Pandemic-Related Changes in Technology Use Among a Sample of Previously Hospitalized Older Adult New Yorkers: Observational Study.

BACKGROUND: The COVID-19 pandemic increased the importance of technology for all Americans, including older adults. Although a few studies have indicated that older adults might have increased their technology use during the COVID-19 pandemic, further research is needed to confirm these findings, especially among different populations, and using validated surveys. In particular, research on changes in technology use among previously hospitalized community-dwelling older adults, especially those with physical disability, is needed because older adults with multimorbidity and hospital associated deconditioning were a population greatly impacted by COVID-19 and related distancing measures. Obtaining knowledge regarding previously hospitalized older adults' technology use, before and during the pandemic, could inform the appropriateness of technology-based interventions for vulnerable older adults. OBJECTIVE: In this paper, we 1) described changes in older adult technology-based communication, technology-based phone use, and technology-based gaming during the COVID-19 pandemic, compared to before the COVID-19 pandemic and 2) tested whether technology use moderated the association between changes in in-person visits and well-being, controlling for covariates. METHODS: Between December 2020 and January 2021 we conducted a telephone-based objective survey with 60 previously hospitalized older New Yorkers with physical disability. We measured technology-based communication through three questions pulled from the National Health and Aging Trends Study COVID-19 Questionnaire. We measured technology-based smart phone use and technology-based video gaming through the Media Technology Usage and Attitudes Scale. We used paired t tests and interaction models to analyze survey data. RESULTS: This sample of previously hospitalized older adults with physical disability consisted of 60 participants, 63.3% of whom identified as female, 50.0% of whom identified as White, and 63.8% of whom reported an annual income of $25,000 or less. This sample had not had physical contact (such as friendly hug or kiss) for a median of 60 days and had not left their home for a median of 2 days. The majority of older adults from this study reported using the internet, owning smart phones, and nearly half learned a new technology during the pandemic. During the pandemic, this sample of older adults significantly increased their technology-based communication (mean difference=.74, P=.003), smart phone use (mean difference=2.9, P=.016), and technology-based gaming (mean difference=.52, P=.030). However, this technology use during the pandemic did not moderate the association between changes in in-person visits and well-being, controlling for covariates. CONCLUSIONS: These study findings suggest that previously hospitalized older adults with physical disability are open to using or learning technology, but that technology use might not be able to replace in-person social interactions. Future research might explore the specific components of in-person visits that are missing in virtual interactions, and if they could be replicated in the virtual environment, or through other means.

The impact of ffc-al-eit-d in assisted living during the covid-19 pandemic

The purpose of this study was to test the preliminary effectiveness and feasibility of implementation of Function Focused Care for Assisted Living Using the Evidence Integration Triangle in Assisted Living Communities with Residents with Dementia (FFC-AL-EIT-D) during the pandemic. This was a single group pre-post study design including 51 communities in a single state. The communities ranged in size from 8 to 50 residents with a mean of 13 (SD = 7). The majority (99%) were for profit. Following implementation of FFC-AL-EIT-D there was significant improvement in environments and policies supporting physical activity and some evidence suggesting they used new supplies to engage residents in physical activity. There was no change in falls, emergency room, hospital, or nursing home transfers. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Making Care for Older People the Choice of Nurses Today, Tomorrow, and Forever

[...]workplace concerns, such as low staffing levels, low morale, and subsequent burnout, are pushing nurses out of health care entirely. In those settings, resources are limited and have been for decades. [...]complexity characterizes the needs of all residents under these nurses' care. [...]nursing homes specifically need policy and practice changes to optimize scope of practice and provide around-the-clock professional nurse leadership. Other local efforts include nursing schools offering robust clinical rotations in nursing homes and programs providing opportunities to students to work in long-term care facilities.

Advancing Clinical Trials in Nursing Homes: A Proposed Roadmap to Success.

An effective clinical research effort in nursing homes to address prevention and treatment of COVID-19 faced overwhelming challenges. Under the Health Care Systems Research Network-Older Americans Independence Centers AGING Initiative, a multidisciplinary Stakeholder Advisory Panel was convened to develop recommendations to improve the capability of the clinical research enterprise in US nursing homes. The Panel considered the nursing home as a setting for clinical trials, reviewed the current state of clinical trials in nursing homes, and ultimately developed recommendations for the establishment of a nursing home clinical trials research network that would be centrally supported and administered. This report summarizes the Panel's recommendations, which were developed in alignment with the following core principles: build on available research infrastructure where appropriate; leverage existing productive partnerships of researchers with groups of nursing homes and nursing home corporations; encompass both efficacy and effectiveness clinical trials; be responsive to a broad range of stakeholders including nursing home residents and their care partners; be relevant to an expansive range of clinical and health care delivery research questions; be able to pivot as necessary to changing research priorities and circumstances; create a pathway for industry-sponsored research as appropriate; invest in strategies to increase diversity in study populations and the research workforce; and foster the development of the next generation of nursing home researchers.

Reablement Services Across the World: Effectiveness and Impacting Factors

Due to the ageing of the world population, solutions are necessary to reduce the increasing demand for care. Besides the need for more care, older people often wish to remain as independent as possible and retain as much control as possible. A possible solution are services based on the concept of reablement, which includes working in a more rehabilitative and person-centered manner and has been researched in various forms internationally. Reablement services are promising and use the patient's strengths and, through interdisciplinary cooperation, aims to achieve the goals important for, and set by, the individual to remain/become as independent as possible. During this symposium, five presenters from the US, New-Zealand, Norway and the Netherlands talk about the impact and implementation of reablement services. The first presentation is about the results of a systematic review of the effects of reablement on daily functioning and identifying common features of effective interventions. The second presentation is about a systematic scoping review mapping how physical activity strategies are integrated and explored in reablement research and identifying knowledge gaps. The third presentation is about the significant impact of COVID-19 and its associated restrictions on residents in assisted living communities. The fourth presentation is on combining lessons learned and practical implications from research on reablement services into the SELF-intervention. The fifth presentation describes the implications of funding on practice and outcomes of reablement. This symposium represents the current practice and future directions regarding implementation and research of reablement services across the world.

Pilot Testing of the Promoting Positive Care Interactions (PPCI) in Assisted Living Study During a Pandemic

The purpose of this study was to test the feasibility and preliminary efficacy of Promoting Positive Care Interactions (PPCI)—a four step intervention designed to establish positive care interactions between staff and residents with cognitive impairment or dementia in Assisted Living (AL). Initially designed as a traditional on-site intervention, PPCI was later transformed to be conducted remotely through webinar and virtual meetings due to challenges related to onsite engagement in AL during the COVID-19 pandemic. Additionally, the study adopted shorter timeline, a single group pretest-posttest design, and limited recruitment to staff only;17 care staff were recruited, and data was collected via online surveys and interviews. PPCI was successfully implemented as intended with considerable stakeholder engagement. Findings demonstrated feasibility and promising staff adoption of PPCI. Continued research is needed to optimize the quality of care interactions in AL and evaluate whether online approach to staff training can change staff behavior.

An Age- Friendly Campus Partnership for Hospitalized Older Adults in the COVID Era and Beyond

As hospitals isolate COVID-19 patients to prevent the spread of this highly contagious disease, patients and family are separated during times of critical illness. For many older adults inflicted with coronavirus it is not the fear of dying that matters the most, it is the fear of dying alone. Utilizing the 4Ms approach, University of Maryland, Baltimore (UMB) and University of Maryland Medical Center (UMMC) responded with several initiatives including intergenerational programs designed to shape and inform the development of future healthcare clinicians in addressing what matters the most to patients and leveraging technology to connect them with families, provide mobility opportunities, monitor medications, and reduce errors.

The Impact of COVID-19 and Associated Restrictions on Physical Activity Among Assisted Living Residents

COVID-19 and associated restrictions significantly impacted residents in assisted living (AL) communities. This was a descriptive study of 35 AL communities that were participating in an implementation trial of Function Focused Care for Assisted Living Residents with Dementia during the COVID-19 pandemic. Within twelve months of the COVID-19 pandemic, 18% of the AL communities had at least one resident who was positive for COVID-19. Almost half of the ALs allowed health care providers into the setting. All of the ALs facilitated family visits outside and by telephone and technology, but only 11% allowed visitors inside the community. Over 50% stopped using recreational supplies to encourage physical activity and 28% reported that residents experienced more behavioral and psychological symptoms of dementia. Restrictions designed to prevent the spread of COVID-19 may have negatively impacted resident behavior and the AL staff’s engagement of residents in physical and recreational activities during the pandemic.

The impact of COVID-19 in an assisted living community.

The purpose of this study was to use routinely collected resident assessment data from a single site to evaluate the impact of COVID-19 restrictions on cognition, physical function and behavioral symptoms of residents with dementia. Specifically, it was hypothesized that controlling for age and sex, there would be a decline in cognition and function and an increase in behavioral symptoms at 12 months post implementation of COVID-19 restrictions. Twelve residents from a single memory care site with required Resident Assessments completed prior to and 12 month post initiation of the pandemic and associated quarantines were included. No significant change was noted in function or behavioral symptoms but there was a statistically significant decline in cognition over the 12 month period. Although this study did not support our hypothesis, the findings supported some prior research also noting little significant change among the majority of individuals over the course of the pandemic regardless of regulations.

Racial differences in physical activity in nursing home residents with cognitive impairment.

BACKGROUND: Nursing home (NH) residents with moderate-to-severe cognitive impairment experience mostly sedentary lifestyles. AIM: Previous research has examined racial differences in physical activity (PA) levels in community-dwelling older adults but not in NH residents with cognitive impairment, and the current study aimed to examine these differences. METHODS: This was a secondary data analysis of baseline data from the Function and Behavior Focused Care Intervention (FBFC) study. The sample included 247 cognitively impaired residents from 12 NHs who wore an ActiGraph to measure PA. RESULTS: The residents' mean age was 82.6 (SD = 10.1) and had an average MMSE score of 7.8 (SD = 5.0). The sample (N = 247) was 41% African American and 59% White. African American and White residents engaged in only 50.6 and 46.2 min of light- and 1.5 and 1.1 min of moderate-level PA, respectively. Based on a multivariate analysis of covariance (MANCOVA), there was not a statistically significant difference between African American and White residents on combined dependent PA measures [F (8, 237) = 1.067, p = .387, Wilks' Λ = 0.962]. There was a trend that direct care providers subjectively reported that White residents engaged in more PA than their African American counterparts [F(8, 237) = 2.741, p = .09]. CONCLUSIONS: These findings are not consistent with prior research. However, these findings indicate severely low levels of PA in NH residents, regardless of racial group. Future research should prioritize PA interventions that make accommodations for all NH residents, and especially consider their underlying physical comorbidities and cognitive function.

A Description of Staff-resident Interactions in Assisted Living.

Positive social and care interactions are vital to understand and successfully accomplish the daily care needs of the residents in assisted living (AL) and optimize their quality of life. The purpose of this study was to explore and describe the staff-resident interactions in AL. This descriptive analysis utilized baseline data in a randomized trial that included 379 residents from 59 AL facilities. The majority of the interactions observed were positive; almost 25% were neutral or negative. Most interactions were care-related (31.9%) or one-on-one (27.4%), occurred with nursing (40.2%) or support staff (e.g., dining aide; 24.6%), and involved close interpersonal distance (64.6%). Future research should focus on the transition of neutral or negative interactions to positive and explore the factors that might influence neutral and negative interactions. Additionally, innovative approaches are needed to optimize interactions amid physical distancing in the context of the COVID-19 pandemic.