the results of structured stakeholder surveys. Interrater reliability was measured for some RAI QIs and for those used in Germany, showing overall good Kappa values (>0.6) except for QIs concerning mobility, falls and urinary tract infection. Validity measures were only found for RAI QIs and were mostly moderate. Although a number of QIs are publicly reported and used for comparison and policy decisions, available evidence is still limited. We need broader and accessible evidence for a responsible use of QIs in public reporting.

The Effects of the Opioid Epidemic on Prescribing Practices in Long-Term Care Residents

2019 ◽  
Vol 34 (4) ◽  
pp. 258-267
Author(s):  
Lisa Yamagishi ◽  
Olivia Erickson ◽  
Kelly Mazzei ◽  
Christine O'Neil ◽  
Khalid M. Kamal
Keyword(s):  
Severe Pain ◽  
Long Term Care ◽  
Care Facility ◽  
The United States ◽  
Self Report ◽  
Prescribing Practices ◽  
Term Care ◽  
Data Set ◽  
Opioid Prescribing

OBJECTIVE: Evaluate opioid prescribing practices for older adults since the opioid crisis in the United States.<br/> DESIGN: Interrupted time-series analysis on retrospective observational cohort study.<br/> SETTING: 176-bed skilled-nursing facility (SNF).<br/> PARTICIPANTS: Patients admitted to a long-term care facility with pain-related diagnoses between October 1, 2015, and March 31, 2017, were included. Residents discharged prior to 14 days were excluded. Of 392 residents, 258 met inclusion criteria with 313 admissions.<br/> MAIN OUTCOME MEASURE: Changes in opioid prescribing frequency between two periods: Q1 to Q3 (Spring 2016) and Q4 to Q6 for pre- and postgovernment countermeasure, respectively.<br/> RESULTS: Opioid prescriptions for patients with pain-related diagnoses decreased during period one at -0.10% per quarter (95% confidence interval [CI] -0.85-0.85; P = 0.99), with the rate of decline increasing at -3.8% per quarter from period 1 and 2 (95% CI -0.23-0.15; P = 0.64). Opioid prescribing from top International Classification of Diseases, Ninth Revision category, "Injury and Poisoning" decreased in prescribing frequency by -3.0% per quarter from Q1 to Q6 (95% CI -0.16-0.10; P = 0.54). Appropriateness of pain-control was obtained from the Minimum Data Set version 3.0 "Percent of Residents Who Self-Report Moderate to Severe Pain (Short Stay)" measure; these results showed a significant increase in inadequacy of pain relief by 0.28% per quarter (95% CI 0.12-0.44; P = 0.009).<br/> CONCLUSION: Residents who self-report moderate- to severe pain have significantly increased since October 2015. Opioid prescriptions may have decreased for elderly patients in SNFs since Spring 2016. Further investigation with a larger population and wider time frame is warranted to further evaluate significance.

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