Bringing COVID-19 home for Christmas: a need for enhanced testing in healthcare institutions after the holidays

AbstractFestive gatherings this 2020 holiday season threaten to cause a surge in new cases of novel coronavirus disease 2019 (COVID-19). Hospitals and long-term care facilities are key hotspots for COVID-19 outbreaks, and may be at elevated risk as patients and staff return from holiday celebrations in the community. Some settings and institutions have proposed fortified post-holiday testing regimes to mitigate this risk. We use an existing model to assess whether implementing a single round of post-holiday screening is sufficient to detect and manage holiday-associated spikes in COVID-19 introductions to the long-term care setting. We show that while testing early helps to detect cases prior to potential onward transmission, it likely to miss a substantial share of introductions owing to false negative test results, which are more probable early in infection. We propose a two-stage post-holiday testing regime as a means to maximize case detection and mitigate the risk of nosocomial COVID-19 outbreaks into the start of the new year. Whether all patients and staff should be screened, or only community-exposed patients, depends on available testing capacity: the former will be more effective, but also more resource-intensive.

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Commentary: The Broader Context of Long-Term Care Ethics

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180116000207 ◽

2016 ◽

Vol 25 (3) ◽

pp. 554-556

Author(s):

Jason Lesandrini ◽

Carol O’Connell

Keyword(s):

Care Setting ◽

Long Term Care ◽

Ethical Issues ◽

Term Care ◽

Ethical Concerns ◽

Healthcare Settings ◽

Care Facilities ◽

Ethics Program ◽

Made In

Ethical issues in long-term care settings, although having received attention in the literature, have not in our opinion received the appropriate level they require. Thus, we applaud the Cambridge Quarterly for publishing this case. We can attest to the significance of ethical issues arising in long-term care facilities, as Mr. Hope’s case is all too familiar to those practicing in these settings. What is unique about this case is that an actual ethics consult was made in a long-term care setting. We have seen very little in the published literature on the use of ethics structures in long-term care populations. Our experience is that these healthcare settings are ripe for ethical concerns and that providers, patients, families, and staff need/desire ethics resources to actively and preventively address ethical concerns. The popular press has begun to recognize the ethical issues involved in long-term care settings and the need for ethics structures. Recently, in California a nurse refused to initiate CPR for an elderly patient in a senior residence. In that case, the nurse was quoted as saying that the facility had a policy that nurses were not to start CPR for elderly patients.1 Although this case is not exactly the same as that of Mr. Hope, it highlights the need for developing robust ethics program infrastructures in long-term care settings that work toward addressing ethical issues through policy, education, and active consultation.

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Combating Coronavirus Disease-2019 Outbreak in Long-Term Care Facilities for Frail Older Adults: Preventive Measures and Palliative Care Go Hand-in-Hand

Journal of Palliative Care ◽

10.1177/08258597211039364 ◽

2021 ◽

pp. 082585972110393

Author(s):

Hon Wai Benjamin Cheng

Keyword(s):

Palliative Care ◽

Long Term Care ◽

Care Delivery ◽

Nursing Home Residents ◽

Respiratory Illness ◽

Term Care ◽

The People ◽

Care Facilities ◽

Novel Coronavirus

While the whole population is at risk from infection with the coronavirus, older people—often frail and subject to multimorbidity—are at the highest risk for the severe and fatal disease. Despite strict infection control and social distancing measures, frail adults in long-term care facilities may be at particular risk of transmission of respiratory illness. Treatment decisions are often complex attributed to the heterogeneity of this population with regards to different geriatric domains such as functional status, comorbidity, and poly-pharmacy. While measures must be taken to prevent the novel coronavirus from spreading through these facilities, it is also essential that residents with coronavirus disease 2019 (COVID-19) have access to the symptom management and support they want and deserve. What most nursing home residents want during the course of their illness is to be able to stay in their facilities, to be surrounded by the people they love most, and to feel relief from their physical and emotional pain. By addressing the limited access to hospice and palliative care delivery in nursing homes, we can prevent unnecessary suffering and pain from COVID-19 as well as lay the groundwork for improving care for all residents moving forward.

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Nurturing whole person care with nature

International Journal of Whole Person Care ◽

10.26443/ijwpc.v5i1.163 ◽

2018 ◽

Vol 5 (1) ◽

Author(s):

Lynn Leach ◽

Cheryl Moore

Keyword(s):

Care Setting ◽

Long Term Care ◽

Systems Of Care ◽

High Standard ◽

Horticultural Therapy ◽

Term Care ◽

Therapy Program ◽

Whole Person ◽

Care Facilities

As part of our goal to provide Whole Person Care to our residents and families, Stedman Community Hospice is committed to integrating alternative therapies to compliment the more traditional systems of care. Our Horticultural Therapy Program was introduced in the spring of 2011 with the launch of our beautiful therapy garden. This workshop will discuss how we have since developed a comprehensive Horticultural Therapy Program in both a hospice and long-term care setting and how this type of program can benefit residents, families and staff. Discussion will include how to utilize community groups, volunteers and students to achieve and maintain a high standard of program. We hope to inspire other care facilities to embrace horticultural therapy as a means to enhance the level of care for everyone.

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