Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 40
Filter
1.
Journal of Long-Term Care ; 2022:163-172, 2022.
Article in English | Scopus | ID: covidwho-2026524

ABSTRACT

Context: Despite being widely used with older adults in the community, there is limited literature on using the de Jong Gierveld Loneliness Scale with older adults living in long-term care (LTC). Objective: The purpose of this article is to discuss the considerations of using this scale with older adults in LTC. Method: Our team consisted of older person and family partners, a clinician, and academic researchers working together in all stages of research using the Loneliness scale to conduct individual interviews with 20 older adults in LTC in Vancouver, Canada, as part of a study exploring the experience of loneliness during the COVID-19 pandemic. Team reflection was embedded in the research process, with reflection data consisting of data transcripts, field notes, and regular team meeting notes. Thematic analysis was employed to identify lessons learned and implications. Findings: Participants had various challenges responding to the scale. Our analysis identified five themes: a) diverse meanings of loneliness, b) multi-faceted factors of loneliness, c) technical challenges, d) social desirability, and e) situational experience. We also offer five recommendations to consider when using this scale with older adults in LTC. Limitations: We used this scale with a small sample of older adults in LTC, which is a more time and labour-intensive population. Data on marital status and educational background was not collected but might help in understanding considerations for using the scale with older adults in LTC. Implications: We offer practical recommendations for using the scale with older adults in LTC, especially how qualitative open-ended questions can complement the scale by providing useful insights into context and complex experiences. © 2022 The Author(s).

2.
Journal of the American Geriatrics Society ; : 1, 2022.
Article in English | Academic Search Complete | ID: covidwho-2019449

ABSTRACT

Background Methods Results Conclusions Care aides (certified nursing assistants, personal support workers) are the largest workforce in long‐term care (LTC) homes (nursing homes). They provide as much as 90% of direct care to residents. Their health and well‐being directly affect both quality of care and quality of life for residents. The aim of this study was to understand the impact of COVID‐19 on care aides working in LTC homes during the first year of the pandemic.We conducted semi‐structured interviews with a convenience sample of 52 care aides from 8 LTC homes in Alberta and one in British Columbia, Canada, between January and April 2021. Nursing homes were purposively selected across: (1) ownership model and (2) COVID impact (the rate of COVID infections reported from March to December 2020). Interviews were recorded and analyzed using inductive content analysis.Care aides were mainly female (94%) and older (74% aged 40 years or older). Most spoke English as an additional language (76%), 54% worked full‐time in LTC homes, and 37% worked multiple positions before “one worksite policies” were implemented. Two themes emerged from our analysis: (1) Care aides experienced mental and emotional distress from enforcing resident isolation, grief related to resident deaths, fear of contracting and spreading COVID‐19, increased workload combined with staffing shortages, and rapidly changing policies. (2) Care aides' resilience was supported by their strong relationships, faith and community, and capacity to maintain positive attitudes.These findings suggest significant, ongoing adverse effects for care aides in LTC homes from working through the COVID‐19 pandemic. Our data demonstrate the considerable strength of this occupational group. Our results emphasize the urgent need to appropriately and meaningfully support care aides' mental health and well‐being and adequately resource this workforce. We recommend improved policy guidelines and interventions. [ FROM AUTHOR] Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

3.
Health Soc Care Community ; 2022 Aug 13.
Article in English | MEDLINE | ID: covidwho-1992807

ABSTRACT

COVID-19 had a devastating impact on older people living in care homes. This study explored the clinical trajectory and management of COVID-19, as well as recovery of older people following infection during the early stages of the pandemic (May to August 2020). A two-phase exploratory qualitative study was used. Frontline staff with experience of caring for older people with COVID-19 were recruited to Phase 1, and senior care home operational and quality managers were recruited to Phase 2. During Phase 1 remote semi-structured interviews (n = 35) were carried out with staff working in care homes, hospital and community settings in England. During Phase 2, a remote consultation event was carried out with senior care home operational and quality managers (n = 11) to share Phase 1 findings and check resonance, relevance and gaps. Data were analysed using Framework Analysis. Older people with COVID-19 presented with wide ranging symptoms, and an unpredictable illness trajectory. The wide range of COVID-19 symptoms required timely testing and supportive interventions. Staff used different interventions to manage symptoms and reported uncertainties of how individuals would respond. In care home settings, health and social care staff needed to work together when administering interventions such as subcutaneous fluids or oxygen therapy. Alongside symptom management, supportive care focused on nutrition and hydration, social interaction, and maintaining physical activity to meet both physical and emotional needs. The effects of prolonged periods of social isolation and inactivity on the health and well-being of older people means rehabilitation is essential to enhance physical and emotional recovery, and to minimise impacts on cognition and function. The pandemic highlighted important areas for care of this population.

4.
Int J Environ Res Public Health ; 19(15)2022 Aug 04.
Article in English | MEDLINE | ID: covidwho-1979212

ABSTRACT

(1) Background: Nursing and care home staff experienced high death rates of older residents and increased occupational and psychosocial pressures during the COVID-19 pandemic. The literature has previously found this group to be at risk of developing mental health conditions, moral injury (MI), and moral distress (MD). The latter two terms refer to the perceived ethical wrongdoing which contravenes an individual's moral beliefs and elicits adverse emotional responses. (2) Method: A systematic review was conducted to explore the prevalence, predictors, and psychological experience of MI and MD in the aforementioned population during the COVID-19 pandemic. The databases CINAHL, APA PsychINFO, APA PsychArticles, Web of Science, Medline, and Scopus were systematically searched for original research studies of all designs, published in English, with no geographical restrictions, and dating from when COVID-19 was declared a public health emergency on the 30 January 2020 to the 3 January 2022. Out of 531 studies screened for eligibility, 8 studies were selected for review. A thematic analysis was undertaken to examine the major underpinning themes. (3) Results: MI, MD, and related constructs (notably secondary traumatic stress) were evidenced to be present in staff, although most studies did not explore the prevalence or predictors. The elicited major themes were resource deficits, role challenges, communication and leadership, and emotional and psychosocial consequences. (4) Conclusions: Our findings suggest that moral injury and moral distress were likely to be present prior to COVID-19 but have been exacerbated by the pandemic. Whilst studies were generally of high quality, the dearth of quantitative studies assessing prevalence and predictors suggests a research need, enabling the exploration of causal relationships between variables. However, the implied presence of MI and MD warrants intervention developments and workplace support for nursing and care home staff.


Subject(s)
COVID-19 , COVID-19/epidemiology , Humans , Morals , Pandemics , Prevalence , Workplace/psychology
5.
Int J Environ Res Public Health ; 19(12)2022 06 16.
Article in English | MEDLINE | ID: covidwho-1963950

ABSTRACT

The care home sector has great potential to benefit from technological innovations and to be at the forefront of developing novel digital solutions to improve the experiences of care home residents, their families, and the staff caring for them. The COVID-19 pandemic exposed variability in digital capabilities and longstanding data challenges within the care home sector. Paradoxically, however, it also increased the use of digital tools and services to support residents and staff. There are, however, a number of barriers to sustained and widespread adoption of digital solutions by care homes. Here, the focus is on foundation-level barriers and the groundwork required to overcome them. Using data from three Scottish-based studies, foundation-level barriers to the adoption of digital tools and services faced by care homes are discussed. These main barriers are the need for robust basic internet connectivity; capabilities for digital data collection; access to data to inform and drive digital solutions; the need for trust in the use of resident data by commercial companies; and the danger that poorly coordinated strategies undermine efforts to build a care home data platform and the digital solutions it can support. Sustained and widespread adoption of digital solutions by care homes will require these foundation-level barriers to be addressed. Strong and stable data and digital foundations supported by sector-specific scaffolding are major prerequisites to the widespread adoption of digital solutions by care homes.


Subject(s)
COVID-19 , Nursing Homes , COVID-19/epidemiology , Data Collection , Humans , Pandemics/prevention & control , Scotland
6.
1st International Conference on Technologies for Smart Green Connected Society 2021, ICTSGS 2021 ; 107:17967-17978, 2022.
Article in English | Scopus | ID: covidwho-1950339

ABSTRACT

BACKGROUND The major aim of this discussion is to spotlight the ageism that has appeared during the COVID-19. Here we discusses about how the older people are wrongly presented in our community and their less value in the society. During this pandemic, covid-19 was resulted into major cause of death for older adults.Ageism is generally seen in the western and developing societies and here, older people are seen with false beliefs and judgments. To overcome this, the health authorities should consider older adults to be an integral part of the population, they should not feel burdened by them. OBJECTIVE The article provides a review of the literature on behaviour and attitudes toward ageism and older adults in the world and discusses the facts and findings on the basis of the review of literature on ageing, age stereotypes, impact of ageism on older people as well as their link toculture and society. METHODS This review articles was published from June 2020 to January 2021 and indexed in the electronic databases Web of Science, PubMed, and WHO official website. Electronic searches were made with visual scanning of reference lists and hand searching of leading journals in the field of ageing and social gerontology. RESULTS During covid-19 pandemic, flexibility of old age should be adopted. Here the treatment should be depends upon chronological age as well as on values and preferences of people. An alternative framework must be established which shows the negative impact of the corona virus on the population. We must stop saying terms called social distancing and better call the best appropriate term such as physical distancing.In the social world, the major asset of emergency situations is intergenerational relation without this relation the life of older people become vulnerable. CONCLUSION In this article, advocates and public health researcher share their opinion about ageism, and try their efforts to reduce the perspective of people towards the older adults that appeared at the time of covid-19. This pandemic shows high mortality rates for older adults than younger adults. We cannot afford to be inattentive for the lost lives caused by ageist behaviour and attitudes. We need to think about of what will happen if we let ageism influence,and how thediscussion and treatment of old people affects during and after the pandemic. © The Electrochemical Society

7.
Gerontological social work and COVID-19: Calls for change in education, practice, and policy from international voices ; : 154-155, 2022.
Article in English | APA PsycInfo | ID: covidwho-1887909

ABSTRACT

This reprinted chapter originally appeared in Journal of Gerontological Social Work, 2020, 63[6-7], 644-645. (The following of the original article appeared in record 2021-00510-018.) Even in times of crisis, social workers and other staff members continue to serve on the frontline and provide services to vulnerable older adults. Effective measures need to be implemented in a uniform manner to help better protect care home residents and their staff. The sparsity of resources available for staff needs to be addressed with the provision and access to adequate personal protective equipment being made early. Following WHO hand hygiene models along with sanitizer provision can help reduce the spread of the infection. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

8.
Journal of Long-Term Care ; 2021:386-400, 2021.
Article in English | Scopus | ID: covidwho-1876505

ABSTRACT

Context: During COVID-19 care-homes had to implement strict Infection Control Measures (ICMs), ­impacting on care and staff morale. Objectives: To explore the lived experiences of care-home staff in ­implementing ICMs. Methods: Mixed-methods study comprising 238 online survey responses and 15 in-depth interviews with care-home staff, November 2020-January 2021 in England. Results: Three themes were ­identified: ‘Integrating COVID-19 ICMs with caring’, ‘Conveying knowledge and ­information’, ‘­Professional and ­personal impacts of care-work during the pandemic’. Reported adherence to ICMs was high but ­fatalistic ­attitudes towards COVID-19 infection were present. Challenges of providing care using ­personal ­protective ­equipment (PPE), especially for residents with dementia, were highlighted. ­Interviewees reported ­dilemmas between strictly implementing ICMs and conflicts with providing best care to ­residents and preserving personal space. Nine months into COVID-19, official guidance was reported as ­confusing, constantly changing and poorly suited to care-homes. Care-home staff ­appreciated ­opportunities to work with other care-homes and experts to interpret and implement guidance. ICM training was ­undertaken using multiple techniques but with little evaluation of these or how to sustain behaviour change. Limitations: Results may not be generalizable to other countries. Implications COVID-19 has had a profound effect on well-being of care-home staff. Despite challenges, participants reported broadly good morale, potentially a ­consequence of supportive colleagues and management. Nevertheless, clear, concise and care-home focussed ICM guidance is still needed. This should include evidence-based assessments on implementing and sustaining adherence. Groups of care-home staff and ICM experts working together to co-create, interpret and implement guidance were viewed positively. © 2021 The Author(s).

9.
Journal of Long-Term Care ; 2021:167-176, 2021.
Article in English | Scopus | ID: covidwho-1876498

ABSTRACT

An important part of care home life is the support given to older residents by their families/friends through regular visiting. Social visits to residents by their families ceased in response to the COVID-19 pandemic and residents were confined to their rooms. This paper reports on how care home staff improvised to address this situation during the first wave of the pandemic. It focuses on steps taken to maintain communication between residents and families to support emotional well-being. We undertook in-depth café-style interviews with twenty-one staff to explore creative practices that they introduced. It was part of a wider Scottish study examining the effect of lockdown on families whose relative was living/dying in a care home (May–October, 2020). Findings reveal the enormous effort by care staff to maintain family connections and the rapid acclimatisation involved working with a number of different on-line platforms, the pulling together of staff from across the care home, and, the attention to emotional well-being of residents living and dying in the care home. Findings highlight the professionalism and commitment of the leadership and staff involved. Whilst some of the staff accounts need no further comment, we draw on some themes from the care home research literature to make sense of the findings in terms of what we might learn going forward. This in-depth qualitative study emphasises the importance of recognising, fostering and nurturing relational compassionate care within long-term care. There is however little evidence whether health and social care policies recognise the importance of this on-going relationship. © 2021 The Author(s).

10.
Int J Qual Stud Health Well-being ; 17(1): 2075532, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1868206

ABSTRACT

BACKGROUND: Essential family caregivers (EFCs) of relatives living in long-term care homes (LTCHs) experienced restricted access to their relatives due to COVID-19 visitation policies. Residents' experiences of separation have been widely documented; yet, few have focused on EFCs' traumatic experiences during the pandemic. Objective: This study aims to explore the EFCs' trauma of being locked out of LTCHs and unable to visit their loved ones in-person during COVID-19. METHODS: Seven online focus groups with a total of 30 EFCs from Ontario and British Columbia, Canada were conducted as part of a larger mixed-method study. We used an inductive approach to thematic analysis to understand the lived experiences of trauma. RESULTS: Four trauma-related themes emerged: 1) trauma from prolonged separation from loved ones; 2) trauma from uncompassionate interactions with the LTCH's staff and administrators; 3) trauma from the inability to provide care to loved ones, and 4) trauma from experiencing prolonged powerlessness and helplessness. DISCUSSION: The EFCs experienced a collective trauma that deeply impacted their relationships with their relatives as well as their perception of the LTC system. Experiences endured by EFCs highlighted policy and practice changes, including the need for trauma-centred approaches to repair relational damage and post-pandemic decision-making that collaborates with EFCs.


Subject(s)
COVID-19 , Caregivers , Humans , Long-Term Care , Ontario , Pandemics
11.
JMIR Serious Games ; 10(2): e36768, 2022 May 10.
Article in English | MEDLINE | ID: covidwho-1834194

ABSTRACT

BACKGROUND: The pandemic has highlighted the importance of low-threshold opportunities for exercise and physical activity. At the beginning of 2020, the COVID-19 pandemic led to many restrictions, which affected seniors in care facilities in the form of severe isolation. The isolation led, among other things, to a lack of exercise, which has led to a multitude of negative effects for this target group. Serious games can potentially help by being used anywhere at any time to strengthen skills with few resources. OBJECTIVE: The aim of this study is to evaluate the effectiveness of a serious game to strengthen motor skills (study 1) and the influence of pandemic restrictions (study 2) on seniors in care facilities. METHODS: The data on motor skills (measured by the Tinetti test) originated from an intervention study with repeated measurements that was interrupted by the pandemic conditions. Data were collected 4 times every 3 months with an intervention group (IG, training 3 times for 1 hour per week) and a control group (CG, no intervention). There were 2 substudies. The first considered the first 6 months until the pandemic restrictions, while the second considered the influence of the restrictions on motor skills. RESULTS: The sample size was 70. The IG comprised 31 (44%) participants, with 22 (71%) female and 9 (29%) male seniors with an average age of 85 years. The CG comprised 39 (56%) participants, with 31 (79%) female and 8 (21%) male seniors with an average age of 87 years. In study 1, mixed-design ANOVA showed no significant interaction between measurement times and group membership for the first measurements (F2.136=1.414, P<.25, partial η2=.044), but there was a significant difference between the CG (mean 16.23, SD 1.1) and the IG (mean 19.81, SD 1.2) at the third time of measurement (P=.02). In study 2 the mixed-design ANOVA (used to investigate motor skills before and after the pandemic conditions between the 2 groups) couldn't reveal any significant interaction between measurement times and group membership: F1.67=2.997, P<.09, partial η2=.043. However, there was a significant main effect of the time of measurement: F1.67=5.44, P<.02, partial η²=.075. CONCLUSIONS: During the first 6 months, the IG showed increased motor skills, whereas the motor skills of the CG slightly deteriorated and showed a statistically significant difference after 6 months. The pandemic restrictions leveled the difference and showed a significant negative effect on motor skills over 3 months. As our results show, digital games have the potential to break down access barriers and promote necessary maintenance for important skills. The pandemic has highlighted the importance of low-threshold opportunities for exercise and physical activity. This potentially great benefit for the challenges of tomorrow shows the relevance of the topic and demonstrates the urgent need for action and research. TRIAL REGISTRATION: Deutsches Register klinischer Studien DRKS00016633; https://tinyurl.com/yckmj4px.

12.
Int J Environ Res Public Health ; 19(8)2022 04 12.
Article in English | MEDLINE | ID: covidwho-1809863

ABSTRACT

BACKGROUND: Although patients with venous leg ulcers are involved in ulcer management, little is known about why and how these patients self-treat their ulcers without direct supervision by health professionals. Yet patients' knowledge of ulcer management can be important for achieving ulcer closure and/or preventing recurrence. This study thus investigates the effects of an educational intervention on knowledge of self-care among patients with venous leg ulcers, mainly on wound dressing practice, compression therapy, physical activity and nutrition. METHODS AND PARTICIPANTS: This research was conducted in three outpatient hospitals in central Croatia. An educational brochure was made and distributed to patients; patients were surveyed about caring for venous leg ulcers before the brochure was distributed and after 3 months. RESULTS: In total, 208 patients were involved in the study: 112 in the experimental group and 96 in the control group. The educational intervention increased awareness of compression therapy, knowledge of recurrence prevention, appropriate lifestyle habits, and warning signs related to venous leg ulcers. CONCLUSIONS: Patient education on illness and self-care is necessary to achieve positive effects in self-care knowledge. In this study, patients learned how to change dressings, learned how to improve their lifestyle, and were empowered to deal with their illness.


Subject(s)
Self Care , Varicose Ulcer , Bandages , Humans , Ulcer , Varicose Ulcer/therapy , Wound Healing
13.
J Am Med Dir Assoc ; 23(6): 923-929.e2, 2022 06.
Article in English | MEDLINE | ID: covidwho-1783456

ABSTRACT

OBJECTIVE: This study aimed to estimate and compare mortality of care home residents, and matched community-dwelling controls, during the COVID-19 pandemic from primary care electronic health records in England. DESIGN: Matched cohort study. SETTING AND PARTICIPANTS: Family practices in England in the Clinical Practice Research Datalink Aurum database. There were 83,627 care home residents in 2020, with 26,923 deaths; 80,730 (97%) were matched on age, sex, and family practice with 300,445 community-dwelling adults. METHODS: All-cause mortality was evaluated and adjusted rate ratios by negative binomial regression were adjusted for age, sex, number of long-term conditions, frailty category, region, calendar month or week, and clustering by family practice. RESULTS: Underlying mortality of care home residents was higher than community controls (adjusted rate ratio 5.59, 95% confidence interval 5.23‒5.99, P < .001). During April 2020, there was a net increase in mortality of care home residents over that of controls. The mortality rate of care home residents was 27.2 deaths per 1000 patients per week, compared with 2.31 per 1000 for controls. Excess deaths for care home residents, above that predicted from pre-pandemic years, peaked between April 13 and 19 (men, 27.7, 95% confidence interval 25.1‒30.3; women, 17.4, 15.9‒18.8 per 1000 per week). Compared with care home residents, long-term conditions and frailty were differentially associated with greater mortality in community-dwelling controls. CONCLUSIONS AND IMPLICATIONS: Individual-patient data from primary care electronic health records may be used to estimate mortality in care home residents. Mortality is substantially higher than for community-dwelling comparators and showed a disproportionate increase in the first wave of the COVID-19 pandemic. Care home residents require particular protection during periods of high infectious disease transmission.


Subject(s)
COVID-19 , Frailty , Adult , Cohort Studies , Female , Humans , Independent Living , Male , Nursing Homes , Pandemics , SARS-CoV-2
14.
BMC Infect Dis ; 22(1): 324, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1770492

ABSTRACT

BACKGROUND: COVID-19 outbreaks still occur in English care homes despite the interventions in place. METHODS: We developed a stochastic compartmental model to simulate the spread of SARS-CoV-2 within an English care home. We quantified the outbreak risk with baseline non-pharmaceutical interventions (NPIs) already in place, the role of community prevalence in driving outbreaks, and the relative contribution of all importation routes into a fully susceptible care home. We also considered the potential impact of additional control measures in care homes with and without immunity, namely: increasing staff and resident testing frequency, using lateral flow antigen testing (LFD) tests instead of polymerase chain reaction (PCR), enhancing infection prevention and control (IPC), increasing the proportion of residents isolated, shortening the delay to isolation, improving the effectiveness of isolation, restricting visitors and limiting staff to working in one care home. We additionally present a Shiny application for users to apply this model to their facility of interest, specifying care home, outbreak and intervention characteristics. RESULTS: The model suggests that importation of SARS-CoV-2 by staff, from the community, is the main driver of outbreaks, that importation by visitors or from hospitals is rare, and that the past testing strategy (monthly testing of residents and daily testing of staff by PCR) likely provides negligible benefit in preventing outbreaks. Daily staff testing by LFD was 39% (95% 18-55%) effective in preventing outbreaks at 30 days compared to no testing. CONCLUSIONS: Increasing the frequency of testing in staff and enhancing IPC are important to preventing importations to the care home. Further work is needed to understand the impact of vaccination in this population, which is likely to be very effective in preventing outbreaks.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/prevention & control , Disease Outbreaks/prevention & control , Humans , Infection Control , Vaccination
15.
Healthcare (Basel) ; 10(2)2022 Feb 05.
Article in English | MEDLINE | ID: covidwho-1706834

ABSTRACT

The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and later translated into Swedish, Italian, and German on the impact of the pandemic on stress and anxiety. Anonymous data from care staff respondents was collected in four countries between 7 October 2020 and 17 December 2010: Sweden (n = 212), Italy (n = 103), Germany (n = 120), and the United Kingdom (n = 167). While care staff in all countries reported learning in multiple areas of care practice, Italy reported the highest levels of learning and the most agreement that changes will occur in the future due to the pandemic. Conversely, care staff in Germany reported low levels of learning and reported the least agreement for change in the future. While the pandemic has strained care home and home care staff practices, our study indicates that much learning of new skills and knowledge has taken place within the workforce. Our study has demonstrated the potential of cross-border collaborations and experiences for enhancing knowledge acquisition in relation to societal challenges and needs. The results could be built upon to improve future health care and care service practices.

16.
Physiotherapy (United Kingdom) ; 114:e106-e107, 2022.
Article in English | EMBASE | ID: covidwho-1701633

ABSTRACT

Keywords: Virtual;Community;Cystic fibrosis Purpose: The requirement for people with cystic fibrosis (PwCF) to shield during COVID19 led to face-to-face contact with the Physiotherapy service being limited. Historically, the Physiotherapy Homecare team completed most of their work through home visits to PwCF during home IVs, pregnancy, exercise support, oxygen assessment, and to optimise airway clearance and nebulised therapies within their own environment. The service covers a wide geographical area ranging from Cumbria to Wales, therefore the Homecare team were often required to drive long distances to deliver the service. The aim was to rapidly transform the service, embracing all the technological advances available to maintain the delivery of care to PwCF in their own home during COVID19. Methods: The service facilitated a rapid distribution of home spirometry devices (Nuvoair) supported by an online portal and app, which was supported by funding from NHS England for all cystic fibrosis centres during the pandemic. Video calls were implemented via Attend Anywhere for treatment sessions and during home IV ward rounds. The service continued to utilise phone call and text message monitoring already established. Results: Over 12 months (April 2020 to March 2021) 70 PwCF were supported by the team. An average of 116 direct contacts per month were delivered. Of these contacts, three were home visits resulting in the team driving 42.8 miles. This compares to a 12-month period prior to COVID19 (January to December 2018) when 194 home visits were carried out resulting in driving in excess of 6000 miles. Patient feedback was gathered from those who had experienced support from both the original home visits and then virtual support. Comments have included: “flexibility of virtual follow up has meant I’ve had more contact allowing quicker changes to my airway clearance and improved adherence rather than 1 visit a month”;“awkward doing airway clearance, like hands on physio”;“can do virtual sessions anywhere”;“no difference between virtual and home visits” and “mixture of virtual and home visits would my preference.” Conclusion(s): It was possible to transform the service into a fully virtual service and maintain patient contact at a satisfactory level. However, this would benefit from a further review against the CF standards of care in the future. Despite the positive feedback and success of maintaining the service there were also limitations such as reduced objective markers, poor internet streams, dislike of technology and inability to evaluate the home environment that would prevent the service being fully virtual in the future. There was a huge reduction in mileage over the year which translates to a cost saving. However, this could be offset by cost associated with telehealth devices when no longer funded by NHS England. Impact: Implementing telehealth and virtual contacts has the potential to increase productivity and efficiency by reducing travelling for patient contacts, though there were some limitations found. In the future a combination of virtual follow ups and home visits will support a robust, bespoke homecare service that is cost effective, meets CF standards and offers flexibility for patients. Funding acknowledgements: This work did not receive any funding.

18.
Aging Ment Health ; : 1-10, 2021 Dec 30.
Article in English | MEDLINE | ID: covidwho-1585423

ABSTRACT

Objectives: To examine experiences of care home staff to better understand how to support them during the ongoing pandemic and in the future.Method: A systematic review examining experiences of care staff over the last year (March 2020-2021).Results: Fourteen papers related to experiences of staff and one was an intervention study. Quantitatively there was evidence of anxiety, PTSD and depression amongst the staff. Qualitatively, seven themes were identified: Poor working conditions; Lack of skills and knowledge; Psychological/Mental health concerns; Feeling undervalued and abandoned; Fears of contagion; Support and the positive impacts of COVID. The intervention study recommended employing needs-based approaches, including educational and wellbeing components.Conclusion: Recommendations are made in terms of how to work with staff, both practically and clinically. There are also suggestions about how to deal with similar situations if they were to reoccur. It is evident that lessons need to be learned because errors were made. Indeed, from a UK perspective, discharging thousands back to care homes, without testing, cost lives. This may have been done to protect the NHS, but it unwittingly 'lockdown' the virus within the care sector.

19.
Euro Surveill ; 26(46)2021 11.
Article in English | MEDLINE | ID: covidwho-1526748

ABSTRACT

We describe the impact of changing epidemiology and vaccine introduction on characteristics of COVID-19 outbreaks in 330 long-term care facilities (LTCF) in England between November 2020 and June 2021. As vaccine coverage in LTCF increased and national incidence declined, the total number of outbreaks and outbreak severity decreased across the LTCF. The number of infected cases per outbreak decreased by 80.6%, while the proportion of outbreaks affecting staff only increased. Our study supports findings of vaccine effectiveness in LTCF.


Subject(s)
COVID-19 , Vaccines , Disease Outbreaks/prevention & control , Humans , Long-Term Care , SARS-CoV-2
20.
Int J Popul Data Sci ; 5(4): 1666, 2020.
Article in English | MEDLINE | ID: covidwho-1441436

ABSTRACT

INTRODUCTION: The ability to identify residents of care homes in routinely collected health care data is key to informing healthcare planning decisions and delivery initiatives targeting the older and frail population. Health-care planning and delivery implications at national level concerning this population subgroup have considerably and suddenly grown in urgency following the onset of the COVID-19 pandemic, which has especially hit care homes. The range of applicability of this information has widened with the increased availability in England of retrospectively collected administrative databases, holding rich patient-level details on health and prognostic status who have made or are in contact with the National Health Service. In practice lack of a national registry of care homes residents in England complicates assessing an individual's care home residency status, which has been typically identified via manual address matching from pseudonymised patient-level healthcare databases linked with publicly availably care home address information. OBJECTIVES: To examine a novel methodology based on linking unique care home address identifiers with primary care patient registration data, enabling routine identification of care home residents in health-care data. METHODS: This study benchmarks the proposed strategy against the manual address matching standard approach through a diagnostic assessment of a stratified random sample of care home post codes in England. RESULTS: Derived estimates of diagnostic performance, albeit showing a non-insignificant false negative rate (21.98%), highlight a remarkable true negative rate (99.69%) and positive predictive value (99.35%) as well as a satisfactory negative predictive value (88.25%). CONCLUSIONS: The validation exercise lends confidence to the reliability of the novel address matching method as a viable and general alternative to manual address matching.

SELECTION OF CITATIONS
SEARCH DETAIL