Leadership in the elderly care home sector

2002 ◽  
Vol 9 (8) ◽  
pp. 24-28 ◽  
Author(s):  
Nadeem Moiden
Keyword(s):  
2021 ◽  
Author(s):  
Josef A.I. Weigl ◽  
Thorsten Werlang ◽  
Michael Wessendorf ◽  
Holger Helbing

Abstract Background: The vaccination campaign against SARS-CoV2 in Germany started at the peak of the second wave. An outbreak in an elderly care home occurred in our county at the time of the second vaccination.Aims: To describe a package of measures to control the outbreak and to prevent a spill over into the general population.Methods: After outbreak confirmation a package of measures such as quarantine of the elderly care home, staff and visitors, and their households was implemented. By sequential testing quarantine measures were lifted. Surveillance of staff and residents by rapid antigen test and symptom monitoring was used in parallel.Results: The outbreak was on-going for around 17 days until it was noticed by a symptomatic external staff member as index case. A total of 23 out of 96 (24.0%) residents and 9 out of 114 (7.9%) staff were infected. Three residents died. Effective first dose vaccine coverage was 85.4% in residents, 27.4% in internal and 10.5% in external staff. Given the long latency period the use of household quarantine prevented a spill over into the public. Already 16 days after notification of the index case the outbreak could be declared over.Conclusions: Interferences between vaccination coverage and outbreak characteristics in regard to an extended latency period were observed. Household quarantine of case as well as contact households is of increased importance in the era of vaccination to prevent further spread into the general population until population based control measures and lockdowns can be lifted.


2021 ◽  
Author(s):  
Anna Jeffery-Smith ◽  
Alice R Burton ◽  
Sabela Lens ◽  
Chloe Rees-Spear ◽  
Monika Patel ◽  
...  

Memory B cells (MBC) can provide a recall response able to supplement waning antibodies with an affinity-matured response better able to neutralise variant viruses. We studied a cohort of vulnerable elderly care home residents and younger staff, a high proportion of whom had lost neutralising antibodies (nAb), to investigate their reserve immunity from SARS-CoV-2-specific MBC. Class-switched spike and RBD-tetramer-binding MBC with a classical phenotype persisted five months post-mild/asymptomatic SARS-CoV-2 infection, irrespective of age. Spike/RBD-specific MBC remained detectable in the majority who had lost nAb, although at lower frequencies and with a reduced IgG/IgA isotype ratio. Functional spike/S1/RBD-specific recall was also detectable by ELISpot in some who had lost nAb, but was significantly impaired in the elderly, particularly to RBD. Our findings demonstrate persistence of SARS-CoV-2-specific MBC beyond loss of nAb, but highlight the need for careful monitoring of functional defects in RBD-specific B cell immunity in the elderly.


Author(s):  
Josef A. I. Weigl ◽  
Thorsten Werlang ◽  
Michael Wessendorf ◽  
Holger Helbing

Abstract Aim The vaccination campaign against SARS-CoV2 in Germany started at the peak of the second wave. An outbreak in an elderly care home occurred in our county at the time of the second vaccination. We describe a package of measures to control the outbreak and to prevent a spill over into the general population. Subjects and methods After outbreak confirmation, a package of measures such as quarantine of the elderly care home, staff and visitors, and their households was implemented. By sequential testing, quarantine measures were lifted. Surveillance of staff and residents by rapid antigen test and symptom monitoring was used in parallel. Results The outbreak was on-going for around 17 days until it was noticed by a symptomatic external staff member as index case. A total of 23 out of 96 residents (24.0%) and nine out of 114 staff (7.9%) were infected. Three residents died. Effective first-dose vaccine coverage was 85.4% in residents, 27.4% in internal, and 10.5% in external staff. Given the long latency period, the use of household quarantine prevented a spill over into the public. Already 16 days after notification of the index case the outbreak could be declared over. Conclusions Interferences between vaccination coverage and outbreak characteristics in regard to an extended latency period were observed. Household quarantine of case as well as contact households is of increased importance in the era of vaccination to prevent further spread into the general population until population-based control measures and lockdowns can be lifted.


2020 ◽  
Author(s):  
Jallavi Panchamia ◽  
Bhavya Bhagat ◽  
Vishakha Bharati ◽  
Anushree Joshi ◽  
Dileep Mavalankar

AbstractObjectiveThe study intended to understand the effect of Coronavirus disease 2019 (COVID-19) on western Indian elderly care homes. The study aimed to know the actions taken by administration of homes and challenges faced during the lockdown period.MethodTotal 44 care homes across three states of western India were contacted for data collection during the period of September-November 2020. Structured interview of the manager or owner of the elderly care homes were taken to gather required information to achieve the study objectives.ResultsOut of 44 care homes, seven care homes reported 146 case of corona virus infection and four deaths. Hence, the reported covid cases rate found to be 928 per 10,000 residents.DiscussionResults of the study indicated that significant steps were taken by these old age care homes to stave off the infection spread among the inmates. It was observed that average 26% of the occupants were sent back to their home/relative’s home before the lockdown to decongest the care homes. Administrators adopted the new policies at care home and adhered the government guidelines. Care homes in western India seemed to have very low infection rate and very low number of deaths as compared to western world.


2020 ◽  
Vol 5 ◽  
pp. 232
Author(s):  
Maria Krutikov ◽  
Tom Palmer ◽  
Alasdair Donaldson ◽  
Fabiana Lorencatto ◽  
Gill Forbes ◽  
...  

Global infection and mortality rates from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are disproportionately high in certain populations, including the elderly. Care home residents are frequently exposed to infection due to contact with staff and other residents, and are highly susceptible to infection due to their age and co-morbidity. In England, official statistics suggest that at least 25% of all deaths in care home residents since the start of pandemic are linked to coronavirus disease 2019 (COVID-19), but limited testing for SARS-CoV-2 early in the pandemic means estimates of the true burden of disease are lacking. Additionally, little is known about patterns of transmission between care homes, the community and hospitals, or the relationship between infection and immunity in care home staff and residents. The VIVALDI study plans to address these questions. VIVALDI is a prospective cohort study aiming to recruit  6,500 staff and 5000 residents from 105 care homes across England. Successive rounds of testing for infection will be performed over a period of 12 months.  Nasopharyngeal swabs will detect evidence of viral RNA and therefore active infection (accompanied by collection of data on symptoms), whereas blood tests will detect antibodies and evidence of cellular immunity to SARS-CoV-2. Whole genome sequencing of viral isolates to investigate pathways of transmission of infection is planned in collaboration with the COVID-19 Genomics UK Consortium. Qualitative interviews with care home staff will investigate the impact of the pandemic on ways of working and how test results influence infection control practices and behaviours. Data from residents and staff will be linked to national datasets on hospital admissions, antibody and PCR test results, mortality and care home characteristics.  Data generated will support national public health efforts to prevent transmission of COVID-19 and protect care home staff and residents from infection. Protocol registration: ISRCTN14447421 05/06/2020


Proceedings ◽  
2019 ◽  
Vol 25 (1) ◽  
pp. 12
Author(s):  
Nifli ◽  
Raili ◽  
Kiritsi ◽  
Kamboura-Nifli

AIM: Aging has been associated with reduced physical performance and morbidity. Living in a residential care home may be beneficial with regard to long-term medical assistance, but the diminished fundamental or instrumental daily activities further contribute to the deteriorated physical health and fall risk. Therefore, the aim of this study was to implement a motivation program to sustain and potentially increase physical activity in residential settings. MATERIAL & METHOD: Thirteen female residents of the Larissa Municipality Elderly Care Nursing Home (17% of bed capacity), 61-92 years old, with mild cognitive impairment (MMSE score 11-20) and diverse health conditions, participated in this pilot program. The intervention lasted from September 2018 to June 2019 and included two practical sessions of field walking, geriatric NHS workouts, plant care, and creative artwork per week. The quantitative and descriptive elements of STEADI battery were used to assess physical performance at the beginning and end of the intervention. RESULTS: All participants complied with gardening activities, half were in full compliance with the bi-weekly session schedule, and two adopted independent exercise activities. No participant was free of fall risk either at the beginning or at the end of the intervention, and 6 incidents were recorded concerning 5 people. One individual achieved finally the TUG goal of 12 s, but overall the shift of test performance did not reach statistical significance (p = 0.196). Leg strength and endurance score were above the average score for age in another case, and no significant change was observed during the study period (p = 0.738). Contrariwise, balance was significantly improved (p < 0.001), and half of the participants were able to complete the tandem or the single foot stand stage. CONCLUSIONS: A multidisciplinary approach may be effective in promoting physical performance indices, and STEADI tools are sensitive to such changes. However, seasonal infections, chronic conditions, and medication have a severe impact on leg strength and walking speed, and occasionally may mask the beneficial effect of exercise in the elderly, even to the point of an individual not being able to commence the assessment.


2018 ◽  
Vol 28 (2) ◽  
pp. 571-574
Author(s):  
Ivanka Stambolova ◽  
Stefan Stambolov

In outpatient care the home care, including hospices, is recognized as a model for providing quality, cost-effective and charitable care. The focus is mainly on the care that helps everyday lifeof the patient as well as the relatives, rather than on treatment, and in most cases it takes place in the patients' home. In Europe, in recent years there has been a real "boom" in home care due to demographic processes linked to increased needs for elderly care and chronically ill under the conditions of limited financial resources.In outpatient medical care in our country by means of a national framework contract there are regulated visits to the patient's home by a doctor, as well as visits by medical staff employed by him - nurse, midwife, medical assistant / paramedic / for manipulation, counseling and monitoring. At the same time there is no regulated legal activity in the Republic of Bulgaria, which is essentially the subject of home care.Since 1994 „Caritas“ has carried out the "Home Care" service, which provides a complex - health and social care for over 360 sick adults in a place where the elderly person feels the most comfortable - in their own home. „Caritas Home Care“ is provided by mobile teams of nurses and social assistants who visit the elderly at home and provide them with the necessary care according to their health and social needs.With the establishment of the first „Home Care Center“ in Lozenets region, Sofia, with the support of the PHARE ACCESS program in 2003, the Bulgarian Red Cross introduces in Bulgaria an integrated model for provision of health care and social services in the home of adults, chronically ill and people with permanent disabilities. To date, there are a number of problems in home care related to the realization of home care for patients in need in out-of-hospital settings: lack of legal regulation for home care, lack of qualified staff in outpatient care; lack of organization and structures for care; unsettled funding and the inability of the part of the population that is most in need of care to pay for it, there is no regulation to control the activity. Although home care began over 20 years ago, our country is yet to make its way to the European program called „Home care in Europe“.


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