"Let me touch him": Perceptions and experiences of family caregivers of nursing home residents during the COVID-19 outbreak in Israel.

Older adults in nursing homes were particularly vulnerable to COVID-19 morbidity and mortality worldwide. Due to the COVID-19 pandemic, visitations in nursing homes were restricted. The present study examined the perceptions and experiences of family caregivers of nursing home residents during the COVID-19 crisis in Israel and their coping strategies. Online focus group interviews were held with 16 family caregivers of nursing home residents. Three main categories were identified through Grounded Theory techniques: (a) Anger and decreased trust in nursing homes; (b) Perception of the residents as victims of the nursing home policy; (c) Coping strategies at different levels. The outbreak redefined family caregivers' understanding of their role. Practical implications include making the voice of the family caregivers heard, identifying effective coping strategies, and creating a dialogue between family caregivers, nursing home managements, and staff.

"They just did what they usually do": Mistreatment, abuse, and neglect in nursing homes from the perspective of Ministry of Health auditing teams.

The aim of this article was to examine how Ministry of Health auditing teams experience quality of care, mistreatment, abuse, and neglect in nursing homes in Israel. The research included four in-depth focus groups consisting of 19 multidisciplinary auditors. The qualitative analysis was encoded in stages with repeated comparisons between individual participants and within groups and led to three main themes: (1) Failure in addressing basic, personal, and social needs of residents in nursing homes; (2) Mistreatment manifested in violation of residents' privacy and human dignity, neglect, and physical harm; (3) Abuse, including psychological, financial, and physical abuse. The findings can be explained by the characteristics of nursing homes as total institutions, as well as perceptions of ageism and de-humanization of the residents. In addition, the findings highlight the importance of the auditing role in monitoring the nursing homes' quality of care and the safety of the residents.

"You Killed the Hospital, They Have No Place Left": The Experience of Nursing Home Multidisciplinary Staff in Israel during the COVID-19 Pandemic.

The purpose of the present study is to examine how multidisciplinary staffs experienced and coped with the COVID-19 pandemic crisis in nursing homes. The research included six in-depth online focus groups consisting of 21 multidisciplinary staff members from 14 Israeli nursing homes. The qualitative analysis was encoded in stages with repeated comparisons between individual participants and within groups and led to four main themes: (a) Multidisciplinary staff perceptions of nursing home management's performance in relation to them, which was experienced as insufficient appreciation and feelings of abandonment among the non-medical staff; (b) Multidisciplinary staff perceptions of the Ministry of Health's performance, which was experienced as chaotic and disconnected albeit supportive on the personal level; (c)The nursing home multidisciplinary staff experience during the COVID-19 pandemic, in terms of perceived stress and burnout, as well as development of a routine; (d) The multidisciplinary staff's coping strategies, which included commitment to work despite risk, redefinition of their role, and staff insights about the need to take responsibility for their role and not rely on outside help. The findings indicate the importance of relationships that promote support and mutual communication between multidisciplinary staff, and both nursing home management and Ministry of Health.KEY POINTS Nursing home multidisciplinary staff experienced disconnection from and abandonment by nursing home management and Ministry of Health during the Covid-19 pandemic.Nursing home multidisciplinary staff experienced stress and burnout but also developed a routine.Despite intensified negative emotional feelings, multidisciplinary staff also underwent processes of redefining their role and gaining greater independence.Findings indicate the importance of creating a climate that facilitates mutual sharing, listening and learning.

A systematic review of existing ageism scales.

Ageism has been shown to have a negative impact on older people's health and wellbeing. Though multiple scales are currently being used to measure this increasingly important issue, syntheses of the psychometric properties of these scales are unavailable. This means that existing estimates of ageism prevalence may not be accurate. We conducted a systematic review aimed at identifying available ageism scales and evaluating their scope and psychometric properties. A comprehensive search strategy was used across fourteen different databases, including PubMed and CINAHL. Independent reviewers extracted data and appraised risk of bias following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Of the 29,664 records identified, 106 studies, assessing 11 explicit scales of ageism, were eligible for inclusion. Only one scale, the 'Expectations Regarding Aging' met minimum requirements for psychometric validation (i.e., adequate content validity, structural validity and internal consistency). Still, this scale only assesses the 'stereotype' dimension of ageism, thus failing to evaluate the other two ageism dimensions (prejudice and discrimination). This paper highlights the need to develop and validate a scale that accounts for the multidimensional nature of ageism. Having a scale that can accurately measure ageism prevalence is key in a time of increasing and rapid population ageing, where the magnitude of this phenomenon may be increasing.

Knowledge and attitudes about mental health among older immigrants from the former Soviet Union to Israel and their primary care physicians.

Previous studies have documented a high prevalence of psychological distress and mental illness among older immigrants from the former Soviet Union (FSU) in Israel. Yet, this population rarely seeks help from mental health providers. The present study aimed to identify beliefs and attitudes about depression and anxiety among older immigrants from the FSU treated in primary care, and among their primary care physicians, who were also FSU immigrants. The study used focus group (FG) interviews with primary care patients (n = 12) and physicians (n = 23). The interviews were transcribed and analyzed using open thematic coding. Three main themes were identified: a) avoidance of discussion of mental health and stigma regarding mental illness; b) expectations to control one's mental state; and c) limited opportunities to acquire knowledge about Western mental health. Primary care physicians recognized the barriers facing their older immigrant patients concerning mental health diagnosis and treatment. Yet, due to work overload, their ability to assist older immigrants was limited. The findings suggest that older immigrants from the FSU might benefit from mental health information and exchange of ideas about Western mental health.

Subjective Meanings and Identification With Middle Age.

The "middle-age" life period has not been researched extensively and lacks a theoretical conceptualization. The present study explores subjective experiences of members of this age-group. This is a qualitative research, based on in-depth interviews and thematic analysis, which looks into the life stories of 25 Israeli residents aged 48-64 years. The results indicate that the definition of middle age is not clear-cut, and some participants regard their age negatively. Yet, participants report that this period is characterized by a relief of tasks, broader choice opportunity, a sense of liberation, peace of mind, experience, self-awareness, and self-acceptance. Description of middle age as a peak in life, with concerns about future old age, came up repeatedly. Middle-aged individuals' difficulties to identify with their age-group and the social concept that dichotomizes age into young versus old are discussed. The article calls for further research of and engagement with middle age.

Migration and changes in loneliness over a 4-year period: the case of older former Soviet Union immigrants in Israel.

Both older adult and immigrant populations are at a high risk of loneliness. The current research compares older veteran Israelis to older immigrants who arrived in Israel from the former Soviet Union (FSU) after 1989. Early studies have found high levels of loneliness among older FSU immigrants; however, little is known regarding changes in loneliness among this group over time. The present study examines change in loneliness among older FSU immigrants and older veteran Jewish Israelis and its potential predictors. A prospective association between immigrant's status and loneliness over time was examined using the second (2009/2010) and third (2013) waves of SHARE-Israel. The sample consisted of 208 FSU immigrants and 1080 veteran Jewish Israelis. Bivariate analyses indicated that in 2009/2010, older FSU immigrants were significantly lonelier than older veteran Jews, and more disadvantaged on all social and health variables measured. Yet, no significant differences emerged between the two groups with regard to loneliness in 2013. In the adjusted model, older immigrants presented positive change in loneliness (less loneliness over time) compared with veteran Jewish Israelis. Depressive symptoms explained a large part of the variance in change in loneliness. Potential explanations suggest that the long-term psychological adjustment process and the characteristics of the FSU immigrants in Israel as a large and relatively strong immigrant group have served as protective factors with regard to changes in loneliness over time.

Suicidal behavior among immigrants.

INTRODUCTION: This paper explores the association between suicidal behavior and immigrant status among Israeli residents from the former USSR (FSU). METHOD: The Israeli component of the World Mental Health Survey (INHS) provided information on suicide ideations, plans and attempts. The INHS samples included Israel-born Jews (n = 2,114) and post-1990 immigrants from the FSU (n = 814). Data on completed suicide were extracted from the countrywide report of the Ministry of Health. RESULTS: The controlled lifetime rates of suicidal behavior among FSU immigrants were significantly higher than among their Israel-born counterparts. A higher risk was found in the first years following immigration among young adults with higher education and without a spouse. Completed suicide rates were higher among the FSU immigrants than in the general Israeli population with the largest risk among young-adult immigrant men. DISCUSSION: The findings are consistent with previous studies and are discussed in the context of both suicide rates in the country of origin and migratory stressors. Preventive measures are suggested.