Long-term care for patients with dementia

Older people with dementia in long-term care constitute a complex population. It is important to establish at an early stage after admission the reasons for the placement and gain a good understanding of the background problems and agree a comprehensive care plan which should pay particular attention to management of infections, attitudes to hospitalisation, and palliative care. We discuss the pertinent clinical issues along with the importance of vaccination. The emergence of telemedicine is important. No chapter on long-term care of people with dementia is complete without consideration of the effects and legacy of COVID-19. Finally, a case history illustrating some common issues, and how they might be addressed, is included. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Care burden, loneliness, and social isolation in caregivers of people with physical and brain health conditions in English-speaking regions: Before and during the COVID-19 pandemic.

BACKGROUND: Public health restrictions due to the COVID-19 (SARS CoV-2) pandemic have disproportionately affected informal caregivers of people living with long term health conditions. We aimed to explore levels of care burden, loneliness, and social isolation among caregivers of people with enduring physical and brain health conditions in English-speaking regions worldwide, by investigating outcomes before and during the COVID-19 pandemic. METHODS: A cross-sectional anonymous online survey data from 2287 English-speaking caregivers of people with long term health conditions from four English-speaking regions (UK, Ireland, USA, New Zealand) included measures of care burden, loneliness, and social isolation, reported before and during the COVID-19 pandemic. Analyses were descriptive, followed by an ordinal regression model for predictors of burden. RESULTS: Compared to pre-pandemic levels, all caregivers experienced a significant increase in burden, loneliness, and isolation. Caregivers of people with both brain health and physical conditions were the most burdened and had the highest levels of loneliness and isolation compared to caregivers of people with either a brain health or physical condition only. The increase in care burden among caregivers of people with brain health challenges was associated with caregiver's gender, moderate and severe emotional loneliness, magnitude and frequency of isolation during the pandemic, and care circumstances (cohabitation with the care recipient, restrictions on the ability to provide care). CONCLUSIONS: Health and social care interventions should target caregivers' care circumstances and psychological outcomes, particularly in women, accounting for the significant additional burden of care, loneliness, and isolation resulting from pandemic-related restrictions.

Four Steps to Undo the Harms of Legacy Infrastructure in the COVID-19 Recovery

This Brief outlines a four-part stimulus program to deal with harmful legacy infrastructure assets as part of the long-term recovery from COVID-19 in the U.S. Historically, infrastructure, such as roads, pipelines, and transmission lines, while built to serve, sometimes brought harm in the areas of environment, health, and economic opportunity especially to minority communities. The steps suggested to address the inequity of legacy infrastructure are: (1) analyze the costs of inaction on legacy systems;(2) allocate funding for virtual public engagement;(3) offer resources for interim installations and infrastructure experiments;and (4) reward successful infrastructure projects that remove legacy harms.

Prioritize People, Not Projects: Addressing the Harms of Legacy Infrastructure in the COVID-19 Recovery

This Brief looks at legacy infrastructure, such as roads, pipelines, and transmission lines, in the U.S. and the history of inequity that has led to a failure to provide reliable, equitable service to all populations. It starts with a definition of legacy infrastructure and highlights areas such Flint, Michigan where a lack of infrastructure maintenance has resulted in lasting health impacts. Next the costs of legacy infrastructure are discussed including pedestrian fatalities, utility prices, water and air pollution, and water access. The authors suggest that infrastructure investments considered during the COVID-19 recovery should prioritize people over projects and address the harms of legacy infrastructure systems.

Valuing Human Infrastructure: Protecting and Investing in Essential Workers during the COVID-19 Era

The United States requires an enormous class of workers to keep essential services online. The Department of Homeland Security uses a sweeping definition of such essential industries from grocery stores to hospitals to warehouses, which collectively employed 90 million workers prior to the COVID-19 outbreak. A portion of these essential workers?or ?frontline? workers?must physically show up to their jobs and have been especially vulnerable to additional health and economic risks, including many employed in infrastructure-related activities. This analysis?based on Brookings Institution posts written in March and June 2020?defines the country?s essential workforce and explores their economic and demographic characteristics in greater depth, revealing a need for continued protections and investments as part of the COVID-19 recovery.

Boosting Local Climate Resilience and Economic Opportunity in the COVID-19 Era

From the Article: Summer usually marks a time of climate uncertainty, from hurricanes along the coasts to flooding in the Midwest to droughts seemingly everywhere. Once again, climate scientists are predicting an onslaught of major storms over the next few months. If last summer was any indication, states and localities remain unprepared to plan and pay for the damage, let alone the effects of daily rainfall. And because of the COVID-19 [coronavirus disease 2019] pandemic, this summer will be unlike any other. The virus has whipped up an economic storm of its own, leaving millions of businesses closed and workers jobless. Declines in spending and income are hitting individuals hard, while losses in sales and income tax revenue are also wreaking havoc on local and state budgets. Cities and states could experience budget deficits up to $900 billion through 2021, resulting in additional job cuts, service reductions, and project delays.COVID-19 (Disease);Economics