The Association Between new Nurses’ Gerontological Education, Personal Attitudes Toward Older Adults, and Intentions to Work in Gerontological Care Settings in Ontario, Canada

Background The older adult population in Canada is increasing, and many will require care within an acute geriatric unit (AGU) or long-term care facility (LTCF). However, the nursing workforce is not growing at the same pace as the population is aging. New graduate nurses may be able to fill this gap; therefore, it is important to understand their intentions of working in gerontological care settings (i.e., AGU or LTCF). Aim To examine if nursing education and personal attitudes toward older adults influence newly registered nurses’(RNs) intentions to work in a gerontological care setting. Method Nurses (n= 1,103) who registered with the College of Nurses of Ontario for the first time in 2018 were invited to complete a questionnaire. Results The majority of participants (n = 181) reported a positive attitude toward older adults. However, only 14% reported an intention to work in a gerontological care setting. Participants who completed multiple geriatric focused clinical placements were more likely to report an intention to work in these settings. Conclusion This study provides some information regarding the attitudes and intentions of newly RNs toward a career in gerontological care settings. Further research is needed to understand nurses’ intentions regarding working in AGUs or LTCFs.

Immunogenicity of the BNT162b2 mRNA COVID-19 vaccine in older residents of a long-term care facility: relation with age, frailty and prior infection status

Clinical and biological assessment of the COVID-19 vaccine efficacy in the frail population is of crucial importance. The study focuses on measuring the levels of anti-SARS-CoV-2 IgG antibodies before and after BNT162b2 mRNA COVID-19 vaccination among long-term care facility (LTCF) elderly residents. We conducted a prospective, single-center, observational study among LTCF residents. The study protocol was based on three blood sample acquisitions: first taken at baseline—5 days before the first dose of the vaccine, second—20 days after the first dose, and third—12 days after the second shot of the vaccine. The comparison was made for two cohorts: patients with and without prior COVID-19 infection. The data was collected from January to March 2021. A total number of 78 LTCF residents (55 women and 23 men) aged 62–104, 85.72 ± 7.59 years (mean ± SD), were enrolled in the study. All study participants were investigated for the presence of SARS-CoV-2 anti-spike (S) protein IgG, using a chemiluminescent immunoassay. Frailty was assessed with the Clinical Frailty Scale. Among elderly COVID-19 survivors in LTCF, a single dose of vaccine significantly increased anti-SARS-CoV-2 IgG antibody levels. IgG concentration after a single and double dose was comparable, which may suggest that elderly COVID-19 survivors do not require a second dose of vaccine. For residents without a previous history of COVID-19, two doses are needed to achieve an effective serological response. The level of anti-SARS-CoV-2 IgG antibodies after vaccination with BNT162b2 mRNA COVID-19 did not correlate with the frailty and age of the studied individuals.

Intra- and Extra-Hospital Dissemination of IMP-22-Producing Klebsiella pneumoniae in Northern Portugal: The Breach of the Hospital Frontier Toward the Community

The emergence of infections (and colonization) with Enterobacteriaceae-producing carbapenemases is a threatening public health problem. In the last decades, we watched an isolated case becoming a brutal outbreak, a sporadic description becoming an endemic problem. The present study aims to highlight the dissemination of IMP-22-producing Klebsiella pneumoniae in the North of Portugal, through the phenotypic and genotypic characterization of isolates collected from hospitalized patients (n=5) and out-patients of the emergency ward of the same acute care hospital (n=2), and isolates responsible for the intestinal colonization of residents in a Long-Term Care Facility (n=4). Pulsed-field gel electrophoresis (PFGE) results, associated with conjugation experiments pointed to a pattern of both vertical and horizontal dissemination. Overall, and complementing other studies that give relevance to IMP-22-producing K. pneumoniae in the clinical settings, here we show for the first time the public health threatening breach of the hospital frontier of this resistance threat, toward the community.

Becoming More Rugged and Better Resourced: The R2 Resilience Program’s© Psychosocial Approach to Thriving

The past decade has seen growing interest in interventions that build resilience as a complementary practice to trauma-informed care. From school-based programs focused on self-regulation and academic success to programs that support the well-being of disadvantaged populations or healthcare workers at risk of burnout, the concept of resilience is being used most commonly for programming that builds the capacity of individuals to adapt under conditions of adversity. Critiques have raised concerns that resilience-promoting programs demonstrate bias toward changing individual-level factors such as cognitions (e.g., mindfulness and grit), behavior (e.g., expressing gratitude and changing personal routines), or attachments (e.g., feeling secure in relationships) which help people adapt to socially toxic situations without changing access to the resources they require to overcome exposure to adverse psychosocial factors. This trend belies advances to the theory of resilience which support a more contextualized, multisystemic understanding of how external protective factors (resources) enhance individual qualities (ruggedness) and vice versa. Building on a multisystemic description of resilience, the R2 Resilience Program© was developed and piloted with six different populations ranging from clients of urban social services to workers in a long-term care facility, managers in the health care sector, staff of a Fortune 500 corporation, students in a primary to grade 12 school, and adult volunteers affiliated with an international NGO. Focused on building both individual ruggedness and enhancing people’s resources (the two Rs), the program provides contextualized content for each population by selecting from 52 resilience promoting factors with a strong evidence base to create training curricula that enhance the personal qualities and social, physical, and institutional resources most likely to support resilience. This paper reviews the justification for a multisystemic approach to designing resilience interventions and then explains the process of implementation of the R2 program. Preliminary findings are reported, which suggest the program is experienced as effective, with evaluations ongoing.

Group Vaccination Five Days before a COVID-19 Outbreak in a Long-Term Care Facility

Rapid vaccination may be of benefit in long-term care facilities (LTCF) that are affected by an ongoing COVID-19 outbreak. However, there are concerns regarding the safety and effectiveness of such an approach, particularly regarding the vaccination of pre-symptomatic patients. Here, we report the effectiveness of vaccination in a German LTCF hit by an outbreak that was detected 5 days after the first vaccine doses were administered. In detail, 66.7% of the unvaccinated patients experienced an unfavorable course; this proportion was much lower (33.3%) among the vaccinated patients. Even though this study is limited by a small number of patients, the observation and the comparison with related published data shows that vaccination (i) is safe and (ii) may still be of benefit when given shortly before an infection or even in pre-symptomatic LTCF-patients.

How can music therapy support family relationships for people living in a long-term care facility with neuro-disabilities, when regular visits can be challenging?

<p>This exegesis will present the findings which emerged from secondary analysis of clinical practice data collected during a music therapy placement. The setting for this research is a long-term residential care facility for people aged 18 to 65 with a variety of physical and neurological conditions, including cerebral palsy, traumatic brain injury, stroke and multiple sclerosis. The aim of the facility is to maximise the quality of life for the residents and support their medical needs. The research aim was developed out of a personal interest regarding how family members might be included in music therapy sessions. The research question evolved into “How can music therapy support family relationships for people living in a long-term care facility with neuro-disabilities, when regular visits can be challenging”. The core themes suggest family relationships can be enhanced through conversations, the gift of music, culture, artefacts, ritual and other activities. The findings include a case vignette to illustrate important points made in the exegesis. Overall, I believe this research will add new insight into the importance of family connections in rehabilitation and overall wellbeing for the residents.</p>

How can music therapy support family relationships for people living in a long-term care facility with neuro-disabilities, when regular visits can be challenging?

<p>This exegesis will present the findings which emerged from secondary analysis of clinical practice data collected during a music therapy placement. The setting for this research is a long-term residential care facility for people aged 18 to 65 with a variety of physical and neurological conditions, including cerebral palsy, traumatic brain injury, stroke and multiple sclerosis. The aim of the facility is to maximise the quality of life for the residents and support their medical needs. The research aim was developed out of a personal interest regarding how family members might be included in music therapy sessions. The research question evolved into “How can music therapy support family relationships for people living in a long-term care facility with neuro-disabilities, when regular visits can be challenging”. The core themes suggest family relationships can be enhanced through conversations, the gift of music, culture, artefacts, ritual and other activities. The findings include a case vignette to illustrate important points made in the exegesis. Overall, I believe this research will add new insight into the importance of family connections in rehabilitation and overall wellbeing for the residents.</p>

Long-term care placement: The transitional support needs and preferences of spousal dementia caregivers

Background and objectives Many spousal caregivers experience stress, depression, loneliness, guilt and grief when placing a partner with dementia into long-term care. However, there is little research about their transitional support experiences, needs and preferences. This study aimed to gain a deeper understanding of these issues from spousal caregiver and long-term care facility staff perspectives, to inform subsequent support and intervention development. Research design and methods Semi-structured interviews and small group discussions were held separately with spousal caregivers ( n = 9) and care facility staff ( n = 11). Criterion and variation sampling aimed to ensure a range of experiences and perspectives. The ‘Framework’ approach was utilised for data analysis. Interpretation was with respect to underpinning models of stress-grief process in dementia caregiving. Findings A range of informational, psychoeducational and psychosocial supports were identified to help spousal caregivers cope better with the stressors and losses experienced throughout the transition from home to long-term care. Improved education about disease progression, information relating to long-term care provision, peer support and dementia-specific grief counselling were deemed important. Opportunities for better support within care facilities were also identified. Support should be tailored to individual needs and preferences. Discussion and implications The findings suggest a supportive care framework be developed, encompassing the trajectory from assessment for and admission into long-term care to end-of-life and post-bereavement support. Spousal caregivers should have their support needs assessed by trained health or social care professionals and be offered a range of support options as appropriate.