scholarly journals Ownership and COVID-19 in care homes for older people: A living systematic review of outbreaks, infections, and mortalities

2021 ◽  
Author(s):  
Anders Malthe Bach-Mortensen ◽  
Ben Verboom ◽  
Ani Movsisyan ◽  
Michelle Degli Esposti
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Care Home ◽  
Academic Research ◽  
Developed Countries ◽  
Care Homes ◽  
For Profit ◽  
News Reports ◽  
Increased Risk ◽  
New Research

AbstractBackgroundThe adult social care sector is increasingly outsourced to for-profit providers, who constitute the largest provider of care homes in many developed countries. During the COVID-19 pandemic, for-profit providers have been accused of failing their residents by prioritising profits over care, prevention, and caution, which has been reported to result in a higher prevalence of COVID-19 infections and deaths in for-profit care homes. Although many of these reports are anecdotal or based on news reports, there is a growing body of academic research investigating ownership variation across COVID-19 outcomes, which has not been systematically appraised and synthesised.ObjectivesTo identify, appraise, and synthesise the available research on ownership variation in COVID-19 outcomes (outbreaks, infections, deaths, shortage of personal protective equipment (PPE) and staff) across for-profit, public, and non-profit care homes for older people, and to update our findings as new research becomes available.DesignLiving systematic review.MethodsThis review was prospectively registered with Prospero (CRD42020218673). We searched 17 databases and performed forward and backward citation tracking of all included studies. Search results were screened and reviewed in duplicate. Risk of bias (RoB) was assessed in duplicate according to the COSMOS-E guidance. Data was extracted by ABM and independently validated. The results were synthesised by country, RoB, and model adjustments, and visualised using harvest plots.ResultsTwenty-nine studies across five countries were included, with 75% of included studies conducted in the Unites States. For-profit ownership was not consistently associated with a higher probability of a COVID-19 outbreak. However, there was compelling evidence of worse COVID-19 outcomes following an outbreak, with for-profit care homes having higher rates of accumulative infections and deaths. For-profit providers were also associated with shortages in PPE, which may have contributed to the higher incidence of infections and deaths in the early stages of the pandemic. Chain affiliation was often correlated with an increased risk of outbreak but was usually not reported to be associated with higher rates of deaths and infections.ConclusionFor-profit ownership was a consistent risk factor for higher cumulative COVID-19 infections and deaths in the first wave of the pandemic. Thus, ownership and the characteristics associated with FP care home providers may present key regulatable factors that can be addressed to improve health outcomes in vulnerable populations and reduce health disparities. This review will be updated as new research becomes published, which may change the conclusion of our synthesis.

scholarly journals An exploration of hydration practices in Maltese residential care homes for older people

2021 ◽  
Vol 23 (11) ◽  
pp. 1-12
Author(s):  
Francesca Micallef ◽  
Marisa Vella ◽  
Alan Sciberras Narmaniya ◽  
Glenda Cook ◽  
Juliana Thompson
Keyword(s):  
Older People ◽  
Residential Care ◽  
Care Home ◽  
Good Health ◽  
Care Homes ◽  
Complex Needs ◽  
Increased Risk ◽  
Adequate Hydration ◽  
Axial Coding ◽  
Sugary Beverages

Background/aims The integral relationship between adequate hydration and good health is widely recognised. Older people with complex needs and frailty can struggle to maintain adequate hydration, with residents in care home settings being at an increased risk of dehydration. The aim of this study was to explore current hydration practices in residential care homes in Malta. Methods An exploratory qualitative approach was adopted to explore staff's views and approaches in supporting residents' hydration. Data was collected via semi-structured, individual and small group interviews with staff from two care homes from the central and southern region of Malta. A process of open coding, followed by axial coding, was used to analyse the data. Peer debriefing was performed throughout, until agreement was reached among the research team about the final themes and sub-themes. Results Three themes emerged from the data: culture of promoting fluid intake; challenges in supporting older people to achieve optimum hydration; hydration practices and approaches. Conclusions A hydration promotion culture was demonstrated through various practices adopted in the care homes. The strong focus on water intake, in response to concerns about consuming sugary beverages, has implications for the promotion of a person-centred approach to hydration care. Inconsistencies in monitoring of fluids and daily recommended targets highlights the importance of policies or guidelines to guide hydration practice. Challenges related to refusal of fluids and language barriers among non-native staff were evident and justify further research is this area.

Care homes for older people

2013 ◽  
Author(s):  
Tom Dening ◽  
Alisoun Milne
Keyword(s):  
Older People ◽  
Residential Care ◽  
Physical Disability ◽  
Care Home ◽  
Developed Countries ◽  
Care Homes ◽  
Standards Of Care ◽  
Ageing Population ◽  
Behavioural Disturbance ◽  
The Uk

Although only 5% of the total over 65 population in developed countries lives in a care home, the lifetime risk of needing residential care is considerable. In the UK, 418 000 older people occupy nearly 12 000 care homes; the sector has a total value of around £14 billion. Care home residents tend to be very old, most are women, and most have complex co-morbid needs. Most people enter a care home because they can no longer live independently due to ill health, notably dementia. Dementia affects over two thirds of all residents; physical disability and functional impairment are also common. Behavioural disturbance is common as is depression. There are concerns about excessive reliance on medication, and more emphasis recently has been placed on improving standards of care. Evidence suggests that training and good leadership is effective. With the ageing population, the provision and the funding of care home places will come under increasing pressure. The solutions to this are yet to be determined.

scholarly journals Care homes and COVID-19 in Hong Kong: how the lessons from SARS were used to good effect

2020 ◽  
Author(s):  
Lina Chow
Keyword(s):  
Hong Kong ◽  
Older People ◽  
Asymptomatic Carrier ◽  
Care Home ◽  
Family Members ◽  
Virus Transmission ◽  
Developed Countries ◽  
Care Homes ◽  
Good Effect ◽  
Influenza Outbreaks

Abstract In Hong Kong, about 15% of older people (aged 80 and above) live in care homes, one of the highest proportions in the world. During the spread of severe acute respiratory syndrome in 2003, the crude fatality rate for older people in care homes that were infected was 72%. After taking the advice of a team of international experts, the Hong Kong Government implemented comprehensive preventive measures to cope with the future epidemics. This commentary evaluates the effectiveness of these measures in coping with both influenza outbreaks and COVID-19 and suggests the lessons learnt are relevant to both developed and less developed countries? Lockdown in care homes is very effective under two conditions. Healthcare workers must wear surgical masks in the care home. Hospitals must adopt a strict policy to prevent virus transmission by discharged patients. Care homes situated within high-rise residential towers are particularly vulnerable to COVID-19 transmission; their residents can more easily be infected by asymptomatic carriers from the community. Airborne virus can also be transmitted more swiftly in care homes with open-plan layouts. Lockdown had been shown to significantly reduce influenza outbreaks in care homes. On the other hand, lockdown causes loneliness to residents. Care homes allow residents to move freely within the care home though with the risk of spreading the virus by resident who is an asymptomatic carrier. Finally, lockdown may cause family members to have guilty feelings. Family members can only make video call or window visit to residents.

scholarly journals What is the prevalence of loneliness amongst older people living in residential and nursing care homes? A systematic review and meta-analysis

2020 ◽  
Vol 49 (5) ◽  
pp. 748-757 ◽  
Author(s):  
Clare Gardiner ◽  
Pete Laud ◽  
Tim Heaton ◽  
Merryn Gott
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Nursing Care ◽  
Social Engagement ◽  
Significant Variation ◽  
Meta Analysis ◽  
Care Home ◽  
Care Homes ◽  
Prevalence Estimates ◽  
Age Range

Abstract Background the number of older people living in residential and nursing care homes is rising. Loneliness is a major problem for older people, but little is known about the prevalence of loneliness amongst older people living in care homes. Aim to undertake a systematic review of literature on the prevalence of moderate and severe loneliness amongst older people living in residential and nursing care homes. Design we systematically reviewed the databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Embase, Scopus, Cochrane and Allied and Complementary Medicine Database (AMED) from inception to January 2019. We included all studies reporting data on the prevalence of loneliness amongst older people living in care homes. A random-effects meta-analysis was conducted on all eligible data. Results a total of 13 articles were included, representing 5,115 participants (age range of 55–102 years, mean age 83.5 years, 68% female). There was a significant variation between studies in estimates of prevalence. The prevalence of moderate loneliness ranged from 31 to 100%, and the prevalence of severe loneliness ranged from 9 to 81%. The estimated mean prevalence of ‘moderate loneliness’ was 61% (95% confidence interval (CI): 0.41, 0.80). The estimated mean prevalence of ‘severe loneliness’ was 35% (95% CI: 0.14, 0.60). Conclusion the prevalence of both moderate loneliness and severe loneliness amongst care home residents is high enough to warrant concern. However, the significant variation in prevalence estimates warrants further research. Future studies should identify which interventions can address loneliness and promote meaningful social engagement to enhance quality of life in care homes.

scholarly journals Investigating alexithymia in autism: A systematic review and meta-analysis

2019 ◽  
Vol 55 ◽  
pp. 80-89 ◽  
Author(s):  
Emma Kinnaird ◽  
Catherine Stewart ◽  
Kate Tchanturia
Keyword(s):  
Systematic Review ◽  
Emotional Processing ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Autistic People ◽  
Increased Risk ◽  
Popu Lations ◽  
Specific Subgroup ◽  
New Research ◽  
Meta Analyses

AbstractBackground:New research suggests that, rather than representing a core feature of autism spectrum disorder (ASD), emotional processing difficulties reflect co-occurring alexithymia. Autistic individuals with alexithymia could therefore represent a specific subgroup of autism who may benefit from tailored interventions. The aim of this systematic review and meta-analysis was to explore the nature and prevalence of alexithymia in autism using the Toronto Alexithymia Scale (TAS).Methods:Online scientific databases were searched systematically for studies on ASD popu lations using the TAS. Meta-analyses were performed to evaluate differences in scores between the ASD and neurotypical groups, and to determine the prevalence of alexithymia in these populations.Results:15 articles comparing autistic and neurotypical (NT) groups were identified. Autistic people scored significantly higher on all scores compared to the NT group. There was also a higher prevalence of alexithymia in the ASD group (49.93% compared to 4.89%), with a significantly increased risk of alexithymia in autistic participants.Conclusions:This review highlights that alexithymia is common, rather than universal, in ASD, supporting a growing body of evidence that co-occurring autism and alexithymia represents a specific subgroup in the ASD population that may have specific clinical needs. More research is needed to understand the nature and implications of co-occurring ASD and alexithymia.

Urinary catheterization in care homes for older people: self-reported questionnaire audit of catheter management by care home staff

2006 ◽  
Vol 62 (1) ◽  
pp. 29-36 ◽  
Author(s):  
C.A.M. McNulty ◽  
J. Bowen ◽  
C. Foy ◽  
K. Gunn ◽  
E. Freeman ◽  
...  
Keyword(s):  
Older People ◽  
Care Home ◽  
Care Homes ◽  
Urinary Catheterization ◽  
Care Home Staff

scholarly journals Psychometric properties and feasibility of use of dementia specific quality of life instruments for use in care settings: a systematic review

2019 ◽  
pp. 1-15 ◽  
Author(s):  
Laura J. Hughes ◽  
Nicolas Farina ◽  
Thomas E. Page ◽  
Naji Tabet ◽  
Sube Banerjee
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Psychometric Properties ◽  
Care Home ◽  
Care Homes ◽  
Cosmin Checklist ◽  
Many Instruments ◽  
The Uk ◽  
Quality Instruments

ABSTRACTBackground:Over 400,000 people live in care home settings in the UK. One way of understanding and improving the quality of care provided is by measuring and understanding the quality of life (QoL) of those living in care homes. This review aimed to identify and examine the psychometric properties including feasibility of use of dementia-specific QoL measures developed or validated for use in care settings.Design:Systematic review.Methods:Instruments were identified using four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) and lateral search techniques. Searches were conducted in January 2017. Studies which reported on the development and/or validation of dementia specific QoL instruments for use in care settings written in English were eligible for inclusion. The methodological quality of the studies was assessed using the COSMIN checklist. Feasibility was assessed using a checklist developed specifically for the review.Results:Six hundred and sixteen articles were identified in the initial search. After de-duplication, screening and further lateral searches were performed, 25 studies reporting on 9 dementia-specific QoL instruments for use in care home settings were included in the review. Limited evidence was available on the psychometric properties of many instruments identified. Higher-quality instruments were not easily accessible or had low feasibility of use.Conclusions:Few high-quality instruments of QoL validated for use in care home settings are readily or freely available. This review highlights the need to develop a well-validated measure of QoL for use within care homes that is also feasible and accessible.

scholarly journals Quality improvement collaborative aiming for Proactive HEAlthcare of Older People in Care Homes (PEACH): a realist evaluation protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023287 ◽  
Author(s):  
Reena Devi ◽  
Julienne Meyer ◽  
Jay Banerjee ◽  
Claire Goodman ◽  
John Raymond Fletcher Gladman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Older People ◽  
Care Home ◽  
Realist Evaluation ◽  
Evaluation Framework ◽  
Care Homes ◽  
Quality Improvement Initiative ◽  
Quality Improvement Collaborative ◽  
Programme Theory ◽  
Health And Social Care

IntroductionThis protocol describes a study of a quality improvement collaborative (QIC) to support implementation and delivery of comprehensive geriatric assessment (CGA) in UK care homes. The QIC will be formed of health and social care professionals working in and with care homes and will be supported by clinical, quality improvement and research specialists. QIC participants will receive quality improvement training using the Model for Improvement. An appreciative approach to working with care homes will be encouraged through facilitated shared learning events, quality improvement coaching and assistance with project evaluation.Methods and analysisThe QIC will be delivered across a range of partnering organisations which plan, deliver and evaluate health services for care home residents in four local areas of one geographical region. A realist evaluation framework will be used to develop a programme theory informing how QICs are thought to work, for whom and in what ways when used to implement and deliver CGA in care homes. Data collection will involve participant observations of the QIC over 18 months, and interviews/focus groups with QIC participants to iteratively define, refine, test or refute the programme theory. Two researchers will analyse field notes, and interview/focus group transcripts, coding data using inductive and deductive analysis. The key findings and linked programme theory will be summarised as context-mechanism-outcome configurations describing what needs to be in place to use QICs to implement service improvements in care homes.Ethics and disseminationThe study protocol was reviewed by the National Health Service Health Research Authority (London Bromley research ethics committee reference: 205840) and the University of Nottingham (reference: LT07092016) ethics committees. Both determined that the Proactive HEAlthcare of Older People in Care Homes study was a service and quality improvement initiative. Findings will be shared nationally and internationally through conference presentations, publication in peer-reviewed journals, a graphical illustration and a dissemination video.

scholarly journals Hearing and vision care provided to older people residing in care homes: a cross-sectional survey of care home staff

2020 ◽  
Author(s):  
Wendy Andrusjak ◽  
Ana Barbosa ◽  
Gail Mountain
Keyword(s):  
Older People ◽  
Vision Loss ◽  
Care Home ◽  
Care Homes ◽  
Eye Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Home Staff ◽  
Chi Square Analysis ◽  
Vision Care

Abstract Background: Hearing and vision loss in older people has proven to affect physical and mental health and increase the speed of cognitive decline. Studies have proven certain practices and aspects of staff knowledge increase the effective care of residents’ ears and eyes, yet it is not known which of these are being implemented in care homes. This study aims to identify the gaps in staff knowledge and underused practices evident in long term care homes when identifying and managing hearing and vision difficulties in older residents. Methods: This study used a cross-sectional survey design. Survey questions were informed by the existing literature and were focused on practices, staff knowledge, and other aspects that have shown to affect residents’ hearing and vision care. The survey was sent to care homes across England between November 2018 and February 2019 both via Email and in paper format for care home staff to complete. Descriptive statistics and Chi-Square analysis was used to assess the factors particularly influencing the current care being provided to care home residents. Results: A total of 400 care home staff responded from 74 care homes. The results revealed that screening tools are rarely used by staff to identify hearing and vision impairments, care homes have limited access to other assistive devices, and audiology services do not regularly assess care home residents. A majority of staff were also not entirely confident in their knowledge of ear and eye care. Responses were also affected by the respondents’ job role, length of time working in care homes and also the care home type and care home capacity revealing a lack of standardised practice and shared communication. Conclusion: This study identifies which practices known to facilitate ear and eye care are currently under used in care homes across England and what particularly staff are not knowledgeable on when it comes to ear and eye care. This can now inform future research of the areas requiring improvement to as effectively address to acknowledged slow identification and poor management of hearing and vision loss in older people residing in care homes.

scholarly journals Oral manifestations in premature infants. A systematic review

2020 ◽  
Author(s):  
Lara Vivero Couto ◽  
Elena Planells del Pozo ◽  
José Ignacio Salmerón Escobar ◽  
Jorge Molina López ◽  
Ángela Ruiz-Extremera ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Delivery ◽  
Preterm Infants ◽  
Developed Countries ◽  
Prenatal Development ◽  
Supporting Evidence ◽  
Dental Anomalies ◽  
Enamel Defects ◽  
Increased Risk

Abstract Background Preterm delivery, defined as delivery occurring before a gestational age of 37 weeks, represents 6-10% of all births in developed countries. Preterm infants are characterized by a short prenatal development period and are at an increased risk of systemic disorders as a result of their immaturity. Few studies have analyzed oral alterations among preterm infants. This systematic review examines the orofacial characteristics most commonly found among preterm infants versus infants born at term and evaluates their repercussions upon oral health and quality of life.Methods The search was limited to articles published in English or Spanish that compared orofacial characteristics of preterm infants versus infants born at term. Their methodological quality was assessed based on the guidelines of the Joanna Briggs Institute (JBI).Results Most of the studies found the prevalence of structural enamel defects of the primary dentition to be greater among preterm infants. Other disorders such as structural enamel defects of the permanent dentition, caries, malocclusions or alterations in dental composition, size and development also appeared to be more frequent among preterm infants, though the supporting evidence was weak.Conclusions Further studies are needed, analyzing the association between preterm delivery and certain orofacial disorders such as caries, malocclusions and dental anomalies.

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