COVID-19 resources

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Practical implications of physical distancing, social isolation, and reduced physicality for older adults in response to COVID-19

Journal of Gerontological Social Work

The public health response to the COVID-19 pandemic involves physical distancing measures which have the potential to lead to increased social isolation among older adults. Implications of social isolation are potentially wide-ranging including poorer health outcomes, disruption of social interactions and routines, reduced meaningful activity, reduced social and emotional support, loneliness, potential for grief, loss, and trauma responses, limited access to resources, and reduced physicality. Social workers must advocate for the value of social relationships and identify creative ways to enhance the social connections of older adults during pandemic responses or other situations that require physical distancing measures.

Last updated on hub: 20 June 2020

Practical nursing recommendations for palliative care for people with dementia living in long-term care facilities during the COVID-19 pandemic: a rapid scoping review

International Journal of Nursing Studies

Background: The acute nature of COVID-19 and its effects on society in terms of social distancing and quarantine regulations affect the provision of palliative care for people with dementia who live in long-term care facilities. The current COVID-19 pandemic poses a challenge to nursing staff, who are in a key position to provide high-quality palliative care for people with dementia and their families. Objective: To formulate practice recommendations for nursing staff with regard to providing palliative dementia care in times of COVID-19. Design and method: A rapid scoping review following guidelines from the Joanna Briggs Institute. Eligible papers focused on COVID-19 in combination with palliative care for older people or people with dementia and informed practical nursing recommendations for long-term care facilities. After data extraction, the researchers formulated recommendations covering essential domains in palliative care adapted from the National Consensus Project's Clinical Practice Guidelines for Quality Palliative Care. Data sources: The researchers searched the bibliographic databases of PubMed, CINAHL and PsycINFO for academic publications. The researchers searched for grey literature using the search engine Google. Moreover, this study included relevant letters and editorials, guidelines, web articles and policy papers published by knowledge and professional institutes or associations in dementia and palliative care. Results: In total, 23 documents (7 (special) articles in peer-reviewed journals, 6 guides, 4 letters to editors, 2 web articles (blogs), 2 reports, a correspondence paper and a position paper) were included. The highest number of papers informed recommendations under the domains ‘advance care planning’ and ‘psychological aspects of care’. The lowest number of papers informed the domains ‘ethical care’, ‘care of the dying’, ‘spiritual care’ and ‘bereavement care’. This study found no papers that informed the ‘cultural aspects of care’ domain. Conclusion: Literature that focuses specifically on palliative care for people with dementia in long-term care facilities during the COVID-19 pandemic is still largely lacking. Particular challenges that need addressing involve care of the dying and the bereaved, and ethical, cultural and spiritual aspects of care. Moreover, we must acknowledge grief and moral distress among nursing staff. Nursing leadership is needed to safeguard the quality of care and nursing staff should work together within an interprofessional care team to initiate advance care planning conversations in a timely manner, to review and document advance care plans, and to adapt goals of care as they may change due to the COVID-19 situation.

Last updated on hub: 28 January 2021

Practical steps to improve air flow in long-term care resident rooms to reduce COVID-19 infection risk

Journal of the American Medical Directors Association

The potential for spread of COVID-19 infections in skilled nursing facilities and other long-term care sites poses new challenges for nursing home administrators to protect patients and staff. It is anticipated that as acute care hospitals reach capacity, nursing homes may retain COVID-19 infected residents longer prior to transferring to an acute care hospital. This article outlines 5 pragmatic steps that long-term care facilities can take to manage airflow within resident rooms to reduce the potential for spread of infectious airborne droplets into surrounding areas, including hallways and adjacent rooms, using strategies adapted from negative-pressure isolation rooms in acute care facilities.

Last updated on hub: 13 November 2020

Practising ethically during COVID-19: social work challenges and responses

International Social Work

This article draws on findings of an international study of social workers’ ethical challenges during COVID-19, based on 607 responses to a qualitative survey. Ethical challenges included the following: maintaining trust, privacy, dignity and service user autonomy in remote relationships; allocating limited resources; balancing rights and needs of different parties; deciding whether to break or bend policies in the interests of service users; and handling emotions and ensuring care of self and colleagues. The article considers regional contrasts, the ‘ethical logistics’ of complex decision-making, the impact of societal inequities, and lessons for social workers and professional practice around the globe.

Last updated on hub: 17 September 2020

Practising social work groups online: practitioners’ reflection on the COVID-19 outbreak

International Social Work

Conducting online social work groups, as a substitute for traditional forms of groups, was uncommon in Hong Kong before the outbreak of COVID-19. Frontline social workers encountered several difficulties and challenges while trying to provide this alternative form of social work intervention. This article serves as a reflection on the use of online social work groups from social work practitioners’ point of view at this critical juncture.

Last updated on hub: 31 March 2021

Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19

medRxiv

This article is a preprint and has not been peer-reviewed. Background Studies have shown that working in frontline healthcare roles during epidemics and pandemics was associated with PTSD, depression, anxiety, and other mental health disorders. Objectives The objectives of this study were to identify demographic, work-related and other predictors for clinically significant PTSD, depression, and anxiety during the COVID-19 pandemic in UK frontline health and social care workers (HSCWs), and to compare rates of distress across different groups of HCSWs working in different roles and settings. Methods A convenience sample (n=1194) of frontline UK HCSWs completed an online survey during the first wave of the pandemic (27 May – 23 July 2020). Participants worked in UK hospitals, nursing or care homes and other community settings. PTSD was assessed using the International Trauma Questionnaire (ITQ); Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9); Anxiety was assessed using the Generalized Anxiety Disorder Scale (GAD-7). Results Nearly 58% of respondents met the threshold for clinically significant PTSD, anxiety or depression, and symptom levels were high across occupational groups and settings. Logistic regression analyses found that participants who were concerned about infecting others, who felt they could not talk with their managers, who reported feeling stigmatised and who had not had reliable access to personal protective equipment (PPE) were more likely to meet criteria for a clinically significant mental disorder. Being redeployed during the pandemic, and having had COVID were associated with higher odds for PTSD. Higher household income was associated with reduced odds for a mental disorder. Conclusions This study identified predictors of clinically significant distress during COVID-19 and highlights the need for reliable access to PPE and further investigation of barriers to communication between managers and staff.

Last updated on hub: 17 November 2020

Preparing for a challenging winter 2020/21

Academy of Medical Sciences

This report considers a worst-case scenario for winter 2020/21 – a likely mix of COVID-19, bad seasonal influenza and cold weather; what this would mean for deaths, NHS capacity and social care; and the actions that would enable the health and social care system to better cope in the face of new winter pressures resulting from the pandemic. The need for health and social care undergoes large seasonal fluctuations, peaking in the winter, with the NHS and social care systems typically operating at maximal capacity in the winter months. The report identifies four additional challenges that have great potential to exacerbate winter 2020/21 pressures on the health and social care system, by increasing demand on usual care as well as limiting surge capacity: a large resurgence of COVID-19 nationally, with local or regional epidemics; disruption of the health and social care systems due to reconfigurations to respond to and reduce transmission of COVID-19; a backlog of non-COVID-19 care; and a possible influenza epidemic that will add pressure. The paper argues that there is a need for urgent preparation to mitigate the risks of a particularly challenging winter 2020/21, including: minimising community SARS-CoV-2 transmission and impact; organising health and social care settings to maximise infection control and ensure that COVID-19 and routine care can take place in parallel; improving public health surveillance for COVID-19, influenza and other winter diseases; and minimising influenza transmission and impact, including by maximising the uptake of influenza vaccination by health and social care workers. Includes a ‘Peoples perspective’ report in appendix, written by patients and carers, that calls for the actions to be developed through engagement with patients, carers and the public to ensure services, guidelines and communications work for people, rather than focusing plans on individual medical conditions.

Last updated on hub: 16 July 2020

Preparing social services and public services professionals for meaningful roles in disaster services

Journal of Evidence-Based Social Work

This manuscript reviews the importance of disaster preparedness for the social services and public services professional. The value in separating fact from fiction in regard to probabilities for biological, chemical, and nuclear terrorism is highlighted. The various phases of disaster preparedness are elucidated along with the components of the effective all-hazards plan. Consideration of the psychological impact of disasters is presented in conjunction with the role of the mental health worker in the amelioration of outcomes. The role of electronic technology in disaster preparedness is elaborated, and useful websites are cited to facilitate disaster planning.

Last updated on hub: 07 November 2020

Pre-print: The impacts of COVID-19 on unpaid carers of adults with long-term care needs and measures to address these impacts: a rapid review of the available evidence

International Long-term Care Policy Network

Context: Unpaid carers are the backbone of long-term care (LTC) systems around the world. The COVID-19 pandemic has further increased the pressure many unpaid carers experience, however, in contrast to people living in residential care settings, their experience has been largely absent from public reporting. Objective: This study aims to map the available evidence on the impact of COVID-19 on unpaid carers of adults with LTC needs to provide an overview of measures identified from the literature to address the impact. Method: This study conducted a rapid review of the academic and grey literature on unpaid carers of adults with LTC needs during the COVID-19 pandemic. Findings: This study identified five key themes that highlight the impact of COVID-19 on unpaid carers of people living in the community. These include changes in care responsibilities, concerns around COVID-19 infections, changes in the availability of formal and informal support, financial as well as physical and mental health implications. Unpaid carers of people in residential care settings reported difficulties in communicating with residents, concerns about quality of care and COVID-19 entering the care home. This study also found that technology, financial assistance and support for working carers can help to mitigate these effects. Limitations: The evidence reported in this review is based largely on cross-sectional data and some of the data reported relies on convenience samples. Implications: This study highlights the financial and health impact many unpaid carers experience. Given the vital support carers provide to adults with LTC needs policy makers should consider supporting unpaid carers to mitigate the negative impact on their lives.

Last updated on hub: 31 March 2021

Preprint: the relationship between ownership of nursing homes and their response to the COVID-19 pandemic: a systematic review

International Long-term Care Policy Network

Introduction: The nursing home sector has been disproportionally affected by the 2019 coronavirus disease (COVID-19) and pandemic. Nursing home residents are particularly vulnerable to the virus, resulting in a high number of outbreaks and deaths. However, some nursing homes fared better than others; organisational characteristics to some extent may mediate the effect of the COVID-19 pandemic. The aim of this literature review is to evaluate the relationship between ownership structure of nursing homes and their performance during the COVID-19 crisis. Methods: A rapid literature review was conducted in PubMed and Web of Science. This literature review followed a systematic approach including a risk of bias assessment. Articles were selected based on a pre-defined set of PICOT criteria that included studies which compared for-profit nursing homes to non-profit and public nursing homes with regard to the effectiveness in response to the COVID-19 pandemic, measured in terms of number of COVID-19 cases and deaths. Results: In total, eighteen papers were included in this systematic review. The majority of papers found a significant relationship in the unadjusted statistics between ownership status and effectiveness in response to the COVID-19 pandemic. However, the adjusted figures paint a more nuanced picture. The relationship seems to be mediated by other organisational (e.g. size), process (e.g. access to personal protective equipment) and contextual factors (e.g. regional spread of COVID-19). Conclusion: Ownership matters, but mainly because of the underlying organisational, process and contextual factors. The policy implications of these findings are timely: policymakers can either disincentivise for-profit entities (or favour non-profit providers), or improve the regulation of underlying factors that relate to COVID-19 outcomes. Even as discussions are undertaken about the values that underlie the future of nursing home ownership, steps can be taken now within existing ownership structures to address the factors most closely associated with outcomes. In the short-term it is better to address these mediating factors, but for the long-term, this review is in keeping with previous literature suggesting policymakers should be wary of for-profit nursing homes. [Note: this is a preprint – has not peer reviewed yet]

Last updated on hub: 15 March 2021

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