Who’s in the House: Staffing in Long-Term Care Homes During the COVID-19 Pandemic (original) (raw)
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COVID-19 and Healthcare Workers’ Struggles in Long Term Care Homes
Journal of Concurrent Disorders, 2020
The global COVID-19 pandemic has led to a ‘new normal’ with public health measures of physical distancing and quarantine, as well as disruptions to programs, services, delivery, and dampened workers’ health, safety, and well-being. For example, mandatory self-isolation has been put into place by the federal government for travelers arriving in Canada, as well as those who experience any symptoms related to COVID-19, including many essential front-line workers. Employees with families and domestic care obligations have also been affected, for instance, public health nutrition programs that were offered in some public schools have been hampered as a result of the implementation of e-learning in order to control the spread of COVID-19. There was also significant loss of employment, which put pressure on workers as they shifted from multi-earner households and became sole earners. This added mental stress, and both financial and psychological pressures on workers. Existing research shows significant mental health issues that can affect the well-being of workers in long term care (LTC) homes, such as stress, depressive symptoms, and trauma (Morgan, Stewart, D’Arcy, et al., 2005; McGilton, McGillis-Hall, Wodchis et al., 2007; Astrakianakis, Chow, Hodgson et al., 2014; Woodhead, Northrop, and Edelstein, 2014; Braedley, Owusu, Przednowek et al., 2018; Syed, 2020a). Several systemic inequities have also been revealed by the pandemic, including those affecting LTC homes in Canada.
of LTC until the most recent model 1.2. Current arrangements in LTC 1.3. Debates around the development of a LTC system 1.4. LTC governance 1.5. General functioning of the residential care system 2. DESCRIPTION OF THE EVOLUTION OF THE PANDEMIC IN SOCIETY AT LARGE, AND IN THE RESIDENTIAL CARE AND HEALTHCARE SECTORS MORE SPECIFICALLY 2.1. Evolution of the epidemic 2.2. The effects of the epidemic on the healthcare system 2.3. The epidemic in the public and political debates 3. DESCRIPTION AND ANALYSIS OF THE MEASURES ADOPTED TO ADDRESS THE IMPACT OF THE PANDEMIC ON THE RESIDENTIAL CARE SECTOR FOR THE OLDER-AGE POPULATION 3.1. Background of preparedness for the Crisis 3.2. General Impact of the Epidemic on the Residential Care Sector and Policy Responses 3.3. Ensuring quality healthcare in nursing homes 3.4. The recovery of activity and the future of the residential sector
Home Health Care Management & Practice
Home health and home care (HH&HC) agencies provide essential medical and supportive services to elders and people with disabilities, enabling them to live at home. Home-based care is an important alternative to facility-based care, especially for infection prevention during the COVID-19 pandemic. The majority of the HH&HC workforce is comprised of aides, who also are vulnerable to COVID-19. There are limited data on the COVID-19 experience of HH&HC agencies, clients and aides. A survey of Massachusetts HH&HC agency managers was conducted June 1 to 30, 2020 to assess the impact of COVID-19 on agencies, clients, and aides early in the pandemic and to identify needs for future pandemic planning. Of the 94 agencies with completed surveys, most (59.6%) provided services to clients with COVID-19 and 3-quarters (73.7%) employed aides who tested positive for COVID-19, were symptomatic, and/or quarantined. Most agencies (98.7%) experienced a decrease in demand for home visits, reflecting cli...
The Impact of COVID-19 on Nursing Homes: Study Design and Population Description
International Journal of Environmental Research and Public Health, 2022
Nursing homes for the elderly in Spain have experienced high rates of infection and mortality from COVID-19, although rates have varied from one region to another. Madrid is the region where most institutionalized older adults have died from the coronavirus. However, there is little known about the psychosocial and environmental factors involved in the high incidence of COVID-19 among the institutionalised population in this region. This article describes the protocol of a study on nursing homes during the SARS-CoV-2 pandemic in the Autonomous Community of Madrid (hereafter: Region of Madrid or Madrid Region) and provides information on the study design, measures used, and characteristics of the population studied. A questionnaire about life in nursing homes during the COVID-19 pandemic was designed and a total of 447 persons over 60 years of age without cognitive impairment—220 in private nursing homes and 227 in public nursing homes—participated by answering questions about different topics: personal situations during the pandemic, feelings and methods of coping, residential environment, health, quality of life, ageism, and self-perception of ageing. The institutionalised person profile discussed in this study was an old woman, widowed, without children, with a low level of education, with multimorbidity, and who perceived her health and quality of life positively. Most of the participants were very concerned about COVID-19 and its effects. In fact, 38% had been diagnosed with COVID-19, of whom 20% were admitted to hospital and 20% had suffered negative impacts, such as pain and neurological problems. In addition, 70% of the residents remained confined to their rooms, which increased their perceptions of loneliness and social isolation. The worst-rated aspects of the nursing home resulted from the restrictive measures imposed on nursing homes during the pandemic. This research offers useful material for understanding the pandemic and its consequences from the perspective of the older institutionalised population, which could provide insights for designing public policies.
BioMed Research International
The COVID-19 pandemic had a great negative impact on nursing homes, with massive outbreaks being reported in care facilities all over the world, affecting not only the residents but also the care workers and visitors. Due to their advanced age and numerous underlying diseases, the inhabitants of long-term care facilities represent a vulnerable population that should benefit from additional protective measures against contamination. Recently, multiple countries such as France, Spain, Belgium, Canada, and the United States of America reported that an important fraction from the total number of deaths due to the SARS-CoV-2 infection emerged from nursing homes. The scope of this paper was to present the latest data regarding the COVID-19 spread in care homes worldwide, identifying causes and possible solutions that would limit the outbreaks in this overlooked category of population. It is the authors’ hope that raising awareness on this matter would encourage more studies to be conducte...
2021
MC-COVID19 Coordination mechanisms in Coronavirus management between different levels of government and public policy sectors in 15 European countries The political and administrative management of the healthcare crisis provoked by the COVID 19 is a key issue in preventing the spread of the disease. The Mc-COVID 19 project is set to analyse the socio-sanitary co-ordination procedures in the context of institutionalized older-age care (age group that appears particularly vulnerable in this epidemic context), in Spain as well as in the rest of the EU-15. This study focuses on the articulation of resources between health and social policies, and aim to contribute to improve the effectiveness of the decision-making process and crucial aspects in the fight against the pandemic. Findings also aim to be useful to inform other public policy sectors involved in crisis-related situations.
The Gerontologist, 2021
Background and Objectives There is an urgency to respond to the longstanding deficiencies in health human resources in the long-term care (LTC) home sector, which have been laid bare by the coronavirus disease 2019 (COVID-19) pandemic. Nurse practitioners (NPs) represent an efficient solution to human resource challenges. During the current pandemic, many Medical Directors in LTC homes worked virtually to reduce the risk of transmission. In contrast, NPs were present for in-person care. This study aims to understand the NPs’ roles in optimizing resident care and supporting LTC staff during the pandemic. Research Design and Methods This exploratory qualitative study employed a phenomenological approach. A purposive sample of 14 NPs working in LTC homes in Ontario, Canada, was recruited. Data were generated using semistructured interviews and examined using thematic analysis. Results Four categories relating to the NPs’ practices and experiences during the pandemic were identified: (a...
Direct and Indirect Effects of COVID-19 on Long-Term Care Residents and Their Family Members
Gerontology, 2022
Introduction: The first cases of COVID-19 in Israel were reported in February 2020. Family visits were prohibited from March 10, 2020, and then allowed on a limited basis on April 20, 2020. This article examines how COVID-19 impacted long-term care residents and their family members from the perspective of long-term care facility (LTCF) administrative staff. Methods: An online survey was sent to Israeli LTCF administrators between mid-July and mid-October 2020, resulting in 52 completed questionnaires. Quantitative analysis involved descriptive statistics using SPSS, with differences compared via t tests, ANOVA, and χ2 tests. Qualitative analysis involved thematic analysis of responses to open-ended questions. Results: COVID-19 was reported to have multiple types of negative impact on residents, including direct effects on morbidity and mortality as well as indirect effects manifested as negative reactions to measures aimed at limiting infection, including isolation from relatives, ...
Long-term care settings in the times of COVID-19: challenges and future directions
International Psychogeriatrics
Long-term care settings in the times of COVID-19: challenges and future directions The term "long-term care settings" (LTCS) encompasses settings that provide a range of services to meet older persons' needs for social, personal, and/or health care. These settings may include nursing homes or assisted living facilities, which are designed for people who require assistance in performing activities of daily living, such as bathing or transferring; meals, cleaning services, and social activities are also provided. A skilled nursing facility differs from assisted living in that it aims to meet not only the residents' physical needs but also their medical needs. Hence, this setting provides in-patient medical treatment and rehabilitation services in addition to the services enumerated above (Sanford et al., 2015). Continuing care retirement communities, on the other hand, represent a residential alternative for older persons, who are independent, when first entering the setting. Residents are free to choose a variety of on-site services, including social activities, health care services, cleaning, and prepared meals. Depending on older persons' evolving needs, more intensive levels of care might be available to allow older persons to age in place (Ayalon, 2016). Hence, LTCS cater to a varied population of older persons, with very different care needs and resources. The nature of the facilities, the quality of care provided, the cost, and the source of funding may vary dramatically across settings.