scholarly journals #MoreThanAVisitor: Families as “Essential” Care Partners During COVID-19

2020 ◽  
Author(s):  
Candace L Kemp
Keyword(s):  
Family Involvement ◽  
Long Term Care ◽  
Research Policy ◽  
Well Being ◽  
Direct Care ◽  
Negative Consequences ◽  
Public Health Response ◽  
Term Care ◽  
Care Partners

Abstract The public health response to the current Coronavirus pandemic in long-term care communities, including assisted living, encompasses prohibiting visitors. This ban, which includes family members, has been criticized for being unfair, unhealthy, and unsafe. Against this backdrop, I examine the roles family play in residents’ daily lives and care routines. I argue that classifying family as “visitors” rather than essential care partners overlooks their critical contributions and stems from taken-for-granted assumption about gender, families, and care work, and I demonstrate why families are more than visitors. Policies that ban family visits also reflect a narrow understanding of health that focuses on mitigating infection risk, but neglects overall health and well-being. This policy further stems from a limited comprehension of care relations. Research shows that banning family visits has negative consequences for residents, but also families themselves, and direct care workers. I argue that identifying ways to better understand and support family involvement is essential and demonstrate the utility of the Convoys of Care model for guiding the reconceptualization of family in long-term care research, policy, and practice during and beyond the pandemic.

The Ethics in Long-Term Care Model: Everyday Ethics and the Unseen Moral Landscape of Assisted Living

2021 ◽  
pp. 073346482110498
Author(s):  
Candace L. Kemp ◽  
Jason Lesandrini ◽  
Jennifer Craft Morgan ◽  
Elisabeth O. Burgess
Keyword(s):  
Decision Making ◽  
Assisted Living ◽  
Long Term Care ◽  
Ethical Issues ◽  
Research Policy ◽  
Term Care ◽  
Case Examples ◽  
Care Partners ◽  
Moral Landscape

Assisted living (AL) communities are long-term care settings where people live, work, and visit, and where social relationships and care, including end-of-life care, are negotiated. Assisted living is fraught with uncertainty and conflict about values, especially given residents’ cognitive and physical frailty. These value-laden issues have implications for both resident and care partners’ experiences. Yet, almost no research has examined ethics in this complex care environment. In this article, we draw on and synthesize existing theory, research, and practice knowledge to offer a conceptual model and discuss case examples that highlight everyday ethical issues in AL. We conceptualize the moral decision-making process and hence the moral landscape of AL, as influenced by a myriad of multi-level factors that shape interpersonal encounters and decision-making involving residents and their care partners, which ultimately shape individuals’ actions and experiences in the setting. We conclude by discussing implications for research, policy, and practice.

Prevalent Insomnia Concerns and Perceived Need for Sleep Intervention Among Direct-Care Workers in Long-Term Care

2020 ◽  
pp. 073346482097861
Author(s):  
Soomi Lee ◽  
Taylor F. Vigoureux ◽  
Kathryn Hyer ◽  
Brent J. Small
Keyword(s):  
Long Term Care ◽  
Well Being ◽  
Direct Care ◽  
Direct Care Workers ◽  
Sleep Onset Latency ◽  
Term Care ◽  
Perceived Need ◽  
Care Workers ◽  
Long Sleep

This study examined sleep concerns among direct-care workers in long-term care and their perceived need for a sleep intervention. Thirty-five participants reported their sleep concerns and willingness to participate in a sleep intervention with preferred delivery forms/content. Multiple sleep characteristics were assessed via ecological momentary assessment and actigraphy for 2 weeks. Eighty percent reported at least one sleep concern with insomnia-related concerns being most prevalent. Those with insomnia-related concerns tended to have long sleep onset latency, frequent awakenings, suboptimal (long) sleep duration, and long naps. Most participants (66%) expressed interest in participating in a sleep intervention either online or in group sessions; interest was higher in those with insomnia-related concerns. Mindfulness strategies were most preferred, followed by cognitive-behavioral therapy and sleep hygiene education. The high prevalence of insomnia-related concerns in direct-care workers needs to be addressed for the well-being of these workers and for the quality of geriatric care delivery.

scholarly journals Mental well‐being of staff in long‐term care facilities at risk

2021 ◽  
Author(s):  
Chiaki Ura ◽  
Tsuyoshi Okamura ◽  
Akinori Takase ◽  
Masaya Shimmei ◽  
Yukan Ogawa
Keyword(s):  
At Risk ◽  
Long Term Care ◽  
Well Being ◽  
Term Care ◽  
Care Facilities ◽  
Mental Well Being

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 Informal carer in Portugal: moving towards political recognition in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I Fronteira ◽  
J Simoes ◽  
G Augusto
Keyword(s):  
Informal Care ◽  
Long Term Care ◽  
Well Being ◽  
Oecd Countries ◽  
Low Fertility ◽  
Informal Carer ◽  
Term Care ◽  
System Perspective ◽  
Informal Carers

Abstract Informal care represents around 80% of all long term care provided in EU countries. Nevertheless, the needs for this type of care are expected to increase in the coming years in all OECD countries. Portugal is among the OECD countries with the highest ageing index (21.5% of the population was older than 65 years in 2017) due to high life expectancy and low fertility rates. As this demographic trend establishes, Portugal is expected to have more than 40% of the population over 65 years in 2037, and the expected prevalence of dementia is 3%, in 2050. In 2015 there were 2.1% of people over 65 receiving long-term care, representing 52% of all long-term care users. Around 38% were receiving care at home. It is estimated that 287,000 people in Portugal depend on informal carers. The agenda towards the official recognition of informal cares has been push forward in the country. Since 2015, several recommendations have been issued by the Parliament as well as legislative initiatives and a proposal for a Status of the Informal Carer is currently under discussion. We analyse the process of formulation of this policy in terms of sectors and stakeholders involved, definition and scope of informal carer, rights and obligations, role of the person being cared for, formal protection (e.g., labor, social, financial, training) and implementation. Recognition of the informal carer is a sector wide approach. One of the main features is the economic, social and labor protection mainly through reconciliation between work life and caring activities and promotion of the carer’s well being. Notwithstanding, and from a health system perspective, community health teams are to be the focal point for informal carers, supporting and providing specific training whenever needed. Despite its relevance, informal care should not be professionalized and responsibility of care should not be shifted from health services to informal carers. Key messages Needs for informal care are expected to increase in the coming years in OECD countries. Recognition of the informal carer is a sector wide approach.

scholarly journals The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 675-675
Author(s):  
Jacqueline Eaton ◽  
Kristin Cloyes ◽  
Brooke Paulsen ◽  
Connie Madden ◽  
Lee Ellington
Keyword(s):  
Focus Groups ◽  
Long Term Care ◽  
Family Members ◽  
Nursing Assistants ◽  
Direct Care ◽  
Term Care ◽  
Memory Care

Abstract Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.

scholarly journals FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rebecca L Mauldin ◽  
Kathy Lee ◽  
Antwan Williams
Keyword(s):  
Long Term Care ◽  
Federal Policy ◽  
Care Facility ◽  
Well Being ◽  
The United States ◽  
Term Care ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

scholarly journals TRAINING STAFF IN LONG-TERM CARE FACILITIES – EFFECTS ON RESIDENTS’ SYMPTOMS, PSYCHOLOGICAL WELL-BEING, AND PROXY SATISFACTION

2021 ◽  
Author(s):  
Pauli J Lamppu ◽  
Marja-Liisa Laakkonen ◽  
Harriet Finne-Soveri ◽  
Hannu Kautiainen ◽  
Jouko V Laurila ◽  
...  
Keyword(s):  
Long Term Care ◽  
Well Being ◽  
Term Care ◽  
Psychological Well Being ◽  
Care Facilities

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

Economic Well-Being of the Chronically Disabled Elderly: Practice and Policy Implications

1993 ◽  
Vol 74 (8) ◽  
pp. 460-467 ◽  
Author(s):  
Jean W. Bauer ◽  
Marlene S. Stum ◽  
Paula J. Delaney
Keyword(s):  
Stepwise Regression ◽  
Long Term Care ◽  
Well Being ◽  
Policy Implications ◽  
Term Care ◽  
Disabled Elderly ◽  
The Disabled ◽  
Care Survey ◽  
Economic Well Being

The 1982 Long-Term Care Survey (N = 5,670) was used to gain an understanding of predisposing, need, and enabling variables that influence the economic well-being of disabled elderly. Stepwise regression results suggest that a combination of enabling and predisposing factors best explained differences in economic well-being. Implications of the findings for practitioners are discussed within the context of practice and policy for the disabled elderly.

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