COVID-19 and older adults in Israel – common challenges and recommendations

2020 ◽  
Vol 21 (4) ◽  
pp. 209-216
Author(s):  
Jiska Cohen-Mansfield
Keyword(s):  
Older Adults ◽  
Nursing Homes ◽  
Policy And Practice ◽  
Community Based ◽  
Older Population ◽  
Term Care ◽  
Content Type ◽  
Systemic Problems ◽  
The Impact

Purpose The impact of COVID-19 has most dramatically affected the older population, and nursing homes have become infection hotspots. As a response, governments have ordered isolation of older adults in geriatric institutions owing to the high risk of critical illness and mortality. The purpose of this paper is to discuss the potential impact of current policies on nursing homes and community-based care and provide suggestions for improvement in care. Design/methodology/approach Taking the situation in Israel as an example, the author discussed major systemic problems pertaining to long-term care facilities and to community based care; the neglect of mental health; systemic deficiencies in end of life care; and the need to revise communications concerning COVID-19. Findings Within each of the identified areas, recommended changes in strategy, policy and practice can help mitigate the dramatic impact of COVID-19 on the living experience of the older population. Originality/value Drawing on the Israeli experience, this paper presents current shortcomings in the policy response to COVID-19 regarding nursing homes and community-based care and provides recommendations that are applicable to other contexts as well. Although some of these have been suggested or even practiced in some locations, many continue to be neglected and have not been discussed even as COVID-19 continues to infect societies around the globe.

Uitbraak COVID-19 in de verpleeghuiszorg

2020 ◽  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Informal Caregivers ◽  
Rapid Review ◽  
Daily Routine ◽  
Term Care ◽  
Care Facilities

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

scholarly journals The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 629-629
Author(s):  
Silke Metzelthin ◽  
Sandra Zwakhalen ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Home Care ◽  
Acute Care ◽  
Long Term Care ◽  
Functional Decline ◽  
Term Care ◽  
The Us ◽  
The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

scholarly journals Housing, Affordability, and Community-Based Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 690-691
Author(s):  
Samara Scheckler
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Long Term Care ◽  
Housing Tenure ◽  
Policy Implications ◽  
Housing Cost ◽  
Home Equity ◽  
Community Based ◽  
Term Care

Abstract The house acts as both an environment of care and a vehicle to financially potentiate long-term community-based support. While housing can empower a diverse set of options for a person-centered aging process, inadequate housing can also impede healthy aging in the community. This symposium teases out the nodes where housing acts to benefit or limit safe community-based aging. The first paper in this symposium, Homeownership Among Older Adults, describes typologies of older adult homeownership and sensitively highlights trends, disparities and important considerations of homeownership in later life. The next two papers take these older adults and explores situations where their housing acts as an asset or as a burden. Identifying Cost Burdened Older Adults acknowledges that housing cost burdens look different for older adults than younger cohorts. A more precise definition of older adult housing cost burden is proposed to help researchers and policymakers better synthesize the complex relationships between older adult housing and their long-term care decisions. The Long-Term Care Financing Challenge then explores the role of home equity in expanding the community-based long-term care choice set for older adults. This paper demonstrates benefits (both realized and unrealized) in home equity and suggests policy implications moving forward. Finally, Cardiometabolic Risk Among Older Renters and Homeowners disentangles the relationship between housing and health by demonstrating health disparities that are associated with housing tenure, conditions and affordability. Taken together, this symposium explores the complex and multidirectional relationships between housing, long-term care and older adult health.

Determining the Long-Term Effectiveness of a Group-Based Physical Activity Program

2018 ◽  
Vol 20 (3) ◽  
pp. 401-408
Author(s):  
Anamica Batra ◽  
Richard C. Palmer ◽  
Elena Bastida ◽  
H. Virginia McCoy ◽  
Hafiz M. R. Khan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Healthy Aging ◽  
Population Level ◽  
The United States ◽  
South Florida ◽  
Community Based ◽  
Evidence Based Programs ◽  
The Impact

Objective. In 2015, only half (48%) of older adults in the United States (≥60 years) reported engaging in any kind of physical activity. Few studies examine the impact of evidence-based programs when adopted in community-based settings. The purpose of this study is to assess the effectiveness of EnhanceFitness (EF) upto 12-months. Method. EF was offered to older adults in South Florida. A total of 222 EF classes were offered between October 2008 and December 2014. Program consisted of a 1-hour session held three times a week. Even though participation was required for 4 months, 1,295 participants continued the program for at least 1 year. Results. All participants showed significant improvement in outcome measures. A mean change of 1.5, 1.7, and 1.9 was seen in number of chair stands at 4, 8, and 12 months (p < .001), respectively. The number of arm curls performed improved from 16.8 at baseline to 18.8, 18.8, and 19.2 at 4-, 8-, and 12-months, respectively. Participants improved their up-and-go time by decreasing from 9.1 (baseline) to 8.7 (4 months) to 8.6 (12 months; p = .001). Discussion. Randomized controlled trials are commonly used to determine the efficacy of an intervention. These interventions when disseminated at the population level have the potential to benefit large masses. EF is currently offered at more than 700 locations. This tremendous success of EF brings attention to an important question of continuous monitoring of these programs to ensure program consistency and intended outcomes. The model used by the Healthy Aging Regional Collaborative could be replicated by other communities.

Impact of lean six sigma at pharmacy unit on hospital profitability before and during Covid-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
A. Heri Iswanto
Keyword(s):  
Six Sigma ◽  
Inpatient Care ◽  
Design Method ◽  
Lean Six Sigma ◽  
Term Care ◽  
New Normal ◽  
Content Type ◽  
Unit Level ◽  
The Impact

Purpose The purpose of this paper is to compare the impact of lean six sigma (LSS) implementation carried out in a pharmaceutical unit on the profitability of outpatient and inpatient care before and during the Covid-19 pandemic. Design/method/approach The data were analyzed descriptively to see the development patterns in four periods: before implementation, during the implementation before the pandemic, during the pandemic and during the enforcement of new normal, in general, and by the length of stay (LOS). Findings The inventory purchase in the pharmaceutical unit dramatically decreased after implementation even during the pandemic and new normal wherein the pre-pandemic it decreased by 27%, during the pandemic 29% and in the new normal 37% compared to pre-LSS. The hospital deficit decreased after implementation before the pandemic by 26% and during the pandemic by 10% from the pre-LSS time. However, during the new normal, the deficit increased by 29%, indicating a diminished effect of LSS on the hospital profits. Research limitations/implications This research raised the possible implication that the implementation of LSS needed to be carried out in the entire hospital to have a large effect, especially on the inpatient care and long-term care installations. Originality/value This research provided empirical evidence regarding the effect of the Covid-19 pandemic on the ability of LSS at the unit level to provide efficiency at the unit level and the entire hospital at various levels of LOS.

Concurrent and Long-Term Predictors of Older Adults’ Use of Community-Based Long-Term Care Services

2004 ◽  
Vol 16 (1) ◽  
pp. 88-115 ◽  
Author(s):  
Jamila Bookwala ◽  
Bozena Zdaniuk ◽  
Lynda Burton ◽  
Bonnie Lind ◽  
Sharon Jackson ◽  
...  
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Community Based ◽  
Term Care ◽  
Care Services

scholarly journals Places of living and places of dying: the case for preventing suicide in residential long-term care

2020 ◽  
pp. 1-16
Author(s):  
Briony Jain ◽  
Viktoryia Kalesnikava ◽  
Joseph E. Ibrahim ◽  
Briana Mezuk
Keyword(s):  
Older Adults ◽  
Suicide Prevention ◽  
Residential Care ◽  
Long Term Care ◽  
Public Health Problem ◽  
Future Research ◽  
Term Care ◽  
The Impact ◽  
Residential Long Term Care

Abstract This commentary addresses the increasing public health problem of suicide in later life and presents the case for preventing suicide in residential long-term care settings. We do so by examining this issue from the perspective of three levels of stakeholders – societal, organisational and individual – considering the relevant context, barriers and implications of each. We begin by discussing contemporary societal perspectives of ageing; the potential impact of ageism on prevention of late-life suicide; and the roles of gender and masculinity. This is followed by a historical analysis of the origin of residential long-term care; current organisational challenges; and person-centred care as a suicide prevention strategy. Finally, we consider suicide in long-term care from the perspective of individuals, including the experience of older adults living in residential care settings; the impact of suicide on residential care health professionals and other staff; and the impact of suicide bereavement on family, friends and other residents. We conclude with recommendations for policy reform and future research. This commentary aims to confront the often unspoken bias associated with preventing suicide among older adults, particularly those living with complex medical conditions, and invoke an open dialogue about suicide prevention in this population and setting.

Peer support in community settings: getting back to our roots

2017 ◽  
Vol 21 (3) ◽  
pp. 184-190 ◽  
Author(s):  
David Crepaz-Keay
Keyword(s):  
Mental Health ◽  
Peer Support ◽  
Community Settings ◽  
Community Based ◽  
Community Benefit ◽  
Content Type ◽  
Mental Health Foundation ◽  
The Impact

Purpose The purpose of this paper is to look at peer support in the context of broader communities. Design/methodology/approach It builds on the author’s experience working with the Mental Health Foundation of developing delivering and evaluating several self-management and peer support initiatives in a variety of settings with a range of different peer groups. It will consider what constitutes a peer and a community, and explore the notion of community solutions for community problems. Findings Peer support in community settings has the capacity to address social isolation, build skills and self-esteem and give individuals a better quality of life – it can also add value to whole communities and reframe the way entire groups are considered within them. It has the ability to be both more accessible and less stigmatising and thus reach more people. This also offers community based peer support as a contributor to preventing the deterioration of mental health and potentially reducing the impact of mental ill-health. Social implications The author needs to think more in terms of whole community and get better at improving how the author measures and articulates this community benefit. This will allow us to make better decisions about how best to apply resources for long term whole community gain. Peer support and peer leadership needs to be at the heart of this process. Originality/value This paper places a familiar approach in a different setting placing peer support firmly outside services and within comunities.

Use of Community-Based Long-Term Care Services by Older Adults

1996 ◽  
Vol 8 (4) ◽  
pp. 512-537 ◽  
Author(s):  
Robert J. Johnson ◽  
Fredric D. Wolinsky
Keyword(s):  
Older Adults ◽  
Long Term Care ◽  
Community Based ◽  
Term Care ◽  
Care Services

Behavioral, psychological and physical symptoms in group homes for older adults with dementia

2006 ◽  
Vol 18 (1) ◽  
pp. 75-86 ◽  
Author(s):  
Joji Onishi ◽  
Yusuke Suzuki ◽  
Hiroyuki Umegaki ◽  
Hidetoshi Endo ◽  
Takashi Kawamura ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Homes ◽  
Long Term Care ◽  
Group Homes ◽  
Physical Symptoms ◽  
Care Hospital ◽  
Sampled Data ◽  
Term Care ◽  
Inappropriate Sexual Behavior

Background: Despite the recent dissemination of group homes in Japan for older adults with dementia, the behavioral and psychological features of the residents remain unknown. To clarify the association of such features with the levels of difficulty encountered by caregivers in coping with these symptoms, we have conducted a survey to compare the frequencies of the symptoms among group homes, nursing homes and a long-term care hospital.Methods: Five hundred and eighty-six older adults aged 65 years or more were sampled. Data were consecutively collected from questionnaires given to the caregivers. The questionnaire included basic activities of daily living, the Mini-mental State Examination, frequencies of behavioral, psychological and physical symptoms, and the levels of difficulty in coping with the symptoms.Results: In group homes, requests to go home, urinary incontinence and frequent complaining were the most commonly observed symptoms. The symptoms associated with disorientation, anxiety and depression were frequently observed in all three care settings. Most of the symptoms were more frequently observed in group homes than in the other two care settings. However, the levels of difficulty in coping with most of the symptoms were the highest in the long-term care hospital, followed in order by the group homes and nursing homes. In group homes, inappropriate sexual behavior was the symptom creating the most stress for the caregivers, followed by verbal and nonverbal abuse and changeable mood.Conclusions: The symptomatic traits of residents in group homes were clarified in the present study. These findings could be helpful in considering desirable placement or the improvement of eligible service provision for older adults with dementia in care facilities.

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