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1.
BMC Geriatr ; 22(1): 142, 2022 02 19.
Article in English | MEDLINE | ID: covidwho-1704829

ABSTRACT

BACKGROUND: COVID-19 restrictions in nursing homes resulted in a reduction in stimuli for residents. This study aimed to explore observed effects of changes in stimuli, both targeted (e.g., planned recreational activities) and untargeted (e.g., spontaneous noise), on challenging behavior in nursing home residents during COVID-19 anti-pandemic measures. METHODS: In an online survey, nursing home healthcare professionals in the Netherlands provided their perspectives on the effects of the reduction in untargeted stimuli on residents with mild, advanced, or no dementia, and on different types of challenging behavior (i.e., psychotic, depressed, anxious, agitated, or apathetic behavior). Additionally, we asked participants' opinions about strategies for limiting untargeted stimuli and for adjusting targeted stimuli for optimal management of challenging behaviors. RESULTS: In total, 199 professionals completed the survey. Residents with advanced dementia and those with psychotic and agitated behavior seemed to benefit from the reductions in stimuli not specifically targeted at the resident. In contrast, residents without dementia and those with depressive and apathetic behavior seemed to be negatively affected by reductions in untargeted stimuli. Participants would like to continue reducing untargeted stimuli in the future (e.g., limiting the use of corridors adjacent to residents' rooms) and to adapt existing or introduce new initiatives involving targeted stimuli (e.g., small-scale, individually tailored activities). Responses to open-ended questions revealed additional initiatives that could be useful in nursing home care. CONCLUSIONS: This study provided lessons to learn from the COVID-19 measures in nursing homes. While many residents may have been negatively affected by the restrictions imposed during the pandemic, specific resident groups may have benefitted from the reduction in untargeted stimuli and from the adjustments made to daily activities. Various strategies and initiatives used in nursing homes during the pandemic seem promising for meeting individual needs in managing challenging behavior. These findings suggest that certain stimuli may affect specific resident groups differently. This underlines the importance of finding the right balance between stimuli and tranquility, tailored to the needs of individual residents. It is important to consider the stimuli present in nursing homes, whether targeted or untargeted, when analyzing and treating challenging behavior.


Subject(s)
COVID-19 , Humans , Nursing Homes , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
2.
International Psychogeriatrics ; 33(S1):27-28, 2021.
Article in English | ProQuest Central | ID: covidwho-1492975

ABSTRACT

Challenging behavior is common in nursing home residents, especially in those with dementia. Our previous study suggested that a decrease in environmental stimuli (i.e., events that take place around residents but are not specifically directed at them) in nursing homes due to restrictions during the COVID-19 pandemic, may affect residents differently. To improve future care, the experience of practitioners can be used to learn about the effects of environmental stimuli on challenging behavior in specific resident groups during the pandemic.From the perspective of practitioners, this study aimed to learn from successful initiatives and observed effects of decreased environmental stimuli on challenging behavior in residents during anti-pandemic measures.An online survey among 199 Dutch nursing home practitioners was conducted from November 2020 to January 2021. Practitioners were asked about alleged effects of diminished environmental stimuli in residents with different types of challenging behavior (i.e., psychotic, depressed, anxious, agitated, apathetic) and with mild vs. advanced or without dementia. Also, their opinion about strategies to limit environmental stimuli was explored.Residents with advanced dementia and those with psychotic and agitated behavior seemed to benefit from diminished environmental stimuli. In contrast, residents without dementia and those with depressive and apathetic behavior seemed to be negatively affected by decreased environmental stimuli. Practitioners indicated that they would like to preserve various strategies to limit environmental stimuli in the future such as reducing the use of corridors adjacent to residents’ rooms. Also, they planned to use adjustments and new initiatives regarding organized activities such as an increased use of small-scale and person-oriented activities. Opinions were divided on receiving visitors in the living room and on imposing visiting hours. In open-ended questions, other initiatives were mentioned that can be useful in nursing home care.Various strategies and initiatives in nursing homes during the pandemic seem promising to meet individual needs. While many residents may be negatively affected by restrictions during the pandemic, specific resident groups may benefit from a decrease in environmental stimuli. These findings underline the importance of a good balance between stimuli and rest in the nursing home, tailored to an individual resident.

4.
Aging Ment Health ; 25(7): 1314-1319, 2021 07.
Article in English | MEDLINE | ID: covidwho-967715

ABSTRACT

OBJECTIVES: From the perspective of the nursing home (NH) practitioners, to gain understanding of (1) whether challenging behavior in NH residents changed during the COVID-19 measures, (2) whether the practitioners' involvement in the treatment of challenging behavior changed, (3) what can be learned from the experience of NH staff. METHODS: A mixed methods study with a survey in 323 NH practitioners (psychologists, elderly care physicians, nurse practitioners) in the Netherlands, and in-depth interviews in 16 NH practitioners. Nonparametric analyses were used to compare estimated proportions of residents with increased and with decreased challenging behavior. Content analyses were conducted for open-ended questions and in-depth interviews. RESULTS: Participants reported changes in challenging behavior with slightly higher proportions for increased (Q1/Mdn/Q3: 12.5%, 21.7%, 30.8%) than for decreased (8.7%, 14.8%, 27.8%, Z = -2.35, p = .019) challenging behavior. Half of the participants reported that their work load increased and work satisfaction worsened during the measures. Different strategies were described to respond to the effects of COVID-19 measures, such as video calls, providing special areas for residents to meet their loved ones, adjusting activities, and reducing the exposure to negative news. CONCLUSIONS: Because COVID-19 measures resulted in both increased and decreased challenging behavior in NH residents, it is important to monitor for their potential long lasting effects. Increased work load and worsened work satisfaction of the NH staff, together with the changes in type of challenging behavior, indicate that the harmful effects of the anti-pandemic measures should be taken seriously.


Subject(s)
COVID-19 , Aged , Humans , Netherlands , Nursing Homes , Pandemics , SARS-CoV-2
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