ADVANCE-C: A Qualitative Study of Experiences Caring for Nursing Home Residents with Advanced Dementia During the COVID-19 Pandemic.

OBJECTIVES: Assessment of Disparities and Variation for Alzheimer's disease Nursing home Care at End of life (ADVANCE) is a multisite qualitative study of regionally diverse Nursing homes (NHs; N = 14) providing varied intensity of advanced dementia care. ADVANCE-C explored the experiences of NH staff and proxies during the COVID-19 pandemic. METHODS: Data collection occurred in five of the ADVANCE facilities located in Georgia (N = 3) and New York (N = 2). Semistructured qualitative interviews with NH staff (N = 38) and proxies of advanced dementia residents (N = 7) were conducted. Framework analyses explored five staff domains: care processes, decision making, organizational resources, vaccinations, and personal experience, and five proxy domains: connecting with residents, NH response, communicating with NH, decision making, and personal impact of the pandemic. RESULTS: Staff mentioned difficulties implementing infection control policies specifically for advanced dementia residents. Staff reported trust between the facility and proxies as critical in making decisions during the pandemic. All staff participants spoke about "coming together" to address persistent staffing shortages. Proxies described their role as an "emotional rollercoaster," emphasizing how hard it was being separate from their loved ones. The accommodations made for NH residents were not beneficial for those with advanced dementia. The majority of proxies felt NH staff were doing their best and expressed deep appreciation for their care. DISCUSSION: Caring for advanced dementia residents during the COVID-19 pandemic had unique challenges for both staff and proxies. Strategies for similar future crises should strive to balance best practices to contain the virus while maintaining family connections and person-centered care.

Using Twitter to understand perspectives and experiences of dementia and caregiving at the beginning of the COVID-19 pandemic.

The COVID-19 pandemic has placed a tremendous burden on all of society, particularly among vulnerable populations such as people living with dementia and their caregivers. Efforts to understand the impact of the COVID-19 pandemic on those living with dementia are crucial towards addressing needs during the pandemic and beyond. This qualitative descriptive study includes a thematic analysis of 6938 tweets from March 17-24, 2020, that included direct or indirect references to COVID-19 and at least one of the following terms/hashtags: Alzheimer, #Alzheimer, dementia, and #dementia. Five themes were identified: continuing care, finding support, preventing spread of COVID-19, maintaining human rights, and the impact of the pandemic on the daily lives of people living with dementia. People living with dementia and their families faced unique challenges related to caregiving, maintaining social connectedness while trying to follow public health guidelines, and navigating the convergence of COVID-19 and dementia-related stigma. Data from Twitter can be an effective means to understand the impacts of public health emergencies among those living with dementia and how to address their needs moving forward by highlighting gaps in practice, services, and research.

SCOPING REVIEW OF FAMILY CAREGIVERS' TRUST IN LONG-TERM CARE HOMES

The majority of care provided with older adults living with Alzheimer's disease or related dementias (ADRD) comes from family caregivers in the community and at least 50% of all long-term care (LTC) home residents live with ADRD (Alzheimer's Association, 2019). Historically, LTC homes have been stigmatized as places of poor staffing, neglect, mistreatment, and abuse, and families report feeling uneasy and distressed when their relatives relocate into LTC homes (Mynhi et al., 2017). [...]entrusting a LTC home with the care of a relative is a major life event. (2019) reported that emergency department transfer decision-making was influenced by families' perceived lack of trust in LTC home care, specifically, families questioned the nurses' ability to perform quality assessments and adequately respond to the residents' medical needs. [...]understanding trust as it relates to power and decision-making in LTC homes is particularly important.

Calidad de vida laboral en hospitales privados del sureste mexicano

La pandemia de Covid-19 ha hecho patente la importancia de contar con sistemas de salud eficientes siendo el personal su activo más valioso. El presente trabajo tuvo como objetivo analizar la calidad de vida laboral del personal de enfermería de dos hospitales privados del sureste mexicano. El estudio se realizó con un enfoque cuantitativo, diseño no experimental, descriptivo de corte transversal y correlacional. La muestra estuvo conformada por las plantillas de personal de enfermería de los hospitales estudiados. Se utilizó el instrumento de Calidad de Vida Laboral ProQOL 5, conformado por 30 reactivos tipo Likert divididos en tres subescalas, satisfacción por compasión, síndrome de quemado y estrés por trauma secundario. Los resultados muestran que ninguna variable sociodemográfica resultó ser un factor diferenciador común, esto sugiere que los componentes de la calidad de vida laboral están influenciados por las características propias de cada hospital. Se encontraron correlaciones directas entre el síndrome de quemado y el estrés por trauma secundario, aunque bajas en los hospitales estudiados. Se concluye, que la calidad de vida laboral del personal corresponde al perfil más positivo, caracterizado por una alta satisfacción por compasión y moderado a bajo síndrome de quemado y estrés por trauma secundario.Alternate abstract:The Covid-19 pandemic has made clear the importance of having efficient health systems, with staff being its most valuable asset. The present work aimed to analyze the quality of work life of the nursing staff of two private hospitals in the Mexican southeast. The study was carried out with a quantitative approach, non-experimental, descriptive cross-sectional and correlational design. The sample was made up of the nursing staff from the hospitals studied. The ProQOL 5 Quality of Work Life instrument was used, made up of 30 Likert-type items divided into three subscales: satisfaction by compassion, burnout syndrome and stress due to secondary trauma. The results show that no sociodemographic variable turned out to be a common differentiating factor, this suggests that the components of the quality of work life are influenced by the characteristics of each hospital. Direct correlations were found between burn syndrome and secondary trauma stress, although low in the hospitals studied. It is concluded that the quality of work life of the staff corresponds to the most positive profile, characterized by high satisfaction due to compassion and moderate to low burn syndrome and stress due to secondary trauma.

The (Mis)Treatment and (Non)Education of Unaccompanied Immigrant Children in the United States

The focus of this brief is on the education of unaccompanied immigrant children arriving from Central America and Mexico, fleeing violence and poverty in their countries. Upon arrival, these children encounter a complicated immigration legal system, while having to navigate a new society within an anti-immigrant sociopolitical context. In recent years, these unaccompanied children have been exposed to traumatic situations such as overcrowded detention centers and abuse. After an analysis of research around this issue, the brief provides recommendations for policymakers and leaders to alleviate the trauma suffered by these children and to ensure that they receive necessary educational and coordinated supports.

A Call to the CMS: Mandate Adequate Professional Nurse Staffing in Nursing Homes.

Editor's note: This article is by 22 nursing gerontology experts who are all advocates of nursing home reform. They are listed at the end of this article.