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1.
Am J Speech Lang Pathol ; 30(1): 318-323, 2021 01 27.
Article in English | MEDLINE | ID: covidwho-1805675

ABSTRACT

Purpose In this article, we draw a parallel between the experience of social isolation that occurred throughout the world during the Coronavirus Disease 2019 pandemic and similar experiences occurring in everyday life for people with communication disorders living in long-term care (LTC) facilities. We propose that speech-language pathologists can use the widespread experience of social isolation as a learning catalyst in the effort to shift the LTC culture to one that more highly values a communicative environment that is accessible to all, thereby reducing risk of social isolation for those with communication disorders. Conclusions Many training paradigms for promoting an accessible communicative environment are available in the speech-language pathology literature, yet institutional barriers exist for their widespread implementation. Overcoming these barriers is a challenge that requires awareness and learning on the part of staff and administration regarding the impact of an unfriendly communicative environment on social isolation, and the resulting psychosocial consequences. Learning theory indicates that new learning in adults is motivated by connections between personal experiences and the material to be learned. Explicitly infusing established training programs with the experience of social isolation brought on by the Coronavirus Disease 2019 pandemic may be the key needed for changing the communicative environment in LTC.


Subject(s)
Communication Barriers , Coronavirus Infections/psychology , Long-Term Care/psychology , Physical Distancing , Coronavirus Infections/therapy , Humans , Inservice Training , Professional-Patient Relations , Social Environment , Social Isolation
2.
J Am Med Dir Assoc ; 23(3): 428-433.e1, 2022 03.
Article in English | MEDLINE | ID: covidwho-1587378

ABSTRACT

OBJECTIVES: The COVID-19 pandemic created unique stressors for caregivers of persons with dementia living in long-term care (LTC) facilities. The purpose of this qualitative study was to identify the challenges associated with caring for a relative with dementia in LTC during the pandemic, as well as resources, strategies, and practices caregivers found helpful in coping with COVID-19. DESIGN: This study was conducted within the context of an ongoing randomized controlled trial of a psychosocial intervention to support caregivers. Open-ended survey responses (n = 125) and semistructured interviews with a subset of the sample (n = 20) collected between June 2020 and June 2021 explored caregivers' experiences during COVID-19. SETTING AND PARTICIPANTS: Participants included 125 family caregivers of persons with dementia living in residential LTC. METHODS: Thematic analysis was used to identify themes capturing caregivers' experiences. RESULTS: In addition to concerns about COVID-19 infection, participants reported key challenges such as the difficulty of maintaining contact with relatives because of visiting restrictions, lack of information about relatives' health and well-being, worries about overburdened LTC staff, impossibility of returning relatives home from the LTC facility, and fears about relatives dying alone. Participants also identified resources, strategies, and practices that they perceived as helpful, including effective infection prevention within the LTC facility, good communication with LTC staff, and creative strategies for connecting with their relatives. CONCLUSIONS AND IMPLICATIONS: This qualitative analysis informs recommendations for practice within LTC facilities, as well as supports that may help caregivers manage stressful situations in the context of COVID-19. Vaccination and testing protocols should be implemented to maximize family caregivers' opportunities for in-person contact with relatives in LTC, as alternative visiting modalities were often unsatisfactory or unfeasible. Informing caregivers regularly about individual residents' needs and status is crucial. Supports for bereaved caregivers should address complicated grief and feelings of loss.


Subject(s)
COVID-19 , Dementia , Caregivers/psychology , Dementia/psychology , Humans , Long-Term Care/psychology , Pandemics , SARS-CoV-2
3.
Nurs Leadersh (Tor Ont) ; 34(2): 21-25, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1444522

ABSTRACT

Loch Lomond Villa is one of the largest long-term care communities within the province of New Brunswick. Our organization supports caring living environments for over 450 clients and their family members along with 354 employees.


Subject(s)
COVID-19/prevention & control , Chief Executive Officers, Hospital/psychology , Long-Term Care/methods , Nurse Administrators/psychology , COVID-19/nursing , Humans , Long-Term Care/psychology , New Brunswick , Nurse's Role/psychology
4.
Geriatr Nurs ; 42(3): 780-781, 2021.
Article in English | MEDLINE | ID: covidwho-1231996

ABSTRACT

The older population and medically frail persons are at higher risk of severe infections and death from coronavirus disease 2019 (COVID-19). Long-term care (LTC) facilities are encouraged to take various actions to safeguard residents and reduce the spread of COVID-19 including by restricting visitors, which leads to isolation. The imposed isolation undermines the autonomy of older adults living in LTC facilities, especially those with dementia, and the isolation from loved ones can worsen cognition and depression. The purpose of this case report is to highlight isolation practices implemented to reduce the spread of COVID-19 in an LTC facility, which increased the social isolation and worsened cognition and depression in a resident with dementia and depression. Because many residents of LTC facilities have dementia, this case is an example of the need for interventions to support the mental health of persons living in LTC facilities during the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Dementia/psychology , Depressive Disorder/psychology , Long-Term Care/psychology , Physical Distancing , Social Isolation/psychology , Aged, 80 and over , COVID-19/epidemiology , COVID-19/transmission , Female , Humans
5.
J Am Med Dir Assoc ; 22(1): 187-192, 2021 01.
Article in English | MEDLINE | ID: covidwho-1065274

ABSTRACT

Long-term care (LTC) residents, isolated because of the COVID-19 pandemic, are at increased risk for negative mental health outcomes. The purpose of our article is to demonstrate how the interRAI LTC facility (LTCF) assessment can inform clinical care and evaluate the effect of strategies to mitigate worsening mental health outcomes during the COVID-19 pandemic. We present a supporting analysis of the effects of lockdown in homes without COVID-19 outbreaks on depression, delirium, and behavior problems in a network of 7 LTC homes in New Brunswick, Canada, where mitigative strategies were deployed to minimize poor mental health outcomes (eg, virtual visits and increased student volunteers). This network meets regularly to review performance on risk-adjusted quality of care indicators from the interRAI LTCF and share learning through a community of practice model. We included 4209 assessments from 765 LTC residents between January 2017 to June 2020 and modeled the change within and between residents for depression, delirium, and behavioral problems over time with longitudinal generalized estimating equations. Though the number of residents who had in-person visits with family decreased from 73.2% before to 17.9% during lockdown (chi square, P < .001), the number of residents experiencing delirium (4.5%-3.5%, P = .51) and behavioral problems (35.5%-30.2%, P = .19) did not change. The proportion of residents with indications of depression decreased from 19.9% before to 11.5% during lockdown (P < .002). The final multivariate models indicate that the effect of lockdown was not statistically significant on depression, delirium, or behavioral problems. Our analyses demonstrate that poor mental health outcomes associated with lockdown can be mitigated with thoughtful intervention and ongoing evaluation with clinical information systems. Policy makers can use outputs to guide resource deployment, and researchers can examine the data to identify better management strategies for when pandemic strikes again.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Depression/psychology , Long-Term Care/psychology , Quality of Life/psychology , Quarantine/psychology , Female , Humans , Male , Mental Health , New Brunswick , Nursing Homes , Risk Factors
6.
Age Ageing ; 50(2): 335-340, 2021 02 26.
Article in English | MEDLINE | ID: covidwho-766513

ABSTRACT

The care and support of older people residing in long-term care facilities during the COVID-19 pandemic has created new and unanticipated uncertainties for staff. In this short report, we present our analyses of the uncertainties of care home managers and staff expressed in a self-formed closed WhatsApp™ discussion group during the first stages of the pandemic in the UK. We categorised their wide-ranging questions to understand what information would address these uncertainties and provide support. We have been able to demonstrate that almost one-third of these uncertainties could have been tackled immediately through timely, responsive and unambiguous fact-based guidance. The other uncertainties require appraisal, synthesis and summary of existing evidence, commissioning or provision of a sector- informed research agenda for medium to long term. The questions represent wider internationally relevant care home pandemic-related uncertainties.


Subject(s)
Attitude of Health Personnel , COVID-19 , Delivery of Health Care , Health Personnel , Homes for the Aged/organization & administration , Long-Term Care , Nursing Homes/organization & administration , Uncertainty , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/therapy , Delivery of Health Care/ethics , Delivery of Health Care/methods , Delivery of Health Care/organization & administration , Focus Groups , Health Personnel/economics , Health Personnel/ethics , Health Personnel/psychology , Health Services Needs and Demand , Humans , Long-Term Care/ethics , Long-Term Care/methods , Long-Term Care/psychology , Qualitative Research , SARS-CoV-2 , United Kingdom/epidemiology
7.
Am J Geriatr Psychiatry ; 28(12): 1299-1307, 2020 12.
Article in English | MEDLINE | ID: covidwho-753380

ABSTRACT

OBJECTIVE: Family visits with residents at long-term care (LTC) facilities have been restricted during the COVID-19 pandemic. The objective was to examine what communication methods, other than in-person visits, during the pandemic were associated with greater positive and lower negative emotional experiences for LTC residents and their family members and friends. DESIGN: Cross-sectional. SETTING: Nationally targeted online survey. PARTICIPANTS: One hundred sixty-one community-dwelling adults who had a family member or friend in a LTC facility. MEASUREMENTS: The Positive and Negative Affect Scale was used to assess participant's own emotions and perceived resident emotions during the pandemic. Questions were asked about nine communication methods other than physical visits (e.g., phone, video-conference, e-mail, and letters) in terms of frequency of use during the pandemic. Sociodemographics, resident health, and facility factors were assessed and used as covariates where indicated. RESULTS: During the pandemic, greater phone frequency was associated with less participant negative emotions (ß = -0.17). Greater e-mail frequency was associated with more perceived resident positive emotions (ß = 0.28). Greater frequency of letters delivered by staff was associated with more participant negative emotions (ß = 0.23). Greater frequency of letters delivered by staff and the postal service were associated with more perceived resident negative emotions (ß = 0.28; ß = 0.34, respectively). CONCLUSION: These findings highlight the importance of synchronous, familiar methods of communication like the phone and email between families and LTC residents to maintain their emotional well-being when in-person visits are restricted.


Subject(s)
Attitude of Health Personnel , Communication , Coronavirus Infections , Family/psychology , Long-Term Care , Pandemics , Pneumonia, Viral , Adult , Aged , Attitude to Health , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Dementia/psychology , Emotional Intelligence , Female , Humans , Infection Control/methods , Interpersonal Relations , Long-Term Care/organization & administration , Long-Term Care/psychology , Long-Term Care/trends , Male , Organizational Innovation , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , SARS-CoV-2 , Skilled Nursing Facilities/trends , Surveys and Questionnaires , Visitors to Patients/psychology
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