scholarly journals The Psychological Consequences of the COVID-19 on Residents and Staff in Nursing Homes

2020 ◽  
Vol 6 (4) ◽  
pp. 254-259
Author(s):  
Shenjiang Mo ◽  
Junqi Shi
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Nursing Home Residents ◽  
Future Research ◽  
Psychological Consequences ◽  
Ethical Challenges ◽  
Role Conflicts ◽  
External Stakeholders

Abstract In this commentary, we overview the existing research on psychological consequences caused by COVID-19 for both residents and staff in the nursing homes. We identify loneliness and emotional anxiety as main psychological consequences for nursing home residents, whereas uncertainty, hopelessness, work overload, and role conflicts are the most salient psychological challenges for the staff in the nursing homes during the pandemic. We then summarize the existing strategies and interventions responsive to the above challenges. We suggest that this overview may help nursing home managers understand what are the key psychological challenges and how to deal with them during a crisis period. Finally, we also encourage future research to pay more attention to exploring interventions specifically designed for vulnerable older people, understanding the role of the nursing home leader team in managing emotional and ethical challenges in organizations, and developing community-wide collaboration with multiple external stakeholders.

The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

2022 ◽  
Vol 8 (1) ◽  
pp. 51-66
Author(s):  
Vesna Žegarac Leskovar ◽  
Vanja Skalicky Klemenčič
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Architectural Design ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Evaluation Tool ◽  
Negative Effect ◽  
Disproportionate Number ◽  
Role Of Nursing

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

Choosing to live in a nursing home: a culturally and linguistically diverse perspective

2015 ◽  
Vol 21 (2) ◽  
pp. 239
Author(s):  
Cecilia A. Yeboah
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Cultural History ◽  
Nursing Home Residents ◽  
Linguistically Diverse ◽  
Culturally And Linguistically Diverse ◽  
Individual Interviews ◽  
Cultural Origins ◽  
Diverse Perspective

As part of the findings of a study on culturally and linguistically diverse older people relocating to a nursing home, this paper contributes to our understanding of how older people draw on their cultural history to explain their decisions to relocate. Family reciprocity was identified by most participants as central to their decisions, regardless of their specific cultural origins. Using the grounded theory methodology, data were collected through progressive, semi-structured, repeated, in-person, individual interviews with 20 residents of four nursing homes in the northern suburbs of Melbourne, Australia. Culturally and linguistically diverse (CALD) older people, regardless of specific cultural origin, make relocation decisions based on the importance and meaning of reciprocity within families. Understanding their decisions as reflecting a culturally valued reciprocity offered a sense of cultural continuity to the relocation and was comforting to the older adults involved in the study. This study also suggests that culturally and linguistically diverse older people are much more active participants in the decision to relocate to a nursing home than is commonly recognised. The four nursing homes in the northern suburbs of Melbourne and the 20 participants studied constitute only a small proportion of all culturally and linguistically diverse older nursing home residents in Australia. Therefore, the findings may not be pertinent to other culturally and linguistically diverse elderly. Nonetheless, this study makes an important contribution to future discussions regarding cultural diversity in the nursing home relocation of culturally and linguistically diverse older Australians. The study findings provide some insight into the conditions and contexts that impact nursing home relocation.

Pain and symptoms of depression in older adults living in community and in nursing homes: the role of activity restriction as a potential mediator and moderator

2014 ◽  
Vol 26 (10) ◽  
pp. 1679-1691 ◽  
Author(s):  
Almudena López-Lopez ◽  
José L. González ◽  
Miriam Alonso-Fernández ◽  
Noelia Cuidad ◽  
Borja Matías
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Nursing Homes ◽  
Older People ◽  
Pain Intensity ◽  
Nursing Home Residents ◽  
Well Being ◽  
Community Dwelling ◽  
Activity Restriction

ABSTRACTBackground:Chronic pain is likely to lead to depressive symptoms, but the nature of this relationship is not completely clear. The aim of the present study is to analyze the role of activity restriction in the pain-depression relationship in older people, and to test the hypothesis that this role is more relevant in community-dwelling older people than in nursing home residents.Method:Depressive symptoms, pain intensity, and activity restriction were measured in a sample of 208 older adults with osteoarthritis, 102 living in nursing homes (NH), and 106 in the community. Analyses were carried out using moderation and moderated mediation analyses approach, treating activity restriction as a confounder.Results:Results showed a significant confounding effect of activity restriction, interaction effect between pain intensity and activity restriction on depression, and modifying effect of pain intensity on depression by adding activity restriction into the model. These results suggest a potential mediating and moderating effects of activity restriction. Moreover, analyses suggest that, surprisingly, the strength of the mediation could be higher in nursing homes.Conclusions:Overall, it may be that what is really important to emotional well-being is not so much pain itself, but rather the way in which the pain alters older people's lives. The greater strength of the mediation in NH might be understood within the scope of self-determination theory. Generally speaking, the NH context has been considered as a coercive setting, promoting non-autonomous orientation. In this context, when events are objectively coercive, people may lack perceived autonomy and hence be at greater risk of depression.

scholarly journals Facility Characteristics and Quality Deficiencies of Florida Nursing Homes With COVID-19 Cases and Deaths

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 945-945
Author(s):  
Xiaochuan Wang ◽  
Courtney Wilson
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Infection Control ◽  
Nursing Home Residents ◽  
The United States ◽  
Future Research ◽  
Staffing Level ◽  
Policy And Practice ◽  
Staff Shortage ◽  
Facility Size

Abstract The Coronavirus disease 2019 (COVID-19) has been disproportionately affecting nursing homes throughout the United States, resulting elevated risk for COVID-19 morbidity and mortality to nursing home residents. Given the high percentage of aging population, large number of nursing homes, and staggering surge of COVID-19 cases in Florida, it’s critical to understand factors that may affect Florida nursing homes’ vulnerability to the COVID-19 pandemic. Using Nursing Home COVID-19 Dataset as of July 26, 2020 obtained through Centers for Medicare and Medicaid Services (CMS), and Provider Info Dataset and Health Deficiencies Dataset available through CMS Nursing Home Compare data, we constructed a database of Florida nursing facilities with confirmed COVID-19 cases and deaths, with corresponding facility characteristics and quality deficiencies. We examined the facility characteristics (e.g. facility size, ownership state, chain affiliation, staffing level) and quality deficiencies (e.g. infection control deficiencies) of Florida nursing homes with and without publicly reported COVID-19 cases and deaths. Results indicated that, as of July 26, 2020, 73.3% and 40.8% of Florida nursing homes had resident COVID-19 cases and death, respectively (N=701). Findings also suggested that Florida nursing homes of large facility size, chain affiliated, and for profit, were significantly more likely to have documented resident COVID-19 cases (p<.05). Larger facility size (120 beds or more), staff shortage, and having prior infection control deficiency citation, were significantly related to the odds of having resident COVID-19 deaths (p<.05). Policy and practice implications and future research directions will be addressed to better protect the at-risk nursing home residents.

APPROPRIATE PRESCRIBING FOR OLDER PEOPLE: A NEW TOOL FOR THE GENERAL PRACTITIONER

2013 ◽  
pp. 1-7
Author(s):  
E. LENAERTS ◽  
F. DE KNIJF ◽  
B. SCHOENMAKERS
Keyword(s):  
Nursing Home ◽  
Older People ◽  
Short Form ◽  
Nursing Home Residents ◽  
Well Being ◽  
The Elderly ◽  
Future Research ◽  
Slight Reduction ◽  
Appropriate Prescribing ◽  
Prescribing Practice

Background:Appropriate prescribing for older people is a challenge. General practitioners (GPs) areaware of their key position in relation to prescribing practice in the elderly. However, they often feel powerlessand report a need for simple GP friendly tools to assess and support their prescribing practice. Objectives: In thisstudy such a tool is developed: the Appropriate Medication for Older people-tool (AMO-tool). The purpose of thestudy is to investigate whether GPs consider the use of the AMO-tool to be practically feasible and resulting inmore appropriate prescribing. Design:This pilot study with an interventional design was conducted over a periodof six months. Setting:The study was conducted in nursing homes visited by GPs. Participants:The studiedpopulation consisted of nine GPs and 67 nursing home residents. Intervention:The intervention consisted of theuse of the AMO-tool. Measurements:The Short Form (SF)-12 questionnaire was administered to the patients.Patients' medication lists were recorded. The GPs completed a semi-quantitative questionnaire on theirexperiences with the AMO-tool. A descriptive qualitative and semi-quantitative analysis was carried out on theGP questionnaire. The results of the SF-12 questionnaires and medication lists were analysed quantitatively. Amultivariate analysis was carried out. Results: In the perception of GPs, applying the AMO-tool to medicationlists of nursing home residents was feasible and resulted in more appropriate prescribing. A slight reduction wasrecorded in the number of medications prescribed. Self-reported well-being improved and rose in parallel withthe number of medication changes. Conclusion:According to GPs, the AMO-tool offers GPs the support in theirprescribing practice. Changes are made to medication lists and improvements occur in patients' self-reportedwell-being. Future research should objectify the appropriateness of prescriptions before and after using the tool.Furthermore, it should investigate the possible causal relationship between the use of the AMO-tool, an increasein appropriateness of medication lists and an improvement of general well-being.

scholarly journals Effect on secondary care of providing enhanced support to residential and nursing home residents: a subgroup analysis of a retrospective matched cohort study

2019 ◽  
Vol 28 (7) ◽  
pp. 534-546 ◽  
Author(s):  
Therese Lloyd ◽  
Stefano Conti ◽  
Filipe Santos ◽  
Adam Steventon
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Residential Care ◽  
Rate Ratio ◽  
Care Home ◽  
Nursing Home Residents ◽  
Care Homes ◽  
Emergency Admissions ◽  
Hospital Use

BackgroundThirteen residential care homes and 10 nursing homes specialising in older people in Rushcliffe, England, participated in an improvement programme. The enhanced support provided included regular visits from named general practitioners and additional training for care home staff. We assessed and compared the effect on hospital use for residents in residential and nursing homes, respectively.MethodsUsing linked care home and administrative hospital data, we examined people aged 65 years or over who moved to a participating care home between 2014 and 2016 (n=568). We selected matched control residents who had similar characteristics to the residents receiving enhanced support and moved to similar care homes not participating in the enhanced support (n=568). Differences in hospital use were assessed for residents of each type of care home using multivariable regression.ResultsResidents of participating residential care homes showed lower rates of potentially avoidable emergency admissions (rate ratio 0.50, 95% CI 0.30 to 0.82), emergency admissions (rate ratio 0.60, 95% CI 0.42 to 0.86) and Accident & Emergency attendances (0.57, 95% CI 0.40 to 0.81) than matched controls. Hospital bed days, outpatient attendances and the proportion of deaths that occurred out of hospital were not statistically different. For nursing home residents, there were no significant differences for any outcome.ConclusionsThe enhanced support was associated with lower emergency hospital use for older people living in residential care homes but not for people living in nursing homes. This might be because there was more potential to reduce emergency care for people in residential care homes. In nursing homes, improvement programmes may need to be more tailored to residents’ needs or the context of providing care in that setting.

scholarly journals LESSONS LEARNED FROM NURSING HOME CIVIL MONETARY PENALTY PROJECTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S770-S770
Author(s):  
Diana L Sturdevant ◽  
Kathleen C Buckwalter
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Lessons Learned ◽  
Federal State ◽  
Future Research ◽  
Term Care ◽  
Home Setting

Abstract Nursing homes must comply with numerous federal/state regulations to receive Medicare and Medicaid funding. Failure to comply with these regulations can result in deficiency citations, and depending on the severity of the deficiency, a resulting Civil Monetary Penalty (CMP). Through the Centers for Medicare and Medicaid Services (CMS) Civil Monetary Penalty Reinvestment Program, CMP funds are reinvested to support activities that benefit nursing home residents and that protect or improve their quality of life or quality of care. This symposium presents some of the unique challenges, successes, failures, and surprise findings from CMP-funded nursing home quality improvement projects in two, predominantly rural Midwestern states: Oklahoma and Kansas. Dr. Williams presents findings of a pilot-study testing an adaptation of a successful family caregiver telehealth support intervention in the nursing home setting and implications for future research. Dr. Sturdevant shares successes, challenges, and unanticipated results from the “It’s Not OK to Fall” project, a comprehensive, 3 year fall prevention project implemented in Oklahoma nursing homes. Lastly, Ms. Round’s paper describes the implementation and findings of a Long-term Care Leadership Academy aimed at improving leadership and team building skills of three levels of nursing home staff, including Administrators/Directors’ of Nursing, RN/LPN charge nurses and certified nursing assistants. Discussant, Dr. Kathleen Buckwalter Ph.D., FAAN, RN, will discuss how principles of nursing home culture change provides a common framework for these projects and conclude by offering suggestions on how promotion of these principles might improve the quality of care provided by nursing homes.

Statin Intake and All-Cause Mortality among Older Nursing Home Residents

Gerontology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Anton De Spiegeleer ◽  
Jordi Van Migerode ◽  
Antoon Bronselaer ◽  
Evelien Wynendaele ◽  
Milan Peelman ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Absolute Risk ◽  
Nursing Home Residents ◽  
Absolute Risk Reduction ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
All Cause Mortality ◽  
The Impact

<b><i>Background:</i></b> Statins are progressively accepted as being associated with reduced mortality. However, few real-world statin studies have been conducted on statin use in older people and especially the most frail, that is, the nursing home residents. <b><i>Objective:</i></b> The aim of this study was to evaluate the impact of statin intake in nursing home residents on all-cause mortality. <b><i>Method:</i></b> This is a cross-sectional study of 1,094 older people residing in 6 nursing homes in Flanders (Belgium) between March 1, 2020 and May 30, 2020. We considered all residents who were taking statins for at least 5 days as statin users. All-cause mortality during the 3 months of data collection was the primary outcome. Propensity score overlap-weighted logistic regression models were applied with age, sex, functional status, diabetes, and cardiac failure/ischemia as potential confounders. <b><i>Results:</i></b> 185 out of 1,094 residents were on statin therapy (17%). The statin intake was associated with decreased all-cause mortality: 4% absolute risk reduction; adjusted odds ratio 0.50; CI 0.31–0.81, <i>p</i> = 0.005. <b><i>Conclusions:</i></b> The statin intake was associated with decreased all-cause mortality in older people residing in nursing homes. More in-depth studies investigating the potential geroprotector effect of statins in this population are needed.

scholarly journals Nothing to complain about? Residents’ and relatives’ views on a “good life” and ethical challenges in nursing homes

2014 ◽  
Vol 23 (2) ◽  
pp. 142-153 ◽  
Author(s):  
Georg Bollig ◽  
Eva Gjengedal ◽  
Jan Henrik Rosland
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Good Life ◽  
Ethical Issues ◽  
Nursing Home Residents ◽  
Well Being ◽  
Ethical Challenges ◽  
Staff Members ◽  
Group Interviews ◽  
The Relationship

Background: Nursing home residents are a vulnerable population. Most of them suffer from multi-morbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature. Most studies have used staff members as informants, some have focused on the relatives’ view, but substantial knowledge about the residents’ perspective is lacking. Objective: To study what nursing home residents and their relatives perceive as ethical challenges in Norwegian nursing homes. Research design: A qualitative design with in-depth interviews with nursing home residents, and focus-group interviews with relatives of nursing home residents. The digitally recorded interviews were transcribed verbatim. Analysis was based on Interpretive Description. Participants and research context: A total of 25 nursing home residents from nine nursing homes in Norway, and 18 relatives of nursing home residents from three of these nursing homes. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Oslo, Norway. Findings and discussion: The main ethical challenges in Norwegian nursing homes from the residents’ and relatives’ perspective were as follows: (a) acceptance and adaptation, (b) well-being and a good life, (c) autonomy and self-determination, and (d) lack of resources. The relationship with the staff was of outmost importance and was experienced as both rewarding and problematic. None of the residents in our study mentioned ethical challenges connected to end-of-life care. Conclusion: Residents and relatives experience ethical challenges in Norwegian nursing homes, mostly connected to “everyday ethical issues.”

scholarly journals Interpreting COVID-19 deaths among nursing home residents in the US: The changing role of facility quality over time

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256767
Author(s):  
Debasree Das Gupta ◽  
Uma Kelekar ◽  
Sidney C. Turner ◽  
Anupam A. Sule ◽  
Taya G. Jerman
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Critical Role ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Cross Sectional ◽  
The Us ◽  
Prior Literature ◽  
Over Time

A report published last year by the Centers for Medicare & Medicaid Services (CMS) highlighted that COVID-19 case counts are more likely to be high in lower quality nursing homes than in higher quality ones. Since then, multiple studies have examined this association with a handful also exploring the role of facility quality in explaining resident deaths from the virus. Despite this wide interest, no previous study has investigated how the relation between quality and COVID-19 mortality among nursing home residents may have changed, if at all, over the progression of the pandemic. This understanding is indeed lacking given that prior studies are either cross-sectional or are analyses limited to one specific state or region of the country. To address this gap, we analyzed changes in nursing home resident deaths across the US between June 1, 2020 and January 31, 2021 (n = 12,415 nursing homes X 8 months) using both descriptive and multivariable statistics. We merged publicly available data from multiple federal agencies with mortality rate (per 100,000 residents) as the outcome and CMS 5-star quality rating as the primary explanatory variable of interest. Covariates, based on the prior literature, consisted of both facility- and community-level characteristics. Findings from our secondary analysis provide robust evidence of the association between nursing home quality and resident deaths due to the virus diminishing over time. In connection, we discuss plausible reasons, especially duration of staff shortages, that over time might have played a critical role in driving the quality-mortality convergence across nursing homes in the US.

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