scholarly journals Long‐Term Nursing Home Entry: A Prognostic Model for Older Adults with a Family or Unpaid Caregiver

2018 ◽  
Vol 66 (10) ◽  
pp. 1887-1894 ◽  
Author(s):  
Jennifer L. Wolff ◽  
John Mulcahy ◽  
David L. Roth ◽  
Irena S. Cenzer ◽  
Judith D. Kasper ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Prognostic Model ◽  
Nursing Home Entry ◽  
Unpaid Caregiver

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.

Association between Functional Status of Chinese Nursing Home Older Adults and Long Term Mortality

2013 ◽  
Vol 14 (2) ◽  
pp. 147.e1-147.e5 ◽  
Author(s):  
Tuen Ching Chan ◽  
Yat Fung Shea ◽  
Ka Hay J. Luk ◽  
Leung Wing Chu ◽  
Hon Wai F. Chan
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Functional Status ◽  
Long Term Mortality

scholarly journals Does High Caregiver Stress Predict Nursing Home Entry?

2009 ◽  
Vol 46 (2) ◽  
pp. 140-161 ◽  
Author(s):  
Brenda C. Spillman ◽  
Sharon K. Long
Keyword(s):  
Nursing Home ◽  
Strong Predictor ◽  
Stress Factors ◽  
Physical Strain ◽  
Term Care ◽  
Care Survey ◽  
Nursing Home Entry ◽  
Home Placement

This study estimates how informal care, paid formal care, and caregiver stress or burden relate to nursing home placement. Data came from the 1999 National Long Term Care Survey and were merged with administrative data. Results show that stress is a strong predictor of entry over follow-up periods of up to two years, and physical strain and financial hardship are important predictors of high levels of caregiver stress. The estimates indicate that reducing these stress factors would significantly reduce caregiver stress and, as a result, nursing home entry. We conclude that initiatives to reduce caregiver stress hold promise as a strategy to avoid or defer nursing home entry.

scholarly journals Communication Technology Preferences of Hospitalized and Institutionalized Frail Older Adults During COVID-19 Confinement: Cross-Sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Guillaume Sacco ◽  
Sébastien Lléonart ◽  
Romain Simon ◽  
Frédéric Noublanche ◽  
Cédric Annweiler ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Older People ◽  
Acute Care ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Term Care ◽  
Telephone Calls ◽  
Acute Care Unit

BACKGROUND Technological communication methods such as telephone calls and video calls can help prevent social isolation and loneliness in frail older adults during confinement. OBJECTIVE Our objectives were to determine which virtual communication method (ie, telephone call or video call) was preferred by confined older hospital patients and nursing home residents and the variables influencing this preference. METHODS The TOVID (Telephony Or Videophony for Isolated elDerly) study was a cross-sectional study that was designed to examine the preference between telephone calls and video calls among frail older adults who were either hospitalized in a geriatric acute care unit or institutionalized in a long-term care and nursing home during the COVID-19 confinement period. RESULTS A total of 132 older people were surveyed between March 25 and May 11, 2020 (mean age 88.2 years, SD 6.2); 79 (59.8%) were women. Patients hospitalized in the geriatric acute care unit were more able to establish communication independently than residents institutionalized in the long-term care and nursing home (<i>P</i>=.03) and were more satisfied with their communication experiences (<i>P</i>=.02). Overall, older people tended to favor telephone calls (73/132, 55.3%) over video calls (59/132, 44.7%); however, their satisfaction degree was similar regardless of the chosen method (<i>P</i>=.1), with no effect of age (<i>P</i>=.97) or gender (<i>P</i>=.2). In the geriatric acute care unit, the satisfaction degrees were similar for telephone calls (40/41, 98%) and video calls (33/38, 87%) in older patients (<i>P</i>=.10). Conversely, in the long-term care and nursing home, residents were more satisfied with the use of video calls to communicate with their relatives (14/15, 93%) versus the use of telephone calls (6/12, 50%; <i>P</i>=.02). CONCLUSIONS Older people confined to health care settings were able to complete telephone calls more independently than video calls, and they tended to use telephone calls more often than video calls. The satisfaction degrees were similar with both modalities and even greater with video calls among long-term care and nursing home residents when they were given assistance to establish communication. CLINICALTRIAL ClinicalTrials.gov NCT04333849: https://www.clinicaltrials.gov/ct2/show/NCT04333849.

Old, Frail, and Uninsured: Accounting for Features of the U.S. Long‐Term Care Insurance Market

Econometrica ◽  
2019 ◽  
Vol 87 (3) ◽  
pp. 981-1019 ◽  
Author(s):  
R. Anton Braun ◽  
Karen A. Kopecky ◽  
Tatyana Koreshkova
Keyword(s):  
Nursing Home ◽  
Low Income ◽  
Long Term Care ◽  
Risk Groups ◽  
Income Risk ◽  
Term Care ◽  
Administrative Costs ◽  
Long Term Care Insurance ◽  
Nursing Home Entry

Half of U.S. 50‐year‐olds will experience a nursing home stay before they die, and one in ten will incur out‐of‐pocket long‐term care expenses in excess of $200,000. Surprisingly, only about 10% of individuals over age 62 have private long‐term care insurance (LTCI) and LTCI takeup rates are low at all wealth levels. We analyze the contributions of Medicaid, administrative costs, and asymmetric information about nursing home entry risk to low LTCI takeup rates in a quantitative equilibrium contracting model. As in practice, the insurer in the model assigns individuals to risk groups based on noisy indicators of their nursing home entry risk. All individuals in frail and/or low‐income risk groups are denied coverage because the cost of insuring any individual in these groups exceeds that individual's willingness‐to‐pay. Individuals in insurable risk groups are offered a menu of contracts whose terms vary across risk groups. We find that Medicaid accounts for low LTCI takeup rates of poorer individuals. However, administrative costs and adverse selection are responsible for low takeup rates of the rich. The model reproduces other empirical features of the LTCI market including the fact that owners of LTCI have about the same nursing home entry rates as non‐owners.

scholarly journals Disparities in the Prevalence of Unmet Needs and Their Consequences Among Black and White Older Adults

2017 ◽  
Vol 30 (9) ◽  
pp. 1427-1449 ◽  
Author(s):  
Clara Berridge ◽  
Vincent Mor
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Unmet Needs ◽  
Multinomial Logistic Regression ◽  
Unmet Need ◽  
Black And White ◽  
Nursing Home Entry ◽  
Home Placement ◽  
The Relationship

Objective:We document differential prevalence of need for assistance with personal, instrumental, and mobility tasks and adverse consequences of unmet needs, nursing home relocation, and mortality among Black and White older adults. Method: Data are from the National Health and Aging Trends Study. Using logistic and multinomial logistic regression, we determine whether race is predictive of reporting need or adverse consequence and test the role of race as a moderator of the relationship between baseline need and three 1-year outcomes. Results: Black older adults are more likely to experience a consequence of unmet need (35.33% vs. 29.97%, p = .028) in unadjusted models. In adjusted models, we find no moderating effect of race on baseline need on nursing home placement (0.00, 95% confidence interval [CI] = [−2.43, 2.42], p = .991), mortality (0.73, 95% = [−1.58, 0.11], p = .089), or a Round 2 consequence of unmet (−0.51, 95% CI = [−1.15, 0.14], p = .121). Discussion: This work highlights the complex relationship between race, need, unmet need, mortality, and nursing home entry.

scholarly journals Nurse-Patient Interaction and Self-Transcendence: Assets for a Meaningful Life in Nursing Home Residents?

2019 ◽  
Author(s):  
Gørill Haugan ◽  
Britt Moene Kuven ◽  
Wenche Mjanger Eide ◽  
Siw Eriksen Tåsen ◽  
Eva Rinnan ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Meaning In Life ◽  
Nursing Home Residents ◽  
Well Being ◽  
Nursing Home Care ◽  
Patient Interaction ◽  
Self Transcendence

Abstract Background. Today, we face a shift to an older population worldwide and its consequences; a noteworthy part of older adults will need 24-hours nursing home care at the end of life. Finding new and alternative approaches to increase wellbeing among nursing home residents is highly warranted. Knowledge about nurse-patient-interaction, self-transcendence and meaning-in-life seems vital in order to guide clinical practice in how to best and efficiently boost wellbeing among older adults in nursing homes. Methods In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH patients representing 27 NHs responded to the nurse-patient interaction, self-transcendence, and the purpose-and-meaning-in-life scales. Inclusion criteria were: (1) municipality authority’s decision of long-term NH care; (2) residential time three months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations (five hypotheses) between the latent constructs were tested by means of structural equation modelling (SEM) using Stata 15.1. Results The SEM-model yielded a good fit (χ2=146.824, p=0.021, df=114, χ2 /df=1.29 RMSEA=0.040, p-close 0.811, CFI=0.97, TLI=0.96, and SRMR=0.063), showing significant relationships between the constructs of nurse-patient interaction, inter- and intra-personal self-transcendence and meaning-in-life. Nurse-patient interaction significantly relates with both inter- and intra-personal self-transcendence and meaning in NH patients. Self-transcendence revealed a fundamental influence on perceived meaning, while nurse-patient interaction demonstrated a significant influence on meaning, mediated by self-transcendence Conclusion According to the rapidly growing number of people over 65 in the world, and the growing segment of people 80-100, the present results are significant in their suggestions that nurse-patient-interaction is a crucial resource in relation to nursing home residents’ wellbeing. Knowledge of how nurse-patient-interaction, self-transcendence and meaning relate to each other among older adults in NHs is important for researchers, nurses, caregivers, nursing educators, and clinicians. Health professionals in nursing homes should learn how to competently use the nurse-patient interaction as a health promoting asset for self-transcendence, meaning and thus well-being. Nursing home nurses should be given more time for interacting with the residents, continuity and mutuality in nurse-patient relationships should be prioritized and facilitated.

scholarly journals COVID-19, Policy, and Nursing Homes: A Health and Aging Policy Fellows Symposium

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 58-58
Author(s):  
Nancy Kusmaul ◽  
Toni Miles ◽  
Lori Frank
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
State Government ◽  
Long Term Care ◽  
Extended Period ◽  
Federal State ◽  
Term Care ◽  
State And Local

Abstract COVID-19 significantly impacted older adults, particularly those in long term care. This symposium focuses on policy, and how policies drove many of the outcomes older adults in care experienced during 2020. We begin with a case study of one nursing home describing their operations, how those were impacted by policies at the local, state and federal levels, and operational factors that proved uncontrollable. From there we look more broadly at a national effort as implemented in one state which leveraged clinical and regulatory experts to partner with nursing homes and disseminate emerging and evidence based practice cohorts to address the realities of the COVID-19 pandemic over an extended period. Then we move from the federal to two state level projects. One looks at the experience of embedding advanced practice nurses (APRNs) into long term care facilities in one state over a five year period including during COVID-19. The final presentation describes hands on support provided by one state government to nursing homes and assisted livings during COVID-19, including the coordination of staff testing and the implementation of the use of the antigen testing machines issued through federal policy. We conclude with a discussion of the interplay of federal, state, and local policy on nursing home experiences in COVID-19 and recommendations for more effective policy interventions.

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