scholarly journals Challenges With Long-Term Care Placement in Pediatric Psychiatry During COVID-19: A Case Series From Inpatient Unit

Cureus ◽  
2021 ◽  
Author(s):  
Jaskaranpreet Kaur ◽  
Ankit Jain
2020 ◽  
Author(s):  
Munira Sultana ◽  
Karen Campbell ◽  
Morgan Jennings ◽  
Manuel Montero-Odasso ◽  
Joseph. B. Orange ◽  
...  

Abstract BACKGROUND: Behavioural and psychological symptoms of dementia (BPSD) worsens as dementia progresses, intensifies caregiver distress and consequent institutionalization. We wanted to evaluate feasibility of Virtual Reality (VR) as non-pharmacologic intervention for BPSD in a Long-Term Care (LTC) home. METHODS: A single site (Henley Place at London, Ontario) case series with a convenience sample (24 older adult residents with moderate to severe dementia). Intervention was 30 minutes of VR experience with Broomx©, five days a week for two weeks. BPSD was measured with Cornell Scale for Depression in Dementia (CSDD), Cohen-Mansfield Agitation Inventory (CMAI) scale, Dementia Observation System (DOS) scale, and proportion of night-time sleep. We validated selected tools with Global Rating of Change (GRC) scale. RESULTS: Implementing VR experience was possible at Henley Place (recruitment rate=40%, the adherence rate=21%, and the attrition=0%) and participants could tolerate it. No emergency transfers or one-to-one staff use were recorded during the intervention period. BPSD measuring instruments also were sensitive to change. CONCLUSION: VR experience can be implemented in a LTC home. TRIAL REGISTRATION: The study was not registered as clinical trial. We obtained ethics approval from ADVARRA Canada Ethics Board before recruiting participants for the study.


2014 ◽  
Vol 15 (3) ◽  
pp. B3
Author(s):  
Rebecca S. King-Tucker ◽  
Rebecca S. King-Tucker ◽  
Maria Knupp ◽  
Terry Edwards ◽  
Elizabeth Walters

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S824-S824
Author(s):  
Alexandria R Ebert ◽  
Emily S Bower ◽  
Yeates Conwell

Abstract Adults aged 70 and older have the highest suicide rates in most countries across the globe (World Health Organization, 2014). Prevalence may increase as the Baby Boomers transition into older adulthood (Phillips, 2014). Disease and disability increase risk for late-life suicide, thus identifying opportunities to intervene within the network of services utilized by older adults with illness and disability could reduce suicide risk. This symposium will explore the impact of disease and disability on late-life suicide risk, and present novel ideas for intervention and prevention. Emphasizing the conference theme, we will discuss prevention points spanning networks of care, including mental health and social services, and long-term care. Dr. Bower will frame the scope of the problem by presenting findings of age-stratified associations between physical illness and suicide attempt among older veterans using secondary data from a retrospective case-control study of veterans. Ms. Lutz will present findings on the relationship between disability and suicidal thoughts from a clinical trial of problem-solving therapy. Dr. Lane will discuss management and identification of suicide risk factors during the transition from independent living to long-term care through the lens of a case-series. Dr. Fullen will present preliminary findings from a novel, randomized controlled trial of a community-based suicide prevention training program for nutrition service volunteers. Dr. Yeates Conwell, Co-Director of the Center for the Study and Prevention of Suicide and Director of the Geriatric Psychiatry Program at the University of Rochester Medical Center, will serve as the discussant.


2020 ◽  
Author(s):  
Munira Sultana ◽  
Karen Campbell ◽  
Morgan Jennings ◽  
Manuel Montero-Odasso ◽  
Joseph. B. Orange ◽  
...  

Abstract BACKGROUND: Behavioural and Psychological Symptoms of Dementia (BPSD) worsens as dementia progresses, intensifies caregiver distress and consequent institutionalization. We wanted to evaluate feasibility of Virtual Reality (VR) as non-pharmacologic intervention for BPSD in a long-term care home. METHODS: A single site (Henley Place at London, Ontario) case series with a convenience sample (24 older adult residents with moderate to severe dementia). Intervention was 30 minutes of VR experience with Broomx©, five days a week for two weeks. RESULTS: Implementing VR experience was possible at Henley Place (recruitment rate=40%, the adherence rate=21%, and the attrition=0%) and participants could tolerate it. No adverse events and one-to-one staff use were recorded during the intervention period. CONCLUSION: VR experience can be implemented in a care home. TRIAL REGISTRATION: The study was not registered as clinical trial. We obtained ethics approval from ADVARRA Canada Ethics Board before recruiting participants for the study.


Author(s):  
Imtiaz Ahmad ◽  
Mohammud Alam ◽  
Ryan Saadi ◽  
Saborny Mahmud ◽  
Emily Saadi

Importance: Patients in long-term care facilities (LTCF) are at a high-risk of contracting COVID-19 due to advanced age and multiple comorbidities. Without effective treatments, outbreaks in such facilities will become commonplace and will result in severe morbidity and mortality. The effectiveness of doxycycline (DOXY) and hydroxychloroquine (HCQ) combination therapy in high risk COVID-19 patients in long-term care facilities is not yet understood. Objective: The goal of this analysis is to describe outcomes after use of DOXY-HCQ combination in high-risk COVID-19 patients in LTCF. Design: Case-series analysis. Setting: Three (3) LTCFs in New York. Participants: From March 19 to March 30, 2020, fifty-four (54) patients, residents of three (3) LTCFs in New York and diagnosed (confirmed or presumed) with COVID-19, were included in this analysis. Exposure: All patients who were diagnosed (confirmed or presumed) with COVID-19 received DOXY-HCQ combination therapy along with standard of care. Main Outcomes and Measures: Patients characteristics, clinical recovery, radiological improvements, medication side-effects, hospital transfer, and death were assessed as outcome measures. Results: A series of fifty-four (54) high-risk patients, who developed a sudden onset of fever, cough, and shortness of breath (SOB) and were diagnosed or presumed to have COVID-19, were started with a combination of DOXY-HCQ and 85% (n=46) patients showed clinical recovery defined as: resolution of fever and SOB, or a return to baseline setting if patients are ventilator-dependent. A total of 11% (n=6) patients were transferred to acute care hospitals due to clinical deterioration and 6% (n=3) patients died in the facilities. Naive Indirect Comparison suggests these data were significantly better outcomes than the data reported in MMWR (reported on March 26, 2020) from a long-term care facility in King County, Washington where 57% patients were hospitalized, and 22% patients died. Conclusion: The clinical experience of this case series indicates DOXY-HCQ treatment in high-risk COVID-19 patients is associated with a reduction in clinical recovery, decreased transfer to hospital and decreased mortality were observed after treatment with DOXY-HCQ.


2020 ◽  
Author(s):  
Munira Sultana ◽  
Karen Campbell ◽  
Morgan Jennings ◽  
Manuel Montero-Odasso ◽  
Joseph. B. Orange ◽  
...  

Abstract BACKGROUND: Behavioural and psychological symptoms of dementia (BPSD) worsens as dementia progresses, intensifies caregiver distress and consequent institutionalization. We wanted to evaluate 1) feasibility of Virtual Reality (VR) as cognitive stimulation therapy for BPSD in a Long-Term Care (LTC) home, 2) participants’ tolerance for the therapy, 3) facilitators and barriers to implementing VR therapy, 4) sensitivity to change of the participants’ BPSD to VR therapy, and 5) longitudinal construct validity of BPSD measuring tools. METHODS: A single site (Henley Place at London, Ontario) case series with a convenience sample (24 older adult residents with moderate to severe dementia). Intervention was 30 minutes of VR therapy with Broomx©, five days a week for two weeks. The change in BPSD was measured with Cornell Scale for Depression in Dementia (CSDD), Cohen-Mansfield Agitation Inventory (CMAI) scale, Dementia Observation System (DOS) scale, and proportion of night-time sleep. We validated selected tools with Global Rating of Change (GRC) scale. RESULTS: Implementing VR therapy was possible at Henley Place (recruitment rate=40%, the adherence rate=21%, and the attrition=0%) and participants could tolerate it. No emergency transfers or one-to-one staff use were recorded during the intervention period. CONCLUSION: VR therapy can be implemented in a LTC home. TRIAL REGISTRATION: The study was not registered as clinical trial. We obtained ethics approval from ADVARRA Canada Ethics Board before recruiting participants for the study.


2016 ◽  
Vol 64 (1) ◽  
pp. 220-221 ◽  
Author(s):  
Dallas P. Seitz ◽  
Amber Knuff ◽  
Jeanette Prorok ◽  
Ken Le Clair ◽  
Sudeep S. Gill

2011 ◽  
Vol 16 (1) ◽  
pp. 18-21
Author(s):  
Sara Joffe

In order to best meet the needs of older residents in long-term care settings, clinicians often develop programs designed to streamline and improve care. However, many individuals are reluctant to embrace change. This article will discuss strategies that the speech-language pathologist (SLP) can use to assess and address the source of resistance to new programs and thereby facilitate optimal outcomes.


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