scholarly journals Vaccination of older adults: Influenza, pneumococcal disease, herpes zoster, COVID-19 and beyond

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Birgit Weinberger
Keyword(s):  
Older Adults ◽  
Herpes Zoster ◽  
Healthy Aging ◽  
Vaccine Development ◽  
Severe Disease ◽  
Disease Onset ◽  
Good Health ◽  
Term Care ◽  
Considerable Morbidity

AbstractPreserving good health in old age is of utmost importance to alleviate societal, economic and health care-related challenges caused by an aging society. The prevalence and severity of many infectious diseases is higher in older adults, and in addition to the acute disease, long-term sequelae, such as exacerbation of underlying chronic disease, onset of frailty or increased long-term care dependency, are frequent. Prevention of infections e.g. by vaccination is therefore an important measure to ensure healthy aging and preserve quality of life. Several vaccines are specifically recommended for older adults in many countries, and in the current SARS-CoV-2 pandemic older adults were among the first target groups for vaccination due to their high risk for severe disease. This review highlights clinical data on the influenza, Streptococcus pneumoniae and herpes zoster vaccines, summarizes recent developments to improve vaccine efficacy, such as the use of adjuvants or higher antigen dose for influenza, and gives an overview of SARS-CoV-2 vaccine development for older adults. Substantial research is ongoing to further improve vaccines, e.g. by developing universal influenza and pneumococcal vaccines to overcome the limitations of the current strain-specific vaccines, and to develop novel vaccines against pathogens, which cause considerable morbidity and mortality in older adults, but for which no vaccines are currently available. In addition, we need to improve uptake of the existing vaccines and increase awareness for life-long vaccination in order to provide optimal protection for the vulnerable older age group.

scholarly journals EAST MEETS WEST: IMPROVING HEALTH AND LONG-TERM CARE FOR OLDER ADULTS IN THE U.S. AND CHINA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S243-S244
Author(s):  
Bei Wu ◽  
Jie Hua Lu
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Long Term Care ◽  
Panel Discussion ◽  
Community Dwelling ◽  
Term Care ◽  
Spousal Caregiving ◽  
Pragmatic Clinical Trials ◽  
The U.S

Abstract As the number of older adults in the U.S. and China continues to increase, promoting healthy aging is essential for individuals, family, and society. Both countries face many similar issues due to their aging populations, including prolonging healthy life expectancy and providing quality of care. However, the change in demographics brings with it unique challenges for both the U.S and China. This forum invites scholars and researchers from these two countries to share their knowledge and insights on promoting healthy aging and improving care for older adults. This forum includes five presentations and one-panel discussion. Two presentations will focus on long-term care (LTC) in China, one is to forecast the needs of LTC in the next five decades, and the other is to evaluate the current LTC needs and discuss LTC policy. Using the data from the Health and Retirement Study, the third presentation aims to re-conceptualize spousal caregiving as a dyad-level phenomenon and provides a dynamic view of the spousal caregiving experiences. The last two presentations will focus on promoting healthy aging through clinical interventions. The fourth one is to evaluate the effectiveness of adaptive computer-based cognitive training among community-dwelling older adults in China. The last presentation provides some examples of using pragmatic clinical trials to improve the care of older adults in skilled nursing facilities in the U.S. After the five presentations, the three panelists will provide feedback to the presentations and share their views on healthy aging with the audience.

scholarly journals Disability and Long-Term Care in Singapore

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 705-705
Author(s):  
Cynthia Chen Huijun ◽  
Ngee Choon Chia
Keyword(s):  
Older Adults ◽  
Older Persons ◽  
Healthy Aging ◽  
Long Term Care ◽  
Population Aging ◽  
International Comparisons ◽  
Term Care ◽  
Life Lessons ◽  
The Impact

Abstract Public systems for long term care (LTC) redistribute resources between generations. Population aging is one of the most significant transformations in the 21st century, where the number of older persons aged 60 years and above is expected to double by 2050, rising to 2.1 billion. We used the Future Elderly Model (FEM) to project the impact of population aging in Singapore up to the year 2050. The FEM is a dynamic economic and demographic microsimulation model. By 2050, the total number of older adults with potential limitation in activities of daily living (ADL) was projected to increase to 275 thousand (18.9%). With the increasing prevalence of disability and chronic diseases, older adults might not have sufficient savings to meet future needs sustainably, despite the expansion of disability insurance from ElderShield to CareShield Life. Lessons and best practices for LTC could be transferred from our experiences to other aging cities globally. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.

scholarly journals Disparities in the Access to Different Types of Long-Term Care Services in Taiwan

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 705-705
Author(s):  
Ya-Mei Chen ◽  
Yuchi Young ◽  
Shih-Cyuan Wu ◽  
Hsiu-Hsi Chen ◽  
Yen-Po Yeh ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthy Aging ◽  
Service Use ◽  
Long Term Care ◽  
International Comparisons ◽  
Sociodemographic Factors ◽  
Care Plan ◽  
Term Care ◽  
Income Status

Abstract Taiwan implemented version 1.0 of its 10-Year Long-Term Care Plan (TLTCP 1.0) in 2007, and version 2.0 (TLTCP 2.0) in 2017. The aim was to develop a system of home- and community-based services (HCBS) for long-term care (LTC). This study assessed and compared disparities in access to LTC services using one county’s database that claims made by 14,051 older adults who applied for LTC services from TLTCP 1.0 (n = 5,025) and TLTCP 2.0 (n = 9,026). We assessed LTC disparities related to five sociodemographic factors (age, gender, living status, urbanization, income status) and seven types of LTC services. Older adults who lived in a city were more likely to use multiple HCBS and transportation services. Older adults who lived alone were more likely to use home care and meal services but not other types of LTC services. All disparities in service use increased from TLTCP 1.0 to TLTCP 2.0. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.

Association of long-term care utilization and functional ability in older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Kyaw
Keyword(s):  
Older Adults ◽  
Functional Ability ◽  
Daily Living ◽  
Healthy Aging ◽  
Long Term Care ◽  
World Health ◽  
Health Priorities ◽  
High Quality ◽  
Term Care

Abstract Background Healthy Ageing is the process of developing and maintaining the functional ability that enables wellbeing in older age as per the World Health Organization (WHO). Establishing foundations necessary for improvements in long-term care (LTC) systems for increasing the world's older adults is one of the public health priorities. LTC provides assisted daily living (ADLs), instrumental assisted daily living (IDALs), healthcare, and social services. This study aims to assess the association of LTC utilization and functional ability in the two industrialized countries with a globalized aging perspective. This study would guide to identify the approaches for establishing fundamentals, developing and sustaining a trained workforce to achieve high-quality, healthy aging. Methods This retrospective longitudinal population-based study, individuals age 65 and above from the national data of the United Kingdom, UK, (English Longitudinal Study of Aging) and the United States, U.S, (Health and Retirement Study). The outcome is LTC: nursing home and home care. Predictors: functional status: scores of ADLs and IADLs, and declining ADLs and IADLs. Covariates are age, gender, marital status, income, chronic diseases. Multiple logistic regression analysis was carried out in SAS software version 9.4, p-vale (p) <0.05. Results LTC utilization (UK) is associated with declining IADLs (OR: 15.01, 95%CI: 1.62,139.23), p- 0.02 with adjustments for covariates. LTC utilization (U.S) is associated with declining ADLs (OR: 2.66, 95%CI:1.82,3.87) and IADLs (OR: 2.42, 95%CI:1.73,3.40), both at p-<0.001. With adjustment for covariates, LTC utilization (U.S) is associated with declining ADLs (OR: 2.20,95%CI:1.51,3.22), p-0.001 and declining IADLs (OR: 2.12, 95%CI:1.49,3.02), p-<0.001. Conclusions Declining functional ability is associated with LTC utilization. This study guide to improve LTC systems to develop personalized social and healthcare foundations, increase the trained workforce. Key messages To demonstrate the long-term care (LTC) utilization by declining functional capacity in the UK and the US older adults to a better understanding of the distribution of LTC utilization between them. To guide developing approaches in the improving long-term care system to achieve high-quality, healthy aging through evidence findings of this national study.

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 Vulnerable Older Adults in Disasters: Effects of Hurricane Irma on Nursing Homes and Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 733-734
Author(s):  
Lindsay Peterson ◽  
David Dosa ◽  
Patricia D’Antonio
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Gulf Coast ◽  
Secondary Data ◽  
Morbidity And Mortality ◽  
Term Care ◽  
The Face ◽  
Qualitative Methodologies ◽  
Hurricane Irma

Abstract Preparedness of residents in long-term care (LTC) in the face of hurricane emergencies is a contested and largely unanswered question. Our prior work involving the U.S. Gulf Coast hurricanes of 2005-08 showed that exposure to various storms on nursing home (NH) residents resulted in significantly more deaths than reported by health care officials. This work also highlighted that evacuation of NH residents, compared to sheltering in place, was independently associated with morbidity and mortality. Hurricane Irma struck Florida on Sept. 10, 2017, prompting the evacuation of thousands of NH and assisted living community (ALC) residents. This symposium will discuss the effects of Hurricane Irma on vulnerable older adults residing in NHs and ALCs using mixed quantitative and qualitative methodologies. The first presentation will discuss morbidity and mortality of NH residents exposed to Hurricane Irma and will stratify by long stay/short stay status and hospice enrollment. The second presentation will discuss improvements and continued barriers to NH preparedness based on interviews with 30 administrators following Hurricane Irma. Using a novel methodology to identify residents of ALCs using secondary data sources, the third presentation will document AL resident morbidity and mortality risk following Hurricane Irma. The final presentation will highlight results of interviews with 70 stakeholders from small and large ALCs concerning the hurricane experiences of residents, including those with dementia. This symposium offers a multi-faceted view of a disaster’s effects on LTC residents across Florida, including novel data from the NH environment and lesser-examined ALCs.

scholarly journals Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chan Mi Park ◽  
Wonsock Kim ◽  
Hye Chang Rhim ◽  
Eun Sik Lee ◽  
Jong Hun Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Outcome ◽  
Long Term Care ◽  
Functional Decline ◽  
Tube Feeding ◽  
Term Care ◽  
Pneumonia Severity ◽  
Frailty Assessment ◽  
Nasogastric Tube Feeding

Abstract Background Pneumonia is a major cause of morbidity and mortality in older adults. The role of frailty assessment in older adults with pneumonia is not well defined. Our purpose of the study was to investigate 30-day clinical course and functional outcomes of pneumonia in older adults with different levels of frailty. Methods A prospective cohort was conducted at a university hospital in Seoul, Korea with 176 patients who were 65 years or older and hospitalized with pneumonia. A 50-item deficit-accumulation frailty index (FI) (range: 0–1; robust < 0.15, pre-frail 0.15–0.24, mild-to-moderately frail 0.25–0.44, and severely frail ≥ 0.45) and the pneumonia severity CURB-65 score (range: 0–5) were measured. Primary outcome was death or functional decline, defined as worsening dependencies in 21 daily activities and physical tasks in 30 days. Secondary outcomes were intensive care unit admission, psychoactive drug use, nasogastric tube feeding, prolonged hospitalization (length of stay > 15 days), and discharge to a long-term care institution. Results The population had a median age 79 (interquartile range, 75–84) years, 68 (38.6 %) female, and 45 (25.5 %) robust, 36 (47.4 %) pre-frail, 37 (21.0 %) mild-to-moderately frail, and 58 (33.0 %) severely frail patients. After adjusting for age, sex, and CURB-65, the risk of primary outcome for increasing frailty categories was 46.7 %, 61.1 %, 83.8 %, and 86.2 %, respectively (p = 0.014). The risk was higher in patients with frailty (FI ≥ 0.25) than without (FI < 0.25) among those with CURB-65 0–2 points (75 % vs. 52 %; p = 0.022) and among those with CURB-65 3–5 points (93 % vs. 65 %; p = 0.007). In addition, patients with greater frailty were more likely to require nasogastric tube feeding (robust vs. severe frailty: 13.9 % vs. 60.3 %) and prolonged hospitalization (18.2 % vs. 50.9 %) and discharge to a long-term care institution (4.4 % vs. 59.3 %) (p < 0.05 for all). Rates of intensive care unit admission and psychoactive drug use were similar. Conclusions Older adults with frailty experience high rates of death or functional decline in 30 days of pneumonia hospitalization, regardless of the pneumonia severity. These results underscore the importance of frailty assessment in the acute care setting.

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