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2.
J Ambul Care Manage ; 45(1): 13-21, 2022.
Article in English | MEDLINE | ID: covidwho-1604140

ABSTRACT

Federally Qualified Health Centers (FQHCs) have been essential in response to COVID-19 outbreaks among vulnerable populations. Our rural FQHC had a primary role in early detection of and response to a poultry plant-related outbreak at the outset of the pandemic that disproportionately and gravely affected the local Hispanic community. The health center activated a rapid local response that included the community's first mass testing event and first acute respiratory treatment clinic, both of which were central to abatement. Lessons learned from this experience provide important guidance for the potential role of FQHCs in infection outbreak preparedness in marginalized communities.


Subject(s)
COVID-19 , Ambulatory Care Facilities , Humans , Pandemics , SARS-CoV-2 , Vulnerable Populations
4.
Geriatr Nurs ; 42(6): 1341-1348, 2021.
Article in English | MEDLINE | ID: covidwho-1433250

ABSTRACT

Certified nursing assistants (CNAs) in nursing home (NH) settings experience considerable work-related and personal stress. Self-compassion is a personal resource linked to improved stress coping and may be particularly relevant to health care workers. In this study, we explored NH CNA's experiences with self-compassion training based on their narrative replies. Twenty-two CNAs (100% female, mean age 48 years, 82% Black/African American) from 3 mid-sized, non-profit NHs in the Southeast US completed either a standard 8-week, 20 h self-compassion training or a 6-week, 6 h modified version designed for health care providers. Qualitative data analyses from post-training focus group discussions identified four themes pertaining to changes in: (1) stress management, (2) appreciation and support, (3) caregiver role, and (4) connection to others. Findings suggested self-compassion training is feasible and beneficial for the stressors that CNAs experience. In the era of COVID-19 and beyond, self-compassion training is a promising method to improve CNAs' well-being.


Subject(s)
COVID-19 , Nursing Assistants , Female , Humans , Male , Nursing Homes , SARS-CoV-2
5.
J Am Med Dir Assoc ; 22(4): 886-892, 2021 04.
Article in English | MEDLINE | ID: covidwho-1155515

ABSTRACT

Long-term services and supports for older persons in the United States are provided in a complex, racially segregated system, with striking racial disparities in access, process, and outcomes of care for residents, which have been magnified during the Coronavirus Disease 2019 pandemic. These disparities are in large measure the result of longstanding patterns of structural, interpersonal, and cultural racism in US society, which in aggregate represent an underpinning of systemic racism that permeates the long-term care system's organization, administration, regulations, and human services. Mechanisms underlying the role of systemic racism in producing the observed disparities are numerous. Long-term care is fundamentally tied to geography, thereby reflecting disparities associated with residential segregation. Additional foundational drivers include a fragmented payment system that advantages persons with financial resources, and reimbursement policies that systematically undervalue long-term care workers. Eliminating disparities in health outcomes in these settings will therefore require a comprehensive approach to eliminating the role of systemic racism in promoting racial disparities.


Subject(s)
Healthcare Disparities , Homes for the Aged/organization & administration , Nursing Homes/organization & administration , Racism , Aged , Aged, 80 and over , COVID-19 , Humans , United States
6.
J Am Med Dir Assoc ; 22(5): 933-938.e5, 2021 05.
Article in English | MEDLINE | ID: covidwho-1101333

ABSTRACT

OBJECTIVES: Assisted living (AL) emerged over 2 decades ago as a preferred residential care option for older adults who require supportive care; however, as resident acuity increased, concern has been expressed whether AL sufficiently addresses health care needs. COVID-19 amplified those concerns, and an examination of recommendations to manage COVID-19 may shed light on the future of AL. This review summarizes recommendations from 6 key organizations related to preparation for and response to COVID-19 in AL in relation to resident health and quality of life; compares recommendations for AL with those for nursing homes (NHs); and assesses implications for the future of AL. DESIGN: Nonsystematic review involving search of gray literature. SETTING AND PARTICIPANTS: Recommendations from key governmental bodies and professional societies regarding COVID-19 in AL, long-term care facilities (LTCFs) in general, and NHs. MEASURES: We collected, categorized, and summarized these recommendations as they pertained to quality of life and health care. RESULTS: Many recommendations for AL and NHs were similar, but differences provided insight into ways the pandemic was recognized and challenged AL communities in particular: recommending more flexible visitation and group activities for AL, providing screening by AL staff or an outside provider, and suggesting that AL staff access resources to facilitate advance care planning discussions. Recommendations were that AL integrate health care into offered services, including working with consulting clinicians who know both the residents and the LTC community. CONCLUSIONS AND IMPLICATIONS: Long-term care providers and policy makers have recognized the need to modify current long-term care options. Because COVID-19 recommendations suggest AL communities would benefit from the services and expertise of social workers, licensed nurses, and physicians, it may accelerate the integration and closer coordination of psychosocial and medical care into AL. Future research should investigate different models of integrated, interdisciplinary health care in AL.


Subject(s)
COVID-19 , Aged , Delivery of Health Care , Humans , Nursing Homes , Quality of Life , SARS-CoV-2
7.
J Am Med Dir Assoc ; 22(3): 484-488, 2021 03.
Article in English | MEDLINE | ID: covidwho-1051740
10.
J Am Med Dir Assoc ; 21(12): 1741-1745, 2020 12.
Article in English | MEDLINE | ID: covidwho-893993

ABSTRACT

The winter respiratory virus season always poses challenges for long-term care settings; this winter, severe acute respiratory syndrome coronavirus 2 will compound the usual viral infection challenges. This special article discusses unique considerations that Coronavirus Disease 2019 (COVID-19) brings to the health and well-being of residents and staff in nursing homes and other long-term care settings this winter. Specific topics include preventing the spread of respiratory viruses, promoting immunization, and the diagnosis and treatment of suspected respiratory infection. Policy-relevant issues are discussed, including whether to mandate influenza immunization for staff, the availability and use of personal protective equipment, supporting staff if they become ill, and the distribution of a COVID-19 vaccine when it becomes available. Research is applicable in all of these areas, including regarding the use of emerging electronic decision support tools. If there is a positive side to this year's winter respiratory virus season, it is that staff, residents, family members, and clinicians will be especially vigilant about potential infection.


Subject(s)
COVID-19 , Pneumonia, Viral , Residential Facilities , Seasons , COVID-19/diagnosis , COVID-19/prevention & control , Humans , Immunization , Nursing Staff , Organizational Policy , Pandemics , Pneumonia, Viral/prevention & control , SARS-CoV-2 , United States
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