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.

scholarly journals Social Distancing vs Social Interaction for Older Adults at Long-Term Care Facilities in the Midst of the COVID-19 Pandemic: A Rapid Review and Synthesis of Action Plans

2021 ◽  
Vol 58 ◽  
pp. 004695802110442
Author(s):  
Farhana Ferdous
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Social Isolation ◽  
Long Term Care ◽  
Rapid Review ◽  
Action Plans ◽  
Term Care ◽  
Social Distancing ◽  
Care Facilities

The present study aimed to systematically analyze the impact of COVID-19-related social distancing requirements on older adults living in long-term care facilities (LTCFs) and to synthesize the literature into thematic action plans to minimize the adverse effects of social isolation. The search included articles published between December 2019 and August 2020 across four databases. The inclusion criteria were used to screen for studies that reported on social isolation and loneliness due to the COVID-19 pandemic in older adults living in LTCFs. This rapid review identified 29 relevant studies and synthesized them into four thematic action plans: technological advancement, remote communication, therapeutic care/stress management, and preventive measures. These thematic action plans and cost-effective strategies can be immediately adopted and used as a resource for all LTCF administrators, healthcare design professionals, and researchers in battling current COVID-19-related issues, and improving social interaction in older adults living in care facilities.

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.

scholarly journals Mitigation of a Coronavirus Disease 2019 Outbreak in a Nursing Home Through Serial Testing of Residents and Staff

2020 ◽  
Author(s):  
Daniel J Escobar ◽  
Maria Lanzi ◽  
Pouné Saberi ◽  
Ruby Love ◽  
Darren R Linkin ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Disease Outbreaks ◽  
Testing Strategy ◽  
Term Care ◽  
Serial Testing ◽  
Universal Testing ◽  
Care Facilities

Abstract Nursing homes and long-term care facilities represent highly vulnerable environments for respiratory disease outbreaks, such as coronavirus disease 2019 (COVID-19). We describe a COVID-19 outbreak in a nursing home that was rapidly contained by using a universal testing strategy of all residents and nursing home staff.

scholarly journals PROTECTING NURSING HOMES AND LONG TERM CARE FACILITIES FROM COVID-19: A RAPID REVIEW OF INTERNATIONAL EVIDENCE

2021 ◽  
Author(s):  
Sally Hall Dykgraaf ◽  
Sethunya Matenge ◽  
Jane Desborough ◽  
Elizabeth Sturgiss ◽  
Garang Dut ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
Rapid Review ◽  
Term Care ◽  
International Evidence ◽  
Care Facilities

scholarly journals The Forgotten Psychopathology of Depressed Long-Term Care Facility Residents: A Call for Evidence-Based Practice

2021 ◽  
pp. 38-44
Author(s):  
Alcina Matos Queirós ◽  
Armin von Gunten ◽  
Manuela  Martins ◽  
Nathalie I.H. Wellens ◽  
Henk Verloo
Keyword(s):  
Older Adults ◽  
Nursing Homes ◽  
Psychiatric Disorders ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Care Facility ◽  
Term Care ◽  
Care Facilities ◽  
Health Complications

Introduction: As Earth’s population is rapidly aging, the question of how best to care for its older adults suffering from psychiatric disorders is becoming a constant and growing preoccupation. Depression is one of the most common psychiatric disorders among older adults, and depressed nursing home residents are at a particularly high risk of a decreased quality of life. The complex requirements of supporting and caring for depressed older adults in nursing homes demand the development and implementation of innovative clinical and organizational models that can ensure early identification of the disorder and high-quality multidisciplinary services for dealing with it. This perspective article aims to provide an overview of the literature and the state of the art of and the urgent need for research on the epidemiology and clinical treatment of depression among older adults. Method: In collaboration with a medical librarian, we conducted literature and bibliometric reviews of published articles in Medline Ovid SP from inception until September 30, 2020, to identify studies related to depression, depressive symptoms, mood disorders, dementia, cognitive disorders, and health complications in long-term care facilities and nursing homes. Results: We had 38,777 and 40,277 hits for depression and dementia, respectively, in long-term care facilities or nursing homes. The search equation found 536 and 1,447 studies exploring depression and dementia, respectively, and their related health complications in long-term care facilities or nursing homes. Conclusion: Depression’s relationships with other health complications have been poorly studied in long-term care facilities and nursing homes. More research is needed to understand them better.

scholarly journals Risk factors for mortality of residents in nursing homes with Covid-19: a retrospective cohort study

2020 ◽  
Author(s):  
Clara Suñer ◽  
Dan Ouchi ◽  
Miquel Àngel Mas ◽  
Rosa Lopez Alarcon ◽  
Mireia Massot Mesquida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities ◽  
Pandemic Response ◽  
Facility Level ◽  
Preventative Interventions

AbstractBackgroundNursing homes have shown remarkably high Covid-19 incidence and mortality. We aimed to explore the contribution of structural factors of nursing home facilities and the surrounding district to all-cause and Covid-19-related deaths during a SARS-CoV-2 outbreak.MethodsIn this retrospective cohort study, we investigated the risk factors of Covid-19 mortality at the facility level in nursing homes in Catalonia (North-East Spain). The investigated factors included characteristics of the residents (age, gender, comorbidities, and complexity and/or advanced disease), structural features of the nursing home (total number of residents, residents who return home during the pandemic, and capacity for pandemic response, based on an ad hoc score of availability of twelve essential items for implementing preventive measures), and sociodemographic profile of the catchment district (household income, population density, and population incidence of Covid-19). Study endpoints included all-cause death and Covid-19-related death (either PCR-confirmed or clinical suspicion).FindingsThe analysis included 167 nursing homes that provide long-term care to 8,716 residents. Between March 1 and June 1, 2020, 1,629 deaths were reported in these nursing homes; 1,089 (66□9%) of them were Covid-19-confirmed. The multivariable regression showed a higher risk of death associated with a higher percentage of complex patients (HR 1□09; 95%CI 1□05-1□12 per 10% increase) or those with advanced diseases (1□13; 1□07-1□19), lower capacity for implementing preventive measures (1□08; 1□05-1□10 per 1-point increase), and districts with a higher incidence of Covid-19 (2□98; 2□53-3□50 per 1000 cases/100,000 population increase). A higher population density of the catchment area was a protective factor (0□60; 0□50-0□72 per log10 people/Km2 increase).InterpretationPresence of residents with complex/advance disease, low capacity for pandemic response and location in areas with high incidence of Covid-19 are risk factors for Covid-19 mortality in nursing homes and may help policymakers to prioritize preventative interventions for pandemic containment.FundingCrowdfunding campaign YoMeCorono (https://www.yomecorono.com/), and Generalitat de Catalunya.Research in contextEvidence before this studyWe searched PubMed for studies exploring the management of Covid-19 in long-term care settings. The search was performed on May 1, 2020, and included the keywords “Covid-19”, “nursing home”, “long term care”, and “skilled nursing facility” with no language restriction. In addition to descriptive reports of Covid-19 mortality in the long-term care setting, we found studies providing evidence on the influence of age and comorbidities to mortality at the individual level. Some authors reported comparisons in the incidence and mortality of Covid-19 between facilities and country areas, and suggested the characteristics of each area/facility that may explain differences in mortality. However, we found no published works specifically investigating the contribution of structural features of the facility and sociodemographic characteristics of the area to explaining differences in Covid-19 mortality among long-term care facilities.Added value of this studyThis is the first analysis of risk of mortality at a facility level of residents with Covid-19 in nursing homes. We enrolled up to 167 nursing homes providing long-term care to 8,716 residents and we actively identified risk factors for Covid-19 mortality at the facility level. We found that nursing homes with lower capacity for pandemic response, and located in districts with a higher incidence of Covid-19 had significantly higher risks of Covid-19 mortality. The percentage of complex and/or advanced disease patients was also a risk factor.Implications of all the available evidenceOur findings provide policymakers with critical information to prioritize long-term care facilities at higher risk when deploying preventative interventions to minimize mortality in this setting. The association between mortality within the nursing home and Covid-19 incidence in the catchment area reinforces the importance of preventing the entry of SARS-CoV-2 into facilities. Nursing homes with limited capacity to implement containment measures should be prioritized when deploying preventative interventions for minimizing Covid-19 mortality in long-term care facilities.

Suicide Prevention Interventions for Older People in Nursing Homes and Long-Term Care Facilities: A Systematic Review

2019 ◽  
Vol 33 (6) ◽  
pp. 307-315 ◽  
Author(s):  
Nicolas Chauliac ◽  
Edouard Leaune ◽  
Virginie Gardette ◽  
Emmanuel Poulet ◽  
Antoine Duclos
Keyword(s):  
Systematic Review ◽  
Nursing Home ◽  
Suicidal Ideation ◽  
Nursing Homes ◽  
Older People ◽  
Long Term Care ◽  
Gatekeeper Training ◽  
Term Care ◽  
Care Facilities

Background: The death rate due to suicide among older people is high, especially among men. Because many older people live in nursing homes or long-term care facilities in high-income countries, reviewing the impact of prevention strategies on the suicidal behavior of residents in these settings is of interest. Methods: Following PRISMA guidelines, we performed a systematic review of the existing literature found in Pubmed, Scopus, Web of Science, PsycINFO, and Sociological Abstracts, focusing on interventions to prevent suicidal behavior or ideation in nursing home residents. The studies’ quality was evaluated according to TIDieR and MMAT. Results: Only 6 studies met the inclusion criteria. Four of them described various “gatekeeper” trainings for nursing home staff and 2 described interventions focused on residents. Only 1 study was randomized. Gatekeeper training studies were mostly before/after comparisons. No intervention demonstrated a direct effect on suicidal ideation or behaviors. One study showed that “life review” had a long-lasting effect on depression scores and another that gatekeeper training led to changes in the care of suicidal residents. Conclusions: Interventions to prevent suicidal ideation or behaviors in nursing homes are not rigorously evaluated, and no conclusion can be drawn on their effectiveness in preventing suicidal behaviors. We propose to better evaluate gatekeeper training for staff as well as peer support. Individual interventions targeting residents could be modified for broader implementation.

scholarly journals LETTER TO THE EDITOR: COVID-19: ROLE OF INTEGRATED REGIONAL HEALTH SYSTEM TOWARDS CONTROLLING PANDEMIC IN THE COMMUNITY, INTERMEDIATE AND LONG-TERM CARE

2020 ◽  
pp. 1-2
Author(s):  
R.A. Merchant
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Long Term Care ◽  
Hospice Care ◽  
Healthcare Providers ◽  
Nursing Home Residents ◽  
Term Care ◽  
Delay In Diagnosis ◽  
Care Facilities

Older adults at home, intermediate and long-term care (ILTC) setting including nursing home and hospice care are vulnerable to COVID-19 infection with increased morbidity and mortality. Singapore is one of the fastest aging countries in Asia where 14.4% of population is above 65 years old and this will double by 2030 (1). About 16000 older adults live in long-term care facilities and many more attend different types of day care facilities (2). Many of the residents are frail, with underlying dementia and / or multimorbidity and often present atypically causing a delay in diagnosis. In many countries, COVID-19 has spread amongst nursing home residents with mortality ranging from 24% in Hungary to 82% in Canada (3). It is known that 56% of residents may test positive while in pre-symptomatic stage, and many countries have put in initiatives to decrease the risk of spread in care homes (4). COVID-19 pandemic has highlighted the importance of communication and collaboration amongst ILTC providers which in many countries are run by non-governmental organization’s, healthcare providers, regional and national healthcare leaders.

Older Adults Diagnosed With Schizophrenia in Long-term Care Facilities: Life Course Theory for Holistic Nursing Research and Practice

2021 ◽  
pp. 089801012110253
Author(s):  
Verónica G. Walker ◽  
Elizabeth K. Walker
Keyword(s):  
Older Adults ◽  
Life Course ◽  
Health Beliefs ◽  
Long Term Care ◽  
Life Course Theory ◽  
Nursing Research ◽  
Term Care ◽  
Holistic Nursing ◽  
Care Facilities

Older adults diagnosed with schizophrenia (OADWS) often enter long-term care facilities with unique challenges related to trauma and stress experienced throughout their life course. Health care workers often report that when they work with this population, they feel unprepared due to limited training. In this article, life course theory is presented as a lens for holistic nursing research and as a way for nurses to adapt interventions already used with cognitively impaired older adults (e.g., those diagnosed with Alzheimer's disease) for OADWS in long-term care. It is hoped that these ideas will facilitate discussion of ways to inform training for holistic long-term care of OADWS. Holistic principles of nursing addressed with life course theory as a lens include the following: (a) accounting for strengths and challenges; (b) honoring experiences, values, and health beliefs; (c) viewing interrelationships with the environment; and (d) nurturing of peace, wholeness, and healing.

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