COVID-19 resources

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Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

European Geriatric Medicine

Introduction: COVID-19 has caused unprecedented challenges in nursing homes. This scoping review, aimed to describe factors that contributed to the spread and mortality of COVID-19 in nursing homes and provide an overview of responses that were implemented to try to overcome such challenges. Methods: The MeSH terms “Nursing homes” and “COVID-19” were searched in MEDLINE Ovid, and English language articles were retrieved that were published between 1 March 2020 and 31 January 2021. Article titles and abstracts were screened by two reviewers, and the results of included articles were grouped by themes. Results: The search retrieved 348 articles, of which 76 were included in the thematic review. 8 articles related to COVID-19 disease characteristics (e.g. asymptomatic transmission), 24 to resident-related factors (e.g. comorbidities, nutrition, cognition), 13 to facility characteristics (e.g. physical space, occupancy, for-profit status), 21 to staffing (e.g. staffing levels, staff-to-resident ratio, staff multi-employment), and 10 to external factors (e.g. availability of personal protective equipment, prevailing health and social care policies). In terms of responses, identified themes included widespread testing, isolation and cohorting of residents, staff protection and support, promotion of residents’ well-being, and technological innovations. Conclusion: COVID-19 exerted severe challenges on the nursing home population and its staff. Both internal and external factors predisposed nursing homes to an increased propensity of spread. Numerous strategies were employed to attempt to mitigate the negative impacts. Substantial learning occurred that may not only aid future pandemic preparedness but improve quality of care for nursing home residents at all times.

Last updated on hub: 18 June 2021

Older adults and Covid 19: social justice, disparities, and social work practice

Journal of Gerontological Social Work

The Covid- 19 pandemic has brought immense challenges to almost every country as it spreads throughout their populations. Foremost among these challenges is the heightened awareness of inequalities in society and the immense toll that the virus has on the most vulnerable. Globally, older people are the most at risk of getting the virus and dying from the it. Yet, although age is a significant contributor, it is its interaction with other factors, chronic conditions, poverty, and race that makes it a strong determinant. These factors reflect disparities and systemic social injustices that interact to increase the vulnerability of older adults. This paper discusses the many roles that social work, with its focus on social change, injustice, and vulnerable groups can intervene at many levels of practice and with specific groups to alleviate these fundamental disparities.

Last updated on hub: 28 January 2021

Older adults and Covid 19: social justice, disparities, and social work practice

Journal of Gerontological Social Work

The Covid-19 pandemic has brought immense challenges to almost every country as it spreads throughout their populations. Foremost among these challenges is the heightened awareness of inequalities in society and the immense toll that the virus has on the most vulnerable. Globally, older people are the most at risk of getting the virus and dying from the it. Yet, although age is a significant contributor, it is its interaction with other factors, chronic conditions, poverty, and race that makes it a strong determinant. These factors reflect disparities and systemic social injustices that interact to increase the vulnerability of older adults. This paper discusses the many roles that social work, with its focus on social change, injustice, and vulnerable groups can intervene at many levels of practice and with specific groups to alleviate these fundamental disparities.

Last updated on hub: 31 August 2020

Older adults during the COVID-19 pandemic – forgotten and stigmatized?

International Social Work

During the current worldwide COVID-19 pandemic, older adults are particularly excluded from in-person society. This essay presents current discussions around self-perceptions and external perceptions of aging during this health crisis. Viewing older adults primarily as members of a risk group hinders recognition of the individuality of millions of older adults worldwide. Social workers should remain aware of the diverse aspects of aging when working with older adults during this pandemic.

Last updated on hub: 25 March 2021

Older adults post-incarceration: restructuring long-term services and supports in the time of COVID-19

Journal of the American Medical Directors Association

Objectives: To describe long-term care services and supports (LTSS) in the United States, note their limitations in serving older adults post-incarceration, and offer potential solutions, with special consideration for the Coronavirus Disease 2019 pandemic. Design: Narrative review. Setting and Participants: LTSS for older adults post-incarceration. Methods: Literature review and policy analysis. Results: Skilled nursing facilities, nursing homes, assisted living, adult foster homes, and informal care from family and friends compose LTSS for older adults, but their utilization suffers from access and payment complexities, especially for older adults post-incarceration. A combination of public-private partnerships, utilization of health professional trainees, and unique approaches to informal caregiver support, including direct compensation to caregivers, could help older adults reentering our communities following prison. Conclusions and Implications: Long-standing gaps in US LTSS are revealed by the coronavirus (severe acute respiratory syndrome coronavirus 2) pandemic. Older adults entering our communities from prison are particularly vulnerable and need unique solutions to aging care as they face stigma and access challenges not typically encountered by the general population. Our review and discussion offer guidance to systems, practitioners, and policy makers on how to improve the care of older adults after incarceration.

Last updated on hub: 19 April 2021

Older adults’ experience of the COVID-19 pandemic: a mixed-methods analysis of stresses and joys

Gerontologist

Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic is experienced differently across individuals, and older adults’ different life experiences lead to a variety of ways of coping. The present study explores older adults’ reports of what about the pandemic is stressful, and what brings joy and comfort in the midst of stress. Research Design and Methods: An online survey asked 825 U.S. adults aged 60 and older to complete questionnaires assessing 3 psychological well-being indicators: perceived stress, negative affect, and positive affect. Participants also responded to open-ended questions about what was stressful and what brought joy or comfort at the time of the survey. A mixed-method approach first qualitatively analyzed the open-ended responses, content analysis identified themes most frequently reported, and quantitative analysis examined the associations between various stressors and joys and the psychological well-being indicators. Results: Qualitative analysis revealed 20 stress categories and 21 joy/comfort categories. The most commonly reported stressors were confinement/restrictions, concern for others, and isolation/loneliness; the most commonly reported sources of joy/comfort were family/friend relationships, digital social contact, and hobbies. Demographic comparisons revealed variations in experience. Independent t tests revealed stress from concern for others, the unknown future, and contracting the virus to be significantly associated with poorer psychological well-being; faith, exercise/self-care, and nature were associated with more positive psychological well-being. Discussion and Implications: Results are discussed in the context of stress and coping theory, highlighting the importance of understanding the unique stress experience of each individual for effective distress intervention.

Last updated on hub: 29 January 2021

Older and ‘staying at home’ during lockdown: informal care receipt during the COVID-19 pandemic amongst people aged 70 and over in the UK

SocArXiv

On 23 March 2020 the UK went into lockdown in an unprecedented step to attempt to limit the spread of coronavirus. Government advice at that time was that all older people aged 70 and over should stay at home and avoid any contact with non-household members. This study uses new data from the Understanding Society COVID 19 survey collected in April 2020, linked to Understanding Society Wave 9 data collected in 2018/19,in order to examine the extent of support received by individuals aged 70 and over in the first four weeks of lockdown from family, neighbours or friends not living in the same household, and how that support had changed prior to the outbreak of the coronavirus pandemic. The research distinguishes between different types of households as given with guidance not to leave home and not to let others into the household, those older people living alone or living only with a partner also aged 70 and above are more likely to be particularly vulnerable. The results highlight both positive news alongside causes for concern. The receipt of assistance with Instrumental Activities of Daily Living(IADLs), especially shopping, has increased particularly among those living alone or with an older partner, reflecting the rise of volunteering and community action during this period. However, not all older people reported a rise, and the majority reported ‘no change’, in the support received. Moreover, amongst those older people reporting that they required support with at least one Activity of Daily Living (ADL) task prior to the pandemic, around one-quarter reported receiving no care from outside the household and one-in-ten of those with two or more ADL care needs reported receiving less help than previously. Although formal home care visits have continued during the pandemic to those who have been assessed by the local government to be in need, it is important to acknowledge that some older people risk not having the support they need.

Last updated on hub: 17 November 2020

Older people in the context of COVID-19: a European perspective

Journal of Gerontological Social Work

The Coronavirus pandemic and associated measures for the protection of the public have impacted differently on different parts of the population and across different nations. In many areas, COVID-19 has also either exacerbated already existing or created new inequalities in relation to specific parts of the population. Older individuals are one group in society that has been widely impacted, while social isolation/shielding measures have placed them in higher risk of loneliness, isolation, financial deprivation and mental health challenges, to name a few. This commentary reflects on such inequalities across four European nations (the United Kingdom (UK), Republic of Ireland, Finland, Spain) and draws attention to the critical role of Gerontological Social Work (GSW), while emphasizing the ways in which social work can intervene. First, we identify common concerns for the rights of older people that span across all four nations, and second, we identify significant roles for GSW practitioners at the individual, community and policy levels and conclude with a call for GSW in these four nations to be reimagined in a time of global crisis.

Last updated on hub: 29 January 2021

Older people: briefing paper

Race Equality Foundation

This paper explores the impact of the pandemic on older people particularly as age has been a predominant risk factor for those affected by the Covid-19, and considers the prevalence of health conditions that Black and minority ethnic older people experience. The onset of the Covid-19 pandemic in early 2020 has highlighted the effects of contemporary and historical racism on health. In the UK ethnic minority people are one of the worst affected groups, with higher mortality and infection rates. Many ethnic minority groups have been disproportionately affected by the lockdowns (local and national) and associated restrictions, which have further hampered their health. The evidence to date shows that the ethnic minority groups (Pakistani, Bangladeshi, Black African and Black Caribbean) that are most likely to suffer higher rates of mortality and poorer health outcomes due to Covid-19, are also those that have been persistently shown over the last few decades to be suffering with the worst health and are the most disadvantaged socially and economically.5 However, the way in which ethnic minority older people specifically have been affected by the pandemic has not been the focus of much research, although the disadvantages facing ethnic minority older people have moved up the agenda for many think tanks (e.g. Centre for Ageing Better, Institute for Public Policy Research (IPPR)) and organisations working in the voluntary, community and social enterprise (VCSE) sector.

Last updated on hub: 17 August 2021

Older people’s nonphysical contacts and depression during the COVID-19 lockdown

Gerontologist

Background and Objectives: With the goal of slowing down the spread of the SARS-CoV-2 virus, restrictions to physical contacts have been taken in many countries. We examine to what extent intergenerational and other types of nonphysical contacts have reduced the risk of increased perceived depressive feelings during the lockdown for people aged 50+. Research Design and Methods: We implemented an online panel survey based on quota sampling in France, Italy, and Spain in April 2020, about 1 month after the start of the lockdown. Our analyses are based on logistic regression models and use post-stratification weights. Results: About 50% of individuals aged 50+ felt sad or depressed more often than usual during the lockdown in the 3 considered countries. Older people who increased or maintained unchanged nonphysical contacts with noncoresident individuals during the lockdown were at a lower risk of increased perceived depressive feelings compared to those who experienced a reduction in nonphysical contacts. The beneficial effect of nonphysical contacts was stronger for intergenerational relationships. The effects were similar by gender and stronger among individuals aged 70+, living in Spain and not living alone before the start of the lockdown. Discussion and Implications: In the next phases of the COVID-19 pandemic, or during any future similar pandemic, policy makers may implement measures that balance the need to reduce the spread of the virus with the necessity of allowing for limited physical contacts. Social contacts at a distance may be encouraged as a means to keep social closeness, while being physically distant.

Last updated on hub: 06 March 2021

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