scholarly journals A Blueprint for Community Health Center and Nursing Home Partnership: Testing for COVID-19 among Residents and Staff at Long-term Care Facilities

2021 ◽  
Vol 32 (1) ◽  
pp. xi-xviii
Author(s):  
Benjamin J. Oldfield ◽  
Stan DeCosta ◽  
Leif Petterson ◽  
Suzanne Lagarde ◽  
Douglas P. Olson
Keyword(s):  
Nursing Home ◽  
Community Health ◽  
Health Center ◽  
Long Term Care ◽  
Community Health Center ◽  
Term Care ◽  
Care Facilities

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.

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

The vulnerability of nursing home residents to the Covid-19 pandemic

2020 ◽  
Vol 23 (2-3) ◽  
pp. 57-60 ◽  
Author(s):  
Edward H Wagner
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Nursing Assistants ◽  
Nursing Home Care ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.

scholarly journals Impact of an Antibiotic Stewardship Program in Long-term Care Facilities: A Nursing Home Network Experience

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S63-S63
Author(s):  
Fabian Andres Romero ◽  
Evette Mathews ◽  
Ara Flores ◽  
Susan Seo
Keyword(s):  
Nursing Home ◽  
Antibiotic Stewardship ◽  
Long Term Care ◽  
Post Intervention ◽  
Term Care ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Care Facilities ◽  
The Impact

Abstract Background Antibiotic stewardship program (ASP) implementation is paramount across the healthcare spectrum. Nursing homes represent a challenge due to limited resources, complexity of medical conditions, and less controlled environments. National statistics on ASP for long-term care facilities (LTCF) are sparse. Methods A pilot ASP was launched in August 2016 at a 270-bed nursing home with a 50-bed chronic ventilator-dependent unit. The program entailed a bundle of interventions including leadership engagement, a tracking and reporting system for intravenous antibiotics, education for caregivers, Infectious Disease (ID) consultant availability, and implementation of nursing protocols. Data were collected from pharmacy and medical records between January 2016 and March 2017, establishing pre-intervention and post-intervention periods. Collected data included days of therapy (DOT), antibiotic costs, resident-days, hospital transfers, and Clostridium difficile infection (CDI) rates. Variables were adjusted to 1,000 resident-days (RD) and findings between periods were compared by Mann–Whitney U test. Results A total of 47,423 resident-days and 1,959 DOT were analyzed for this study. Antibiotic use decreased from 54.5 DOT/1000 RD pre-intervention to 27.6 DOT/1000 RD post-intervention (P = 0.017). Antibiotic costs were reduced from a monthly median of US $17,113 to US $7,073 but was not statistically significant (P = 0.39). Analysis stratified by individual antibiotic was done for the five most commonly used antibiotics and found statistically significant reduction in vancomycin use (14.4 vs. 6.5; P = 0.023). Reduction was also found for cefepime/ceftazidime (6.9 vs. 1.3; P = 0.07), ertapenem (6.8 vs. 3.6; P = 0.45), and piperacillin/tazobactam (1.8 vs. 0.6; P = 0.38). Meropenem use increased (1.3 vs. 3.2; P = 0.042). Hospital transfers slightly trended up (6.73 vs. 7.77; P = 0.065), and there was no change in CDI (1.1 s 0.94; P = 0.32). Conclusion A bundle of standardized interventions tailored for LTCF can achieve successful reduction of antibiotic utilization and costs. Subsequent studies are needed to further determine the impact on clinical outcomes such as transfers to hospitals and CDI in these settings. Disclosures All authors: No reported disclosures.

scholarly journals Constipation and Laxative Use among Nursing Home Patients: Prevalence and Associations Derived from the Residents Assessment Instrument for Long-Term Care Facilities (interRAI LTCF)

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Lene Elisabeth Blekken ◽  
Sigrid Nakrem ◽  
Anne Guttormsen Vinsnes ◽  
Christine Norton ◽  
Siv Mørkved ◽  
...  
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Mixed Effects ◽  
Assessment Instrument ◽  
Term Care ◽  
Laxative Use ◽  
Individualized Care ◽  
Antidementia Drugs ◽  
Care Facilities

Introduction. Constipation is a common, bothersome, and potentially dangerous condition among nursing home (NH) patients. Between 50 and 74% of NH patients use laxatives.Objective. To study prevalence and associations of laxative use and constipation using the comprehensive Norwegian version of the Resident Assessment Instrument for Long-Term Care Facilities.Methods.Cross-sectional study. Patients from 20 NH units were included. Logistic regression was used to analyze the results. Data collected in NHs might be clustered. Consequently, the multivariable models were tested against a mixed effects regression model to investigate variance both on the level of patients and on the level of NH units.Results.In all, 261 patients were included. The prevalence of constipation was 23.4%, and 67.1% used laxatives regularly. Balance problems, urinary incontinence, hypothyroidism, and Parkinson’s disease were associated with constipation. Reduced ability to communicate and number of drugs were associated with laxative use. Antidementia-drugs and being involved in activities 1/3 to 2/3 of daytime were protective factors for laxative use. Mixed effects analyses identified variance on the level of NH units as nonsignificant.Conclusion.Constipation and laxative use are common. Variance is mainly explained by different patient characteristics/health deficiencies. Hence, patients might benefit from individualized care to compensate for deficiencies.

A Comparative Study of Elder Mistreatment Between Community-dwelling Elders and Those Residing in Long-term Care Facilities

2017 ◽  
Vol 41 (S1) ◽  
pp. S664-S664
Author(s):  
B. Saguem ◽  
B. Saoussen ◽  
B.H.A. Béchir
Keyword(s):  
Nursing Home ◽  
Comparative Study ◽  
Long Term Care ◽  
Elder Abuse ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Term Care ◽  
Care Facilities ◽  
Abuse And Neglect

IntroductionElderly who live in settings other than their own homes or those of relatives have received little attention from researchers in Tunisia.AimsTo compare sociodemographic and clinical factors associated with elder abuse between community-dwelling elders and those residing in nursing home.MethodsA comparative study was conducted, including 50 subjects aged 65 years and older living in the community and 20 age- and sex-matched subjects living in a nursing home. Cognitive status, depressive symptoms and autonomy were assessed using mini-mental state examination (MMSE), geriatric depression scale (GDS) and activities of daily living scale (ADL). Elder abuse was evaluated with Indicators of Abuse Screen (IOA).ResultsElder abuse was more prevalent in elderly residing in nursing home (P = 0.009) with a prevalence of 35% and 8% and a mean IOA score of 12.75 and 7.74. Psychological, physical, financial abuse and neglect were reported by elderly residing in nursing home. Those living in community reported exclusively psychological abuse. The victim's reactions were passive in all cases.Elders living in nursing home were more single or divorced (0.000) and financially independent (0.003). They had lower scores of MMSE (0.002) and ADL (0.014), and higher scores of GDS (0.022). A binary logistic regression confirmed that elder abuse was significantly more prevalent in nursing home after eliminating these confounding variables: age, gender, MMSE, GDS and ADL scores (P = 0.018).ConclusionOur results confirm that elderly who live in long-term care facilities are at particular risk for abuse and neglect.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Social Isolation in Long-Term Care Facilities Related to COVID-19: Effect on Resident Anxiety and Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 579-579
Author(s):  
Nazmus Sakib ◽  
Joseph June ◽  
Lindsay Peterson
Keyword(s):  
Risk Factor ◽  
Nursing Home ◽  
Family Support ◽  
Social Isolation ◽  
Assisted Living ◽  
Long Term Care ◽  
Virus Spread ◽  
Term Care ◽  
Care Facilities

Abstract Loneliness is a common problem in long-term care. It has been associated with a higher risk of depression, aggressive behaviors, and anxiety and may be a risk factor for cognitive decline. Loneliness can exacerbate social isolation. The COVID-19 emergency brought on measures in Florida, beginning in March 2020, to separate nursing home (NH) and assisted living community (ALC) residents from each other and family members to limit virus spread. This study examines results of a survey with Florida NH (N=59) and ALC (N=117) administrators concerning effects of these measures. Scaled (1-5, lowest to highest) data indicate that resident anxiety was higher in NHs (M=3.40) than ALCs (M=3.17). Care disruptions related to limited resident-to-resident contact also were worse in NHs (M=3.74) than in ALCs (M=3.21), while care disruptions related to loss of family support were higher among ALCs (M=3.19) than in NHs (M=2.86). Implications of these findings will be discussed.

Forgotten, silent, and overruled: Hearing the voice of the nursing home patient

2018 ◽  
Vol 53 (5-6) ◽  
pp. 395-404 ◽  
Author(s):  
Andrea Williams ◽  
Amber Cadick
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Family Members ◽  
Patient Care Team ◽  
Care Team ◽  
Medical Decision ◽  
Term Care ◽  
Care Facilities ◽  
Medical Care Team

As the population ages, more Americans are moving into nursing homes/long-term care facilities. Per Accreditation Council for Graduate Medical Education 2017 guidelines, family medicine residents are required to gain experience and competence working in long-term care facilities; however, this unique environment poses several challenges for residents to hear the wishes of their patients over the demands of the patient’s medical care team and family members. Also, many patients in long-term care facilities have sensory impairments (e.g., poor eyesight, deafness) and/or cognitive deficits (e.g., dementia). One solution for hearing the patient’s voice over the demands of medical professionals and family members is to train physicians on how to overcome communication barriers with their patients. This article will discuss solution-focused approaches to reducing the barriers of sensory and cognitive impairments through the use of adaptive communication behaviors and adaptive equipment. Ways to improve communication between physicians, nursing-home staff, and patients’ family in order to improve the care patients receive in long-term care facilities will also be addressed. These recommendations are designed to assist with reducing physician frustration, increasing each patient’s input in medical decision-making, and improving communication across the patient care team.

scholarly journals Successful multimodal measures preventing coronavirus disease 2019 (COVID-19) outbreaks without universal frequent testing within long-term care units in the Midwestern Veterans’ Health Care Network

2021 ◽  
pp. 1-3
Author(s):  
Michihiko Goto ◽  
Nicole Ueckert ◽  
Robert K. Meiches ◽  
Eli N. Perencevich
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Long Term Care ◽  
Veterans Health ◽  
Prevention Measures ◽  
Term Care ◽  
Care Facilities ◽  
Health Care Network ◽  
Frequent Testing

Abstract Coronavirus disease 2019 (COVID-19) remains a serious threat for long-term care facilities, and frequent screening of employees and residents places a substantial burden on those facilities. We report our successful multimodal prevention measures without frequent testing, which resulted in no cases within 20 nursing home units over the first 6 months of the pandemic.

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