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1.
Ciriec-Espana Revista De Economia Publica Social Y Cooperativa ; 104:303-331, 2022.
Article in Spanish | Web of Science | ID: covidwho-1820483

ABSTRACT

The advancement of senior cohousing is a push towards the modernization of housing and care for older people, and a challenge for present nursing homes. Cohousing has several years of experience in other European countries, and it is an attractive way of living for older people and/or families who want company and to share tasks. This article analyzes the growth of cohousing for older people in Spain from Third Sector, its barriers, and political impulses, and compares it with the experience in Sweden. Its functioning in Spain is incipient, and the Social Economy plays a key role. There are few consolidated initiatives, and quite a few underway, but the progress is slow due to numerous administrative and financial obstacles. The Covid-19 pandemic has raised the demand for these accommodations and care alternative because they promote and facilitate social contacts, some of the the risks of nursing homes, and comply with sustainable development objectives (SDG). Both Spain and Sweden have a variety of co-housing types, with a big role for cooperatives, but in Sweden they are primarily seen as a type of housing, where older people share fewer activities and maintain their privacy. Recently, there is greater political interest in cohousing. The recovery plans of the Spanish government and some regulations of the Autonomous Communities and City Councils incorporate specific strategies on housing, for the Third Sector, and the care of older people (SAAD) that affects senior cohousing.

2.
CIRIEC - Espana ; - (104):303-331, 2022.
Article in Spanish | ProQuest Central | ID: covidwho-1811194

ABSTRACT

RESUMEN: Es un hecho que ha crecido el número de personas mayores que viven solas y que los servicios sociales en la actualidad presentan muchas deficiencias, que se han evidenciado especialmente con el COVID-19. Estos hechos han convertido al cohousing senior en una atractiva alternativa de alojamiento para ellos. El avance del cohousing senior supone un empuje hacia la modernización de los alojamientos y servicios sociales para las personas mayores, en particular de las residencias. El cohousing senior lleva varios años de experiencia en otros países europeos, y representa una forma de convivir deseable entre los mayores y/o las familias que desean compañía y compartir tareas. Para conocer mejor la posible evolución futura del cohousing senior se introducen algunos apuntes del desarrollo de estos alojamientos en Suecia, un país modelo y guía en materia de políticas de viviendas y cuidados para personas mayores. El objetivo de este artículo es analizar el crecimiento de los alojamientos colaborativos para personas mayores en España desde la economía social, y conocer los problemas encontrados en su implementación, y las soluciones e impulsos políticos a su desarrollo. Hemos revisado la literatura española e internacional sobre cohousing senior durante la última década, y buscado datos en España sobre estos alojamientos en la prensa local y nacional y en la base de datos del proyecto MOVICOMA para determinar su grado de implantación y características. También se consultaron los barómetros de UDP sobre cohousing. Y hemos encontrado que su funcionamiento en España es incipiente, y que existen pocas iniciativas consolidadas, aunque bastantes en marcha, y se comprueba que la economía social juega un papel primordial. El Covid-19 ha elevado la demanda de estos alojamientos y alternativas de cuidado porque promueven y facilitan contactos sociales, evitan riesgos de las residencias, y mantienen a los participantes activos. Pero su implementación es lenta porque cuentan con importantes limitaciones a nivel de diseño, localización, financiación, burocracia excesiva y escaso apoyo público. Últimamente, a nivel político hay un mayor interés por estos alojamientos. Los planes de recuperación del Gobierno de España y algunas regulaciones de las CCAA y Ayuntamientos incorporan estrategias específicas sobre viviendas, otras para la Economía Social y cooperativas, y para el cuidado de los mayores (SAAD) que afectan directa o indirectamente al cohousing senior.Alternate :The advancement of senior cohousing is a push towards the modernization of housing and care for older people, and a challenge for present nursing homes. Cohousing has several years of experience in other European countries, and it is an attractive way of living for older people and/or families who want company and to share tasks. This article analyzes the growth of cohousing for older people in Spain from Third Sector, its barriers, and political impulses, and compares it with the experience in Sweden. Its functioning in Spain is incipient, and the Social Economy plays a key role. There are few consolidated initiatives, and quite a few underway, but the progress is slow due to numerous administrative and financial obstacles. The Covid-19 pandemic has raised the demand for these accommodations and care alternative because they promote and facilitate social contacts, some of the the risks of nursing homes, and comply with sustainable development objectives (SDG). Both Spain and Sweden have a variety of co-housing types, with a big role for cooperatives, but in Sweden they are primarily seen as a type of housing, where older people share fewer activities and maintain their privacy. Recently, there is greater political interest in cohousing. The recovery plans of the Spanish government and some regulations of the Autonomous Communities and City Councils incorporate specific strategies on housing, for the Third Sector, and the care of older people (SAAD) that affects senior cohousing.

3.
Front Public Health ; 10:798779, 2022.
Article in English | PubMed | ID: covidwho-1809610

ABSTRACT

Disproportionately high COVID case and mortality rates in skilled nursing facilities (SNFs) have heightened interest in the role of Certified Nursing Aides (CNAs) in the care of residents living in SNFs. This policy brief will make recommendations for CNA training based on an examination of two sources of secondary data using descriptive statistics. From the first source of secondary data, 34% of CNAs report feeling inadequately trained. The second source, U.S. government data, revealed statistically significant negative correlations between the amount of CNA training required across states and COVID mortality rates (Kendall's τ(b) = -0.32;p = 0.002) but not case rates (Kendall's τ(b) = -0.18;p = 0.09). More training for CNAs may not only reduce health risks from infectious diseases but also improve how they relate to SNF residents during care.

4.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-333406

ABSTRACT

Background: Transmission of SARS-CoV-2 in nursing homes is poorly documented. Methods: Using surveillance data of 228 European private nursing homes, we estimated weekly SARS-CoV-2 incidences and compared to that in the general population, between August 3, 2020 and February 20, 2021. We studied the outcomes of 'episodes of introduction' where one case was first detected and computed attack rates, reproduction ratio (R), and dispersion parameter (k). We estimated the impact of vaccination in preventing SARS-CoV-2 transmission. Findings: During the period, 21,467 residents and 14,371 staff members were in the surveyed facilities. Before vaccination’s roll-out, a cumulated 5,579 SARS-CoV-2 infections were documented among residents and 2,321 among staff. Half (48∙0%) of the infected residents were symptomatic;the fatality rate was 12.7% (95%CI, 11∙9%-13∙6%). The timing of viral circulation in nursing homes did not mirror that in the general population (p-values <0∙001). Out of 502 episodes of SARS-CoV-2 introduction, 77.1% (95%CI, 73∙2%-80∙6%) led to additional cases. Attack rates were highly variable, ranging from 0∙4% to 86∙5%. The reproduction ratio was 1∙16 (95%CI, 1∙11-1∙22) with k = 2∙5 (95%CI, 0∙5-4∙5). Higher staffing ratio and previous natural immunization reduced the probability of an outbreak following introduction. Vaccination started on January 15, 2021, and coverage reached 65.0% among residents, and 42.0% among staff by February 20, 2021. Vaccination yielded a 92% reduction (95%CI, 71%-98%) of outbreak probability, and lowered R to 0∙87 (95%CI, 0∙69-1∙10). Interpretation: SARS-CoV-2 circulation in nursing homes did not mirror spread in the general population. Despite strong preventive measures, transmission likely occurred, regardless of building characteristics. High levels of vaccination were critical to prevent transmission.

5.
15th EAI International Conference on Pervasive Computing Technologies for Healthcare, Pervasive Health 2021 ; 431 LNICST:31-39, 2022.
Article in English | Scopus | ID: covidwho-1797700

ABSTRACT

The Covid-19 pandemic struck the world in spring 2019 and affected most people in the world. One group that suffered the most was older adults and others ‘weak’ citizens. In Sweden where the reported-on study was situated, especially people living in nursing homes and other care facilities suffered immensely, especially in the early stages of the pandemic. In this paper we report on perspectives and lessons learned from a survey compiled by 13 care managers in eleven Swedish municipalities followed by a workshop with ten of these municipality health managers. Our study showcase how technology has been a valuable tool for these organizations during the pandemic. While Internet-cameras in some instances has been used in private homes to facilitate ‘remote monitoring’, many of our findings points to aspects of managing care – a less studied aspect within the Pervasive health community. © 2022, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.

6.
Palliative & Supportive Care ; : 13, 2021.
Article in English | Web of Science | ID: covidwho-1795869

ABSTRACT

Objective The care of seriously ill and dying people is an important task, especially in times of pandemics and regardless of the patients' infection status. Before the SARS-CoV-2 pandemic, healthcare systems were not sufficiently prepared for the challenges of palliative and end-of-life care during a pandemic. The aim was to identify and synthesize relevant aspects and non-therapeutic recommendations of palliative and end-of-life care of seriously ill and dying people, infected and uninfected, and their relatives after one year into the pandemic to outline what actions, practices, and procedures were taken to deal with the pandemic and its consequences. Method A scoping literature review following the methods of the PRISMA-ScR. The electronic literature search was conducted in 09/2020 and updated in 02/2021 using MEDLINE (Pubmed), with no restriction of publication date and eligibility criteria. In addition, a manual search was carried out. Results A total of 280 studies met the inclusion criteria and three main aspects have emerged. The reduction of physical contact due to the risk of infection severely limited the work of palliative care professionals and solutions had to be found to maintain palliative and end-of-life care structures. This has been accompanied by strict visitor restrictions and the need to support patients, relatives, and enable contact. The third relevant aspect is the integration of specialist palliative care expertise into other clinical settings. Significance of results This scoping review demonstrates the need for basic palliative care training for every healthcare professional. It supports the importance of developing a national strategy for palliative care in pandemic times in every country, including the digitalization of the healthcare sector to offer telecommunication/telemedicine.

7.
BMC Geriatr ; 22(1):337, 2022.
Article in English | PubMed | ID: covidwho-1793978

ABSTRACT

INTRODUCTION: Telemedicine use in nursing homes (NHs) expanded during the COVID-19 pandemic. The objectives of this study were to characterize plans to continue telemedicine among newly adopting NHs and identify factors limiting its use after COVID-19. METHODS: Key informants from 9 Wisconsin NHs that adopted telemedicine during COVID-19 were recruited. Semi-structured interviews and surveys were employed to identify participant perceptions about the value of telemedicine, implementation challenges encountered, and plans and barriers to sustaining its delivery after COVID-19. Directed content analysis and a deductive thematic approach using the Systems Engineering Initiative for Patient Safety (SEIPS) model was used during analyses. Quantitative and qualitative data were integrated to identify participant views on the value of telemedicine and the tools and work system enhancements needed to make telemedicine easier and more effective. RESULTS: All participating NHs indicated a preference to continue telemedicine after COVID-19. Urgent assessments of resident change-in-condition and cognitively based sub-specialty consultations were identified as the encounter types most amenable to telemedicine. Reductions in resident off-site encounters and minimization of resident therapy interruptions were identified as major benefits of telemedicine. Twelve work system enhancements needed to better sustain telemedicine were identified, including improvements to: 1) equipment/IT infrastructure;2) scheduling;3) information exchange;and 4) telemedicine facilitators. DISCUSSION: NHs that adopted telemedicine during COVID-19 wish to continue its use. However, interventions that enhance the integration of telemedicine into NH and off-site clinic work systems require changes to existing regulations and reimbursement models to sustain its utilization after COVID-19.

8.
Family Medicine and Primary Care Review ; 24(1):43-50, 2022.
Article in English | Web of Science | ID: covidwho-1792054

ABSTRACT

Background. Frailty was believed to reflect patients' prognosis better than age, but studies regarding the association between these factors are controversial. Moreover, studies highlighting the association of gender to mortality risk in frail patients are limited. Objectives. We aimed to investigate the association of frailty to mortality risk with the dose-response relationship of CFS and the association of gender to mortality risk in frail elderly with COVID-19. Material and methods We performed a comprehensive literature search from several databases, such as Europe PMC, PubMed and DOAJ on 9 July 2021. We searched for studies investigating the association between frailty and mortality in COVID-19 patient. Results A total of 16,438 patients from 15 studies were included. Frailty was found in 52.67% of the patients. The lowest mean age was 65.4 +/- 15.8 years. Pre-frailty (OR 2.07 [1.53-2.79];p < 0.00001;I-2: 72%), mild frailty (OR 2.24 [1.48-3.38];p = 0.00001;I-2: 80%), moderate frailty (OR 2.55 [1.75-3.71];p < 0.00001;I-2: 79%) and severe frailty (OR 3.57 [2.35-5.43];p < 0.00001;I-2: 83%) increase the mortality risk in elderly with COVID-19. Each 1-point increase in CFS increases the mortality risk by 1.4 [1.3-1.5];p = 0.000;I-2: 98.6%. Men had a lower risk of frailty (OR 0.58 [0.43-0.78];p = 0.0004;I-2=36%) but higher mortality risk. Conclusions This meta-analysis showed that pre-frailty and frailty increase the mortality risk in elderly with COVID-19. Each 1-point increase in CFS increased the mortality risk by 1.4. Men had a lower risk of frailty but higher mortality risk.

9.
Italian Sociological Review ; 12(6S):0_1,347-367, 2022.
Article in English | ProQuest Central | ID: covidwho-1791685

ABSTRACT

The research we are presenting is based on the following question: what happened inside the Residential Care Facilities and the nursing homes for the fragile and /or nonself-sufficient elderly, between the first COVID-19 case in Italy (21/02/2020) and the end of the lock-down (04/05/2020)? In order to answer that question we conducted a qualitative exploratory research thanks to which we were able to get in touch with the nursing homes and better understand the resources they used, the obstacles they encountered and some innovations they put in place. For the purpose of the study we collaborated with the Alberto Sordi Foundation. We involve 22 organisations coming from all the regions for two reasons: we were studying a healthcare system based on a regional model;the contagion spread differently in the various regions. The conclusions are focused on three elements that should regard the future perspectives on elderly care models: 1) care, which, seen as fundamental right underlying the recognition of citizenship;2) an experimental territorial governance;3) the implementation of a new service profession called care manager.

10.
Arch Public Health ; 80(1): 58, 2022 Feb 18.
Article in English | MEDLINE | ID: covidwho-1789138

ABSTRACT

BACKGROUND: Belgium monitors the burden of healthcare-associated infections (HAIs) and antimicrobial use in nursing homes (NHs) by participating in the European point prevalence surveys (PPSs) organised in long-term care facilities (HALT surveys). We present the main findings of the three national PPSs conducted in NHs participating in at least one of these surveys, and in a cohort that participated in all three consecutive surveys. METHODS: All NHs were invited to voluntarily participate and conduct the survey on one single day in May-September 2010 (HALT-1), in April-May 2013 (HALT-2) or in September-November 2016 (HALT-3). Data were collected at institutional, ward and resident level. A detailed questionnaire had to be completed for all eligible (i.e. living full time in the facility since at least 24 h, present at 8:00 am and willing to participate) residents receiving at least one systemic antimicrobial agent and/or presenting at least one active HAI on the PPS day. The onset of signs/symptoms had to occur more than 48 h after the resident was (re-)admitted to the NH. RESULTS: A total of 107, 87 and 158 NHs conducted the HALT-1, HALT-2 and HALT-3 survey, respectively. The median prevalence of residents with antimicrobial agent(s) increased from 4.3% (95% confidence interval (CI): 3.5-4.8%) in HALT-1 to 4.7% (95% CI: 3.5-6.5%) in HALT-2 and 5.0% (95% CI: 4.2-5.9%) in HALT-3. The median prevalence of residents with HAI(s) varied from 1.8% (95% CI: 1.4-2.7%) in HALT-1 to 3.2% (95% CI: 2.2-4.2%) in HALT-2 and 2.7% (95% CI: 2.1-3.4%) in HALT-3. Our post-hoc analysis on the cohort (n = 25 NHs) found similar trends. In all three surveys, respiratory tract infections were most frequently reported, followed by skin/wound infections in HALT-1 and urinary tract infections in HALT-2 and HALT-3. Antimicrobials were most commonly prescribed for the therapeutic treatment of an infection: 66.4% in HALT-1, 60.9% in HALT-2 and 64.1% in HALT-3. Uroprophylaxis accounted for 28.7%, 35.6% and 28.4% of all prescriptions, respectively. CONCLUSIONS: None withstanding the limitations peculiar to the study design, the PPSs enabled us to assess the occurrence of and to increase awareness for HAIs and rational antimicrobial use in NHs at both local and national level.

11.
Non-conventional in French | International HTA Database, Grey literature | ID: grc-753845

ABSTRACT

Objectives:The Ministère de la Santé et des Services sociaux (MSSS) would like the medical management arrangements and multidisciplinary care models used in long-term care facilities in other countries to be explored. The objectives of this report are, therefore, to document, in Canada and other OECD (Organisation for Economic Co-operation and Development) member countries, i) the offer of medical care and services and how medical care is provided, ii) the composition of medical care and services teams and the roles and responsibilities of their members (physicians, nurses, specialized nurse practitioners and pharmacists), and iii) physician involvement in the facilities’ management. Conclusions:RESULTS: The availability of physicians in long-term care facilities varies around the world. Some countries and provinces (e.g., the U.S., Ontario and British Columbia) have standards or legislation governing how care is provided. The implementation of standards appears to create value by clarifying medical expectations and providing more medical care and services in a timely fashion. Physician involvement outside of normal work hours varies as well (i.e., daytime from Monday to Friday). To meet the needs of residents outside these hours, access to telephone support and telemedicine between the facility’s care team and a physician seem to be methods used in some provinces and countries (e.g., Ontario, France, Norway and Australia). As for the number of medical visits per 2 year per resident, it seems to vary between 7 and 10, according to information from British Columbia, Manitoba and the United States. In the United States in 2015, there was the equivalent of 1.37 full-time equivalent (FTE) physicians per 1,000 occupied nursing home beds. This is far from the ratio recommended by U.S. experts of one FTE physician per 10 skilled nursing facility beds (facilities with, among other things, temporary physical rehabilitation beds) and 100 nursing facility beds. In Ontario, it is recommended that 4 hours per week be spent on medical practice in long-term care facilities for every 25 to 30 residents. Different practices and types of collaboration are used among different professionals working in long-term care facilities in order to optimize the provision of care for the residents. The three main types of skill mix described in the literature are (1) delegation (the physician assigns a task to another health care professional but remains responsible for it), (2) substitution (expanding the responsibilities of a health care professional, who may then provide some of the same services as the physician and becomes responsible and autonomous in performing these tasks), and (3) supplementation (increasing the scope of a health care professional’s work by allowing them to provide additional services that complement or extend those provided by the physician). Although a combination of all three types is reported in practice, physician substitution with different professionals, such as specialized nurse practitioners (SNPs) and physician assistants, is the one most documented in the publications reviewed. CONCLUSION: The results presented in this state-of-knowledge report provide relevant avenues for reflection on the organization of medical care and services in long-term care facilities. The topics discussed include the different staffing models in place across the OECD countries, the variability in the level of physician involvement in the management of these facilities (and the form of this involvement), and the several forms of skill mix. These results provide insight on the organization of care and services and the sharing of responsibilities among the various members of the care team. Given the aging of the population, the increasing complexity of the residents’ profile, and the difficulties recruiting qualified workers, efforts will certainly have to be made to adjust the way things are done and to continue to offer quality care and services. This reflective work is all the more necessary given the significant impact the COVID-19 pandemic has had on the health and social services system. Lastly, there are several tensions in the mission of long-term care facilities, which is to offer quality care and services in a quality living environment. The combination of these two goals in the reflection on the organization of medical care and services is essential for ensuring residents’ well-being. Methods:The Institut national d'excellence en santé et en services sociaux (INESSS) has prepared a state-of-knowledge report based on the scientific literature and websites of organizations, learned societies and government bodies. A total of 58 primary studies, 9 reviews, 9 expert opinions published in a scientific journal, reports from 7 governments and 23 organizations were examined.

12.
Journal of Infection and Chemotherapy ; 2022.
Article in English | ScienceDirect | ID: covidwho-1783495

ABSTRACT

Introduction Nursing facilities are vulnerable to coronavirus disease 2019 (COVID-19) due to the congregate nature of their housing, the older age of the residents, and the variety of their geriatric chronic conditions. Little is known about the impact of nursing facility COVID-19 on the local health system. Methods We collected data of COVID-19 cases in Nagasaki city from April 15, 2020 to June 30, 2021. We performed universal screening of the healthcare workers (HCWs) and the users of nursing facilities, once the first case of COVID-19 was detected within that facility. The community-dwelling people received testing if they had symptoms or if they were suspected of having close contact with the positive cases. The epidemiological survey for each COVID-19 case was performed by the public health officers of the local public health center. Results Out of 111,773 community-dwelling older adults (age ≥ 65 years) and 20,668 nursing facility users in Nagasaki city, we identified 358 and 71 COVID-19 cases, and 33 and 12 COVID-19 deaths, respectively, during the study period. The incidence rate ratios (IRRs) for COVID-19 and its deaths among the nursing facility users were 1.07 (95% confidence interval (CI), 0.82–1.39) and 1.97 (95%CI, 0.92–3.91) compared with the community-dwelling older adults. Four clusters, which had more than 10 COVID-19 cases, accounted for 60% (65/109) of the overall cases by the HCWs and the users. Conclusions The prevention of COVID-19 clusters is important to reduce the number of COVID-19 cases and deaths among the nursing facility population.

13.
J Appl Gerontol ; : 7334648221081850, 2022 Apr 13.
Article in English | MEDLINE | ID: covidwho-1785006

ABSTRACT

Background: Long-term care homes (LTCHs) restricted essential family caregivers' (EFCs) visitations during COVID-19, and virtual visits using technology were used. Objective: To understand EFCs' virtual visitations experiences during COVID-19 in two Canadian provinces. Methods: Seven focus groups were conducted with EFCs. Thematic analysis was used to identify themes at micro, meso, and macro levels. Results: Four themes were found: 1) a lack of technology and infrastructure; 2) barriers to scheduling visitations; 3) unsuitable technology implementation; and 4) inability of technology to adapt to residents' needs. Discussion: Virtual visitations showcased a confluence of micro, meso, and macro factors that, in some cases, negatively impacted the EFCs, residents, and the relationship between EFCs and residents. Structural and home inequities within and beyond the LTCH impacted the quality of technology-based visitations, underscoring the need to support technology infrastructure and training to ensure residents are able to maintain relationships during visitation bans. Conclusion: EFCs' experiences of technology-based visitations were impacted by structural vulnerabilities of the LTCH sector.

14.
J Am Med Dir Assoc ; 2022 Apr 13.
Article in English | MEDLINE | ID: covidwho-1783454

ABSTRACT

OBJECTIVE: To identify the perceptions of physicians with expertise in nursing home care on the value of physicians who primarily practice in nursing homes, often referred to as "SNFists," with the goal of enriching our understanding of specialization in nursing home care. DESIGN: Qualitative analysis of semistructured interviews. SETTING AND PARTICIPANTS: Virtual interviews conducted January 18-29, 2021. Participants included 35 physicians across the United States, who currently or previously served as medical directors or attending physicians in nursing homes. METHODS: Interviews were conducted virtually on Zoom and professionally transcribed. Outcomes were themes resulting from thematic analysis. RESULTS: Participants had a mean 19.5 (SD = 11.3) years of experience working in nursing homes; 17 (48.6%) were female; the most common medical specializations were geriatrics (18; 51.4%), family medicine (8; 22.9%), internal medicine (7; 20.0%), physiatry (1; 2.9%), and pulmonology (1; 2.9%). Ten (28.6%) participants were SNFists. We identified 6 themes emphasized by participants: (1) An unclear definition and loose qualifications for SNFists may affect the quality of care; (2) Specific competencies are needed to be a "good SNFist"; (3) SNFists are distinguished by their unique practice approach and often provide services that are unbillable or underreimbursed; (4) SNFists achieve better outcomes, but opinions varied on performance measures; (5) SNFists may contribute to discontinuity of care; (6) SNFists remained in nursing homes during the COVID-19 pandemic. CONCLUSIONS AND IMPLICATIONS: There is a strong consensus among physicians with expertise in nursing home care that SNFists provide higher quality care for residents than other physicians. However, a uniform definition of a SNFist based on competencies in addition to standardized performance measures are needed. Unbillable and underreimbursed services create disincentives to physicians becoming SNFists. Policy makers may consider modifying Medicare reimbursements to incentivize more physicians to specialize in nursing home care.

15.
Eur J Epidemiol ; 2022 Apr 10.
Article in English | MEDLINE | ID: covidwho-1782861

ABSTRACT

This essay considers the factors that have contributed to very high COVID-19 mortality in longer-term care facilities (LTCFs). We compare the demographic characteristics of LTCF residents with those of community-dwelling older adults, and then we review the evidence regarding prevalence and infection fatality rates (IFRs), including links to frailty and some comorbidities. Finally, we discuss policy measures that could foster the physical and mental health and well-being of LTCF residents in the present context and in potential future pandemics.

16.
Journal of the American Medical Directors Association ; 2022.
Article in English | ScienceDirect | ID: covidwho-1778262

ABSTRACT

Objectives The present study sought to examine mental health problems among nursing home workers in the context of the COVID-19 pandemic, to investigate COVID-19 related fears, and to identify pre-pandemic factors associated with current mental health issues. Design A cross-sectional, online survey was used. Setting and Participants All employees among six nursing homes in southwestern France (N=455) were solicited between November, 2020 and June, 2021. Methods The survey instrument was developed within the World Mental Health consortium to screen for COVID-related fears, probable generalized anxiety, panic attacks, depression, post-traumatic stress and substance use disorders in the past 30 days. Results The survey was completed by 127 workers (89.0% female, mean age = 43.42 years, SD=11.29), yielding a 28.5% response rate. Overall, 48.03% reported experiencing fear of infecting others at least most of the time. One in eight (14.96%) indicated that close others feared being infected by them. One third of the sample (34.65%) met criteria for at least one probable current mental disorder. Panic attacks (22.05%) were the most frequently-reported mental health problem, followed by depression (16.54%). In multivariate analyses, the only factor associated with having a current probable mental disorder was the presence of any pre-pandemic mental health problem (AOR=4.76, 95%CI=2.08-10.89). Type of employment contract, full-time status, or medical vs non-medical staff status were not significantly associated with mental health status. Conclusions and Implications The study reveals that one third of nursing home workers in the sample report current probable mental disorders, and these were largely associated with pre-pandemic mental health status. Screening for common mental health problems and facilitating access to appropriate care should be prioritized in nursing homes.

17.
Applied Medical Informatics ; 44(1):10-21, 2022.
Article in English | ProQuest Central | ID: covidwho-1777271

ABSTRACT

In the current context of an aging population and the development of assistance to the elderly, the needs of this category of people are increasing. The nursing homes are part of these needs. For an older adult, choosing a nursing home near his or her family, relatives, and friends can also be reassuring and allow regular visits from his or her entourage. The choice of a nursing home is a significant problem for aging adults. This particular category of people wastes too much time, money, and effort in moving to find an establishment that ensures care and meets their basic needs. This paper proposes an agent-based approach that performs nursing homes' search process by userselected personalized criteria. The appointment step follows this process. This approach represents a significant help to dependent older adults.

18.
Int J Environ Res Public Health ; 19(7)2022 Apr 06.
Article in English | MEDLINE | ID: covidwho-1776237

ABSTRACT

COVID-19 posed enormous challenges for nursing home staff, which may have caused stress and mental health problems. This study aimed to measure the prevalence of mental health problems among nursing home staff and investigate the differences in job demands, work functioning and mental health between staff with and without COVID contact or COVID infection and across different levels of COVID worries. In this cross-sectional study, 1669 employees from 10 nursing home organizations filled in an online questionnaire between June and September 2020. The questionnaire measured the participants' characteristics, COVID contact, infection and worries, job demands, work functioning, depressive symptoms and burnout. Differences were investigated with multilevel models to account for clustering at the organization level. Of the participants, 19.1% had high levels of depressive symptoms and 22.2% burnout. Job demands, work functioning, depressive symptoms and burnout differed between participants who never worried and participants who often or always worried about the COVID crisis. Differences were smaller for participants with and without COVID contact or infection. Most models improved when clustering was accounted for. Nursing homes should be aware of the impact of COVID worries on job demands, work functioning and mental health, both at the individual and organizational level.


Subject(s)
Burnout, Professional , COVID-19 , Nursing Staff , Burnout, Professional/epidemiology , Burnout, Professional/psychology , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Mental Health , Nursing Homes , Nursing Staff/psychology
19.
Epidemiol Prev ; 46(1-2): 92-99, 2022.
Article in Italian | MEDLINE | ID: covidwho-1771984

ABSTRACT

BACKGROUND: Health Information Systems (HIS) play a strategic role in the development of community healthcare services, a field still underdeveloped in Italy as shown by the COVID-19 pandemic, and their use for epidemiological purposes is increasing over the years. However, some general critical issues have been reported concerning national community health information systems, but no detailed study was found after a non-systematic review in Medline database and institutional websites. OBJECTIVES: to assess uniformity and comparability of health information collected by the national health information Systems for Home Care (SIAD), Nursing Homes (FAR), and Hospices (HOS) in Italy, three healthcare settings sharing patients with common conditions and healthcare needs. METHODS: information was gathered from current Technical Regulations Papers of the Italian Health Ministry. All variables of the three Information Systems were ordered on the basis of the characteristics provided by the ministerial documents into a single grouping model created for the purpose and their distribution compared among and between the Systems. According to the grouping model, the variables were divided in two main groups: System Variables for administrative, bill, and identification-personal data and the Pathway Variables for patient's conditions and provided healthcare data. Common information content variables among all systems and between two of them were then identified, highlighting those with also identical terminology and allowed values. On the basis of the percentages of common and identical variables, uniformity in content and terminology was then calculated among all systems and between two of them. Besides, levels of content and terminology agreement have been calculated with Cohen's K matching the three Systems in all possible combinations of pairs. RESULTS: there are 70 variables in SIAD, 45 variables in FAR, and 34 in HOS. System variables are nearly the half in FAR and HOS, 22 (48.9%) and 17 (50.0%) variables, respectively. Pathway variables are prevalent only in SIAD, with 55 variables (78.6%). Only SIAD and HOS use ICD-9-CM, with 2 (2.8%) and 9 (26.5%) variables, respectively. The three Systems share 18 common variables, with other 16 common between just two of them. Considering the common variables, the total number of variables used by all the Systems is 97, with 23 System variables (23.7%) and 74 Pathway variables (76.3%). Overall, content uniformity among the three Systems is 18.5%, but becomes 60.9% considering only the System variables and 5.4% for the Pathway variables, with respectively 14 and 4 common variables. Among the common variables, 11 have the same denomination and allowed values, with an overall terminological uniformity of 11.3%. Being all of them System variables, no terminological uniformity has been found among the three Systems.The level of content agreement was fair for the couple FAR-HOS (K Cohen 0.26), but null for HOS-SIAD and SIAD-FAR (K Cohen -0.20 and <0.01). Null was also the level of terminological agreement in all the possible pairs of matched systems (K Cohen all negative). CONCLUSIONS: content and terminology uniformity of National Health Information Systems in Italy for Home Care, Nursing Homes, and Hospices has been found to be poor, with little reference to standardised classification systems and a scarce level of comparability of the information gathered in the three healthcare settings, although similarity in patients' characteristics and provided health services. Data comparability among them is mainly limited to administrative and identification-personal information, with little possibility of comparing information on patients' conditions and provided healthcare in the three settings. This scarce uniformity might undermine the contribution of national Health Information Systems in the development of community healthcare services in Italy and limit the potential of epidemiological research in this area. Also in the light of the establishment of new national Health Information Systems for Primary Care and Community Hospitals, a methodological reassessment of languages, codes, and evaluation tools used by community health services and information systems is needed.


Subject(s)
COVID-19 , Health Information Systems , Home Care Services , Hospices , Nursing Care , COVID-19/epidemiology , Humans , Italy , Nursing Homes , Pandemics
20.
BMC Infect Dis ; 22(1): 307, 2022 Mar 29.
Article in English | MEDLINE | ID: covidwho-1770489

ABSTRACT

BACKGROUND: The air borne SARS-CoV-2 poses a high threat to the elderly and people with underlying diseases. COVID-19 spread quickly in South German nursing homes and for this reason called for preventive measures by the German government. The aim of this paper is to showcase the testing strategies implemented by the Public Health Department Reutlingen to control the spread of COVID-19 in local nursing homes and to report the results thereof. METHODS: This study reports COVID-19 outbreaks in nursing homes in Reutlingen County and how they were dealt with through extensive testing, contact tracing, isolation and hygiene inspections. The testing strategy consisted of three phases: In phase 1 only suspected cases, in phase 2 all staff and residents, and in phase 3 all suspected cases and their contacts were tested. RESULTS: Nearly all residents (98%) and staff members (92%) of all nursing homes in Reutlingen County were tested for SARS-COV-2. 25 of 37 nursing homes had COVID-19 cases, 5 had 30-81 cases/home. 62% of the 395 nursing homes cases were residents, but less than half of them exhibited symptoms (41%). The cases uncovered in nursing homes represented 26% of all 1529 cases in Reutlingen County during the time of this study. CONCLUSIONS: Many COVID-19 cases were discovered through extensive testing, allowing for early interventions. The results shed light on the COVID-19 situation in nursing homes and allowed for individually designed preventive measures. The results also lead to a change in the German legislation. The outbreak management methods of the Public Health Department Reutlingen may also be applicable in other countries.


Subject(s)
COVID-19 , Contact Tracing , Aged , COVID-19/epidemiology , Disease Outbreaks , Humans , Nursing Homes , SARS-CoV-2
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