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1.
Innovation in aging ; 5(Suppl 1):408-408, 2021.
Article in English | EuropePMC | ID: covidwho-1624101

ABSTRACT

Nursing homes across the world have taken very restrictive measures, including a ban for visitors, to prevent and control COVID-19 infections. This study reports on findings of a study investigating guidelines on allowing visitors in nursing homes and the impact on residents’ well-being, family caregivers and staff. In total, 76 nursing homes in the Netherlands were followed using a survey study, including three waves of data collection in (May 2020, September 2020, March 2021. Results indicated a negative impact of a visitation ban for residents’ overall well-being. There was a variety in guidelines of allowing visitors in nursing homes, and showed that safe visiting was possible during the COVID-19 pandemic. Staff perceived a fragile balance between infection prevention and the impact of restriction on residents. In conclusion, a general ban for visitors is not necessary and may do more harm than good for residents living in nursing homes.

2.
Innovation in Aging ; 5(Supplement_1):223-223, 2021.
Article in English | PMC | ID: covidwho-1584716

ABSTRACT

During their life course, many older adults encounter a transition between care settings, for example, a permanent move into long-term residential care. This care transition is a complex and often fragmented process, which is associated with an increased risk of negative health outcomes, rehospitalisation, and even mortality. Therefore, care transitions should be avoided where possible and the process for necessary transitions should be optimised to ensure continuity of care. Transitional care is therefore a key research topic. The TRANS-SENIOR European Joint Doctorate (EJD) network builds capacity for tackling a major challenge facing European long-term care systems: the need to improve care for an increasing number of care-dependent older adults by avoiding unnecessary transitions and optimising necessary care transitions. During this symposium, four presenters from the Netherlands and Switzerland will present different aspects of transitions into long-term residential care. The first speaker presents the results of a co-creation approach in developing an intervention aimed at preventing unnecessary care transitions. The second speaker presents an overview of interventions aiming to improve a transition from home to a nursing home, highlighting the clear mismatch between theory and practice. The third speaker presents the impact of the COVID-19 pandemic on transitions into long-term residential care using an ethnographic study in a long-term residential care facility in Switzerland. The final speaker discusses the results of a recent Delphi study on key factors influencing implementing innovations in transitional care. The discussant will relate previous findings on transitional care with a U.S. perspective.

3.
Innovation in Aging ; 5(Supplement_1):224-224, 2021.
Article in English | PMC | ID: covidwho-1584715

ABSTRACT

COVID-19 has affected long-term residential care (LTRC) disproportionally due to the high-risk population, lack of resources and insufficient preventative measures. Protective measures, including quarantine and strict visitation restrictions have made transitions into LTRC more challenging. Further insight is needed to understand how residents, relatives and staff have experienced this during the COVID-19 pandemic. During four months of fieldwork in a LTRC facility in Switzerland, a rapid ethnography consisting of interviews, observations, informal conversations and document analysis was conducted. This study included a total of 14 residents, 21 healthcare staff from varying departments and 7 relatives of residents. First results indicate that protective measures interfere with a resident’s ability to find meaningful activities and interactions within LTRC as well as the possibility to maintain mobility. This and limited family contact following a move into LTRC prevents a smooth transition from home to LTRC and impacts overall resident quality of life.

4.
Int J Environ Res Public Health ; 18(22)2021 11 22.
Article in English | MEDLINE | ID: covidwho-1534064

ABSTRACT

BACKGROUND: Accessing post-diagnostic care can be difficult for people with dementia and their informal carers. Little is known, however, about the determinants of barriers to access, and how these might vary between countries. The aim of this study was to explore potential inequalities in access to formal dementia care services between England and the Netherlands, specifically from more disadvantaged areas. METHODS: This was a mixed-methods study, involving semi-structured qualitative interviews and a carer questionnaire. People with dementia and informal carers were recruited by clinicians. The postal survey was co-produced with people with dementia, informal carers, and health care professionals. The survey asked carers about their own and their relatives with dementia's, social support service usage and financing; as well as how they were made aware of services and whether they required more support. Qualitative transcripts were analysed by two researchers in each country using thematic analysis. RESULTS: A total of 103 carer questionnaires were received by post and 13 interviews were conducted with people with dementia and family carers between January 2020 and April 2020. Many services were accessed via self-funding. Thematic analysis generated five core themes: Health literacy; Having faith and lack of faith; Service suitability; Structural issues surrounding service provision; and Financing care. One major difference between both country's systems of care were the case manager and network support which people with dementia and carers benefitted from in the Netherlands, which was rarely the case in the UK. CONCLUSIONS: People with dementia and informal carers need to be supported better in accessing formal dementia care services in both the UK and the Netherlands, whilst some learning can be taken to improve access.

5.
BMC Geriatr ; 21(1): 588, 2021 10 22.
Article in English | MEDLINE | ID: covidwho-1477265

ABSTRACT

BACKGROUND: To protect nursing home residents, many governments around the world implemented blanket visitor bans in March and April 2020. As a consequence, family caregivers, friends, and volunteers were not allowed to enter nursing homes, while residents were not allowed to go out. Up until now, little is known on the long-term consequences and effects of visiting bans and re-opening of nursing homes. The aim of the study was to assess the long-term effects of the pandemic on residents, family members, and staff, and their preparedness for the next coronavirus wave. METHODS: A mixed-methods approach was used, consisting of a questionnaire and analyses of documentation (local visiting protocols). Of the 76 nursing home locations that participated in a Dutch national pilot on welcoming visitors back into nursing homes, 64 participated in this follow-up study. Data were collected in September/October 2020. For each nursing home, one contact person completed the questionnaire. Descriptive statistics were calculated for quantitative questionnaire data. Data on open-ended questions, as well as data from the documentation, were analyzed thematically. RESULTS: The study demonstrated that the consequences of strict visiting bans do not disappear at the moment the visiting ban is lifted. Although in October 2020, daily life in nursing homes was more "back to normal," more than one-third of the respondents indicated that they still applied restrictions. Compared to the situation before the pandemic, fewer volunteers were working in the nursing homes, grandchildren visited their relative less often, and visits differed. CONCLUSIONS: Five months after the visiting ban in Dutch nursing homes had been lifted, it still had an impact on residents, family members, and staff. It is questionable whether nursing homes feel prepared for welcoming visitors in the case of new COVID-19 infections. Nursing homes indicated that they felt prepared for the next wave, while at the same time, they were particularly concerned about staff well-being and vitality. It seems wise to invest in staff well-being. In addition, it seems desirable to think about how to support nursing homes in seeking a balance between infection prevention and well-being of residents, family members, and staff.


Subject(s)
COVID-19 , Follow-Up Studies , Humans , Nursing Homes , Pandemics , SARS-CoV-2
6.
Journal of the American Medical Directors Association ; 2021.
Article in English | ScienceDirect | ID: covidwho-1415517

ABSTRACT

Objectives To explore and compare the experiences of care home visits during the pandemic in the UK and the Netherlands. Design Qualitative semi-structured interview studies Setting and Participants Family carers of relatives residing in care homes in the UK and the Netherlands were interviewed remotely. Methods Family carers were asked about their experiences of care home visits during the pandemic, and specifically in the Netherlands after care homes had reopened. Transcripts were analysed in each country separately in the native language using thematic analysis, before discussing findings at multiple analysis meetings. Results Across 125 interviews, we developed four themes: (1) Different types of contact during lockdown;(2) Deterioration of resident health and well-being;(3) Emotional distress of both visitors and residents;(4) Compliance to guidelines and regulations. Visiting in both the UK and the Netherlands was beneficial, if possible in the UK, yet was characterised by alternative forms of face-to-face visits which was emotionally distressing for many family carers and residents. In the Netherlands, government guidance did enable early care home visitation, whilst the UK was lacking any guidance leading to care homes implementing restrictions differently. Conclusions and Implications Early and clear guidance, as well as communication, is required in future pandemics, and in this ongoing pandemic, to enable care home visits between residents and loved ones. It is important to take learnings from this global pandemic to reimagine long-term care, highlighting the value of socialising for care home residents.

7.
Am J Geriatr Psychiatry ; 29(10): 995-999, 2021 10.
Article in English | MEDLINE | ID: covidwho-1300120

ABSTRACT

The pandemic has put the spotlight on older people and on the topic of ageism. In early 2021, a call was made for input into the Thematic Report on Ageism and Discrimination to inform the United Nations Independent Expert on the Rights of Older Persons' forthcoming report to the 48th session of the Human Rights Council. The aim of this paper is to articulate the International Psychogeriatric Association (IPA) and the World Psychiatric Association Section of Old Age Psychiatry (WPA-SOAP) response to this call. This brief statement on ageism with a special focus on older people with mental health conditions is divided into three sections. We start by outlining the various manifestations of ageism in varied contexts and countries with a primary focus on the pandemic. Possible consequences of ageism with a focus on older people's mental health and well-being are outlined. We conclude by discussing ways to overcome ageism and reduce its occurrence, especially during times of extreme conditions.


Subject(s)
Ageism , COVID-19 , Aged , Aged, 80 and over , Humans , Mental Health , Pandemics
8.
Nurs Open ; 2021 Jul 06.
Article in English | MEDLINE | ID: covidwho-1293293

ABSTRACT

AIMS: To gain insight into how direct care staff in Dutch nursing homes experienced work during the COVID-19 pandemic. DESIGN: A qualitative study consisting of semi-structured, face-to-face focus groups was conducted using "the active dialogue approach". METHODS: Participants (n = 29) were care staff from four care teams at Dutch nursing homes. Teams were selected based on the number of COVID-19 infections amongst residents. Data were analysed with conventional content analysis. RESULTS: Themes emerging from the data were the loss of (daily) working structure, interference between work and private life for direct care staff, the importance of social support by the team and a leader, and the effects on relationship-centred care of the measures. Results offer concrete implications for similar situations in the future: psychological support on-site; autonomy in daily work of care staff; an active role of a manger on the work floor and the importance of relationship-centred care.

9.
Int Psychogeriatr ; : 1-8, 2021 Apr 05.
Article in English | MEDLINE | ID: covidwho-1169351

ABSTRACT

OBJECTIVES: On May 11, the Dutch Government allowed 26 nursing homes to welcome 1 visitor per resident, after 2 months of lockdown. The study aimed to monitor in-depth the feasibility of the regulations and their impact on the well-being of residents, their visitors, and healthcare staff. DESIGN: Mixed-methods study in 5 of the 26 facilities; the facilities were affiliated to an academic network of nursing homes. PARTICIPANTS: Visitors and healthcare professionals. INTERVENTION: Allowing visitors using local regulations based on national guidelines. MEASUREMENTS: Digital questionnaire, analyzing documentation such as infection prevention control protocols, attending meetings of COVID-19 crisis teams, in-depth telephone or in-person interviews with visitors and healthcare professionals, and on-site observations. RESULTS: National guidelines were translated with great variety into local care practice. Healthcare professionals agreed that reopening would increase the well-being of the residents and their loved ones. However, there were also great worries for increasing workload, increasing the risk of emotional exhaustion, and the risk of COVID-19 infections. Compliance with local regulations was generally satisfactory, but maintaining social distance and correctly wearing face masks appeared to be difficult. Care staff remained ambivalent for fear of infections. In general, allowing visitors was experienced as having a positive impact on the well-being of all stakeholders. Nevertheless, some residents with dementia showed negative effects. CONCLUSION: The complete lockdown of Dutch nursing homes had a substantial impact on the well-being of the residents. The reopening was welcomed by all stakeholders, but provided a high organizational workload as well as feelings of ambivalence among care staff. In the second wave, a more tailored approach is being implemented. However, facilities are sometimes still struggling to find the right balance between infection control and well-being.

11.
J Am Med Dir Assoc ; 21(7): 900-904, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-598614

ABSTRACT

OBJECTIVES: To prevent and control COVID-19 infections, nursing homes across the world have taken very restrictive measures, including a ban for visitors. These restrictive measures have an enormous impact on residents' well-being and pose dilemmas for staff, although primary data are lacking. A Dutch guideline was developed to cautiously open nursing homes for visitors during the COVID-19 pandemic. This study reports the first findings on how the guideline was applied in the local context; the compliance to local protocols; and the impact on well-being of residents, their family caregivers, and staff. DESIGN: A mixed-methods cross-sectional study was conducted. SETTING AND PARTICIPANTS: In total, 26 nursing homes were permitted to enlarge their possibilities for allowing visitors in their facility. These nursing homes were proportionally representative of the Netherlands as they were selected by their local Area Health Authority for participation. At each nursing home, a contact person was selected for participation in the current study. METHODS: A mixed-methods cross-sectional study was conducted, consisting of questionnaire, telephone interviews, analyses of documentation (ie, local visiting protocols), and a WhatsApp group. RESULTS: Variation in local protocols was observed, for example, related to the use of personal protective equipment, location, and supervision of visits. In general, experiences were very positive. All nursing homes recognized the added value of real and personal contact between residents and their loved ones and indicated a positive impact on well-being. Compliance with local guidelines was sufficient to good. No new COVID-19 infections were reported during this time. CONCLUSIONS AND IMPLICATIONS: These results indicate the value of family visitation in nursing homes and positive impact of visits. Based on these results, the Dutch government has decided to allow all nursing homes in the Netherlands to cautiously open their homes using the guidelines. More research is needed on impact and long-term compliance.


Subject(s)
Coronavirus Infections/prevention & control , Guidelines as Topic , Infection Control/organization & administration , Nursing Homes/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Visitors to Patients/legislation & jurisprudence , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Geriatric Assessment , Guideline Adherence , Homes for the Aged/organization & administration , Humans , Male , Netherlands , Pandemics/statistics & numerical data , Patient Safety , Pneumonia, Viral/epidemiology
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