ABSTRACT
BACKGROUND: The nursing home is a common place of death; however, little is known about the place of death with respect to the people living there. Was there a difference in the frequencies of the places of death of nursing home residents in an urban district and in the individual facilities before and during the COVID-19 pandemic? METHODS: Full survey of deaths by retrospective analysis of death registry data from the years 2018 to 2021. RESULTS: Over the four-year period 14,598 people died, with 3,288 (22.5%) being residents of 31 different nursing homes. Over the reference period before the pandemic (March 1, 2018 to December 31, 2019) 1,485 nursing home residents died: 620 (41.8%) in hospital, 863 (58.1%) in a nursing home. During the pandemic period (March 1, 2020 to December 31, 2021) 1,475 death were registered: 574 (38.9%) in hospital and 891 (60.4%) in a nursing home. The mean age over the reference period was 86.5 years (±8,6; median 88.4; 47.9 to 106.2), in the pandemic period it was 86.7 years (±8,5; median 87.9; 43.7 to 111.7). Before the pandemic 1,006 deaths (67.7%) occurred in females, during the pandemic it was 969 (65.7%). The relative risk (RR) as a measure for the increase in the probabilty for an "in-hospital" death during the pandemic period was 0.94. In different facilities, the number of deaths per bed during the reference and the pandemic period varied between 0.26 and 0.98, and the RR from 0.48 to 1.61. DISCUSSION: For all nursing home residents, the frequency of deaths was not increasing and no shift towards an "in-hospital" death was observed. Several nursing homes revealed substantial differences and opposing trends. The strength and the type of effects of facility-related circumstances remain unclear.
Subject(s)
COVID-19 , Female , Humans , Aged, 80 and over , Pandemics , Retrospective Studies , Routinely Collected Health Data , Germany , Nursing HomesABSTRACT
Nursing home residents comprise a disproportionate share of coronavirus-related deaths in the United States. Additionally, lockdown restrictions disrupted residents' relationships with their family members to an unknown extent. This study explored family members' perceived family role and interactions with nursing home residents and staff during the COVID-19 pandemic. Using a qualitative descriptive approach, 10 family members were interviewed using a semi-structured guide. Interviews were audio-recorded and transcribed verbatim, and data were analyzed using Braun and Clarke's Reflexive Thematic analysis. Themes and subthemes indicated that family members accounted for residents' care in new ways, found existing relationships becoming amplified under stress, maintained connections through creative alternatives, and also felt powerless to provide care, despite their knowledge and experience. Family members increasingly relied on staff to meet residents' care needs and provide updates, and often desired to provide assistance and companionship beyond what policy permitted, representing a major opportunity for improving experiences.
Subject(s)
COVID-19 , Nursing Homes , Humans , COVID-19/epidemiology , Pandemics , Qualitative Research , Communicable Disease Control , FamilyABSTRACT
This reprinted chapter originally appeared in Journal of Gerontological Social Work, 2020, 63[6-7], 642-643. (The following of the original article appeared in record 2021-00510-017.) A nursing home resident and nursing home advocate, describes her personal experience and perspectives about living in a nursing home in Massachusetts, USA during the COVID-19 pandemic. She feels strongly that the money for long-term care reimbursements should be put into the hands of individuals and families to give them the choice of where to get needed services and supports. The importance of having the choice to be able to receive home and community-based services, to be included in the community has been highlighted by the dangerousness of living in crowded institutions during a contagious pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
Age-Friendly Health Systems is a movement to ensure that all care and support for and with older adults across all settings is age-friendly care. Age-Friendly Health Systems provide staff, leadership, and care partner education based on the 4M Framework (What Matters, Medications, Mentation, Mobility). Nursing homes and other settings are often left out of local, state, or federal strategic plans on aging. In addition, limited quality and quantity of nursing home staff impact new program implementation. We consider how programs and services to support older adults can create and sustain an Age-Friendly Ecosystem, including a meaningful role for nursing homes.
Subject(s)
Ecosystem , Nursing Staff , Aged , Humans , Leadership , Nursing HomesABSTRACT
The SARS-CoV2 pandemic meant considerable restrictions in the social life of many people. Older people belong to the high-risk group for a severe to fatal course of the SARS-CoV2 disease, which is why these groups received special protection. This protection included drastic restrictions on their personal and social contacts, including the suspension of psychosocial therapies. This study examines the cognitive and emotional effects of social isolation on older people. A group of 49 participants who lived in nursing homes was tested before and after social isolation in 2020. The results of the present study provide empirical evidence for the negative effects of social isolation of older people in nursing homes regarding cognitive performance, anxiety, depressive symptoms, and quality of life.