COVID-19 resources

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Staying connected during COVID-19: family engagement with adults with developmental disabilities in supported accommodation

Research in Developmental Disabilities

Background: Enduring family engagement and informal support is crucial to the health and well-being of adults with developmental disabilities (DD) residing in supported accommodation. The COVID-19 pandemic and restrictive measures enforced in residential settings have resulted in changes in daily routine and modified the ways families can interact with and provide support to residents. Yet, the impact of these changes has not been empirically explored. Aim: Explore how family caregivers have interacted with and supported their relatives with DD residing in supported accommodation during the pandemic. Methods: Changes in frequencies of communication modes and types of informal support were measured through a cross‐sectional and anonymous online survey which completed by 108 family caregivers of adults with DD. Results: Most family caregivers adopted remote communication technologies; however, these were not perceived to be effective in filling the gap created by reduced face-to-face contact. While families were able to provide emotional support and advocacy using digital technologies, they were limited in their ability to provide significant social support. Conclusions: Findings may help key stakeholders develop and implement novel strategies and policies to accommodate the changing circumstances and to ensure continuity of family engagement and informal support in the context of COVID-19.

Last updated on hub: 04 February 2021

Experiences of young adults with a history of foster care during COVID-19

Children and Youth Services Review

This study assessed the needs, concerns, and strengths of young adults (ages 18–26), previously placed in foster care, in response to coronavirus disease 2019 (COVID-19). One hundred and twenty-seven participants completed the survey in May and June, offering a preliminary description of the impact of Shelter in Place (SIP) due to COVID-19 on their well-being. The mixed-methods, cross-sectional survey assessed participants’ perspectives regarding (1) changes in physical, financial, professional, social, relational, and psychological levels of concern and (2) the general impact of SIP due to COVID-19, as well as the unique impact as a current or former foster youth. Participants reported significant increases in their level of concern in each domain from before SIP orders to during SIP, which was maintained in anticipation of the year following SIP. Participants also described their experiences with SIP and COVID-19 as unique, due to their lived experience as a former foster youth. Findings highlight a need for a coordinated short and long-term response to address the needs and concerns of this vulnerable population.

Last updated on hub: 04 February 2021

Integrated healthcare systems response strategies based on the Luohu Model during the COVID-19 epidemic in Shenzhen, China

International Journal of Integrated Care

COVID-19 has affected primary health-care delivery in metropolitan areas. An integrated health-care system offers advantages in response to the community outbreak and transmission of highly infectious diseases. On the basis of practitioner experience with a pioneering integrated health-care system in Shenzhen, China, this article presents the following effective strategies in response to the epidemic: (1) enhance the public workforce in primary health care; (2) integrate resources to allow regional sharing and efficient use; (3) employ teams centered on general practitioners for community containment; and (4) adopt e-health and telemedicine for healthcare delivery. An integrated health-care system is usually very specific to a particular regional context; however, the core strategies and mechanisms based on the Luohu model can contribute to improving the public health capacity in emergency responses; they can transform health-care delivery in the COVID-19 epidemic. The experience in Shenzhen may help other cities in enhancing and coordinating the preparedness of their health-care systems in dealing with future public health emergencies.

Last updated on hub: 04 February 2021

A rapid response and treatment service for care homes: a case study

British Journal of Community Nursing

Rapid response services provide opportunities for older people living with frailty to remain in their own homes during an episode of deteriorating health. The government has announced additional funding to increase capacity and responsiveness for these services through the Ageing Well programme as part of the NHS Long Term Plan. Older people living with frailty are particularly at risk of the adverse effects of a hospital admission and evidence is emerging of the benefits of enhanced healthcare support to allow them to remain in their own home. The Hospital at Home model offers short-term, targeted interventions at acute hospital level care that can provide a truly person-centred experience within the home. This article describes a Rapid Response and Treatment service for older people living in care homes in Berkshire West and shares Sid's story to demonstrate how such a service is delivered. The COVID-19 pandemic has presented additional challenges and opportunities that highlight the ongoing need for the development of services that will support older people to prioritise what matters to them most.

Last updated on hub: 03 February 2021

COVID-19 testing in English care homes and implications for staff and residents

Age and Ageing

Introduction: Care home residents are at high risk of dying from COVID-19. Regular testing, producing rapid and reliable results is important in this population because infections spread quickly, and presentations are often atypical or asymptomatic. This study evaluated current testing pathways in care homes to explore the role of point-of-care tests (POCTs). Methods: Ten staff from eight care homes, purposively sampled to reflect care organisational attributes that influence outbreak severity, underwent a semi-structured remote videoconference interview. Transcripts were analysed using process mapping tools and framework analysis focussing on perceptions about, gaps within, and needs arising from, current pathways. Results: Four main steps were identified in testing: infection prevention, preparatory steps, swabbing procedure, and management of residents. Infection prevention was particularly challenging for mobile residents with cognitive impairment. Swabbing and preparatory steps were resource-intensive, requiring additional staff resource. Swabbing required flexibility and staff who were familiar to the resident. Frequent approaches to residents were needed to ensure they would participate at a suitable time. After-test management varied between sites. Several homes reported deviating from government guidance to take more cautious approaches, which they perceived to be more robust. Conclusion: Swab-based testing is organisationally complex and resource-intensive in care homes. It needs to be flexible to meet the needs of residents and provide care homes with rapid information to support care decisions. POCT could help address gaps but the complexity of the setting means that each technology must be evaluated in context before widespread adoption in care homes.

Last updated on hub: 03 February 2021

COVID 19 and dementia: experience from six European countries

International Journal of Geriatric Psychiatry

The effects of Covid‐19 have been well documented across the world with an appreciation that older people and in particular those with dementia have been disproportionately and negatively affected by the pandemic. This is both in terms of their health outcomes (mortality and morbidity), care decisions made by health systems and the longer‐term effects such as neurological damage. The International Dementia Alliance (IDEAL) is a group of dementia specialists from six European countries and this paper is a summary of our experience of the effects of COVID‐19 on our populations. Experience from England, France, Germany, the Netherlands, Spain and Switzerland highlight the differential response from health and social care systems and the measures taken to maximise support for older people and those with dementia. The common themes include recognition of the atypical presentation of COVID‐19 in older people (and those with dementia) the need to pay particular attention to the care of people with dementia in care homes; the recognition of the toll that isolation can bring on older people and the complexity of the response by health and social services to minimise the negative impact of the pandemic. Potential new ways of working identified during the pandemic could serve as a positive legacy from the crisis.

Last updated on hub: 03 February 2021

‘It's been adapted rather than impacted’: a qualitative evaluation of the impact of Covid‐19 restrictions on the positive behavioural support of people with an intellectual disability and/or autism

Journal of Applied Research in Intellectual Disabilities

Background: We used a qualitative approach to explore the experiences of social care staff regarding the provision of positive behavioural support (PBS) to people with an intellectual disability at the height of the Covid‐19 restrictions. Method: We conducted semi‐structured interviews with 19 staff who had recently completed a PBS workforce development programme. Data were analysed using thematic analysis. Results: Three themes were identified in the context of the restrictions: The challenges to maintaining quality of life and PBS of the people being supported and staff attempts to overcome these; the ways in which PBS and behaviour support plans were implemented and the impact on behaviours that challenge; the ways in which PBS principles were applied at organisational levels to help to understand and address staff stress and distress. Conclusions: Overall, the staff identified many unexpected benefits of the restrictions. The results are discussed in the context of the study limitations.

Last updated on hub: 03 February 2021

Filling in the gaps: the role of self-advocacy groups in supporting the health and wellbeing of people with learning disabilities throughout the pandemic

The Open University

This report describes research on the role of self-advocacy groups in supporting the health and wellbeing of adults with learning disabilities during the coronavirus pandemic. It is based on interviews with staff and members of 11 self-advocacy groups, representing all regions of England, to find out what they had been doing to support members during lockdown. This research shows how and where self-advocacy was ‘filling in the gaps’ left by other services. The key findings are: 1. Self-advocacy groups worked hard (and fast) to support members to get online, helping to bridge the ‘digital divide’ that many people with learning disabilities experience; 2. Self-advocacy groups provided extensive offline support, for example organising phone rotas, and sending information and activities through the post; 3. Self-advocacy groups played a critical role in supporting mental health and wellbeing during the pandemic by enabling people to stay socially connected; 4. Self-advocacy groups supported people’s physical health during the pandemic in a number of ways, adapting government public health advice on coronavirus to accessible Easy Read format, advising on healthy eating and the importance of physical exercise and supporting members to access and use health services; 5. Self-advocacy staff provided essential frontline services to people, delivering food packages and medication. 6. Self-advocacy staff and volunteers sometimes stepped in to support people in or close to crisis relating to mental or physical health, or safeguarding. 7. Self-advocacy groups signposted members to essential public services and third sector initiatives; 8. Many groups mobilised a local volunteer network to extend their capacity to provide support. 9. Self-advocacy groups went ‘above and beyond’ during the pandemic, with staff often working seven days a week to provide support. 10. As self-advocacy groups became more confident in using online technologies during the pandemic, this strengthened connections between them across different regions of the country.

Last updated on hub: 03 February 2021

Developing social contact models in a time of social distancing: a response to COVID-19: full report

Ambition for Ageing

This report aims to help build more effective social connection projects for older people during the new operating environment of COVID-19. As national and local rules change in response to infection rates, this report offers guidance that can be applicable in a number of different scenarios, from a world where social distancing is the norm to one where we return to complete lockdown. It is important that we focus planning on how we live with COVID-19 rather than how we reconstruct after it. In order to reduce exposure to the COVID-19 virus some social activities are going to be limited and can’t proceed as they once could. In addition, as different people perceive and react to risk in different ways, social connection is best developed by taking a person-centred approach and with recognition that there are as many solutions as there are people. The report outlines a number of tools and examples to help service providers, community groups and commissioners consider what social contact models will look like now and in the future. This includes: a number of design principles to best meet the needs of older people; a checklist of challenges to consider when designing or restarting projects; a collection of case studies of projects compatible with social distancing with key learning.

Last updated on hub: 03 February 2021

Giving civil society the right response: national policy responses for supporting philanthropy, giving and civil society across the world in the context of COVID-19

Charities Aid Foundation

This report examines a range of government responses to civil society during the pandemic – from active, targeted support to ignoring or even competing against the sector – and what this means for rebuilding efforts. We place a particular focus on government responses aimed at unlocking individual giving and philanthropy. Using desk research, roundtable discussions and informal interviews, we have collected an evidence base of good and bad policy practices, with recommendations for how governments of varying capacities can improve their response. The following trends in policy practice were observed: some specific stimulus packages for civil society were seen in the global North but the dominant trend is for measures aimed at the wider economy that either ignore or only incidentally apply to civil society; positive steps have been taken on tax relief in countries such as Russia, Belgium and South Africa to encourage individual giving but there are few flagship campaigns to leverage giving across sectors; many countries have used the crisis to clamp down on civic space and civil society – this has included restrictions on cross-border giving and increased government competition with civil society through centralised government COVID-19 funds that often lack accountability or transparency; the crisis has shown the need for better civil-society infrastructure, particularly in the global South where there is chronic underfunding – civil society’s strength has often been in its self-organising ability and coordinated voice, but it requires more support to maintain this. The report calls on the Government to engage proactively CSOs early and consult on policy design during a crisis and beyond.

Last updated on hub: 03 February 2021

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