COVID-19 resources

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The witness to witness program: helping the helpers in the context of the Covid‐19 pandemic

Family Process

The Witness to Witness Program (W2W), based on Weingarten’s witnessing model (2000, 2003, 2004), began in July 2018 and originally was established to support health care workers and attorneys (our partners) who were experiencing empathic distress working with people involved in various stages of the detention process. The W2W program evolved to offer four primary components: clinician listening sessions geared to deep understanding of the person’s story of their work and its challenges; an inventory of the person’s current internal and external resources both in the present and the past; help with removal of barriers to those resources; and development of a personal toolkit to handle stress. Additional services available to partners and their organizations included psycho‐educational webinars, facilitated peer support groups and organizational consultations to foster trauma‐ sensitive and resilience‐hardy work environments. In March, after lockdowns due to the coronavirus pandemic, W2W pivoted to focus on handouts and webinars addressing how to cope with distress and moral injury, maintaining resilience, coping with grief and dealing with multiple losses caused by the pandemic. Disaster sparked collaboration and innovation. A train the trainers model was developed to reach more community health workers providing services to the Latinx community dealing with losses similar to those experienced by the clients they serve. W2W continues to create virtual communities of support. In doing so we practice doing reasonable hope together (Weingarten, 2010b).

Last updated on hub: 21 August 2020

The “flip”- sustaining complexity and multiplicity post‐quarantine

Family Process

This article describes poststructural ways of responding to the pandemic by looking for openings or gaps within more traditional ways of interacting with dilemmas. The author situates herself within a “positive deviance “ epistemology, which looks for what already works rather than getting captured by the current problem. We “flip” what are the usual ways of responding and explore three different programs that illustrate inventive and assets‐based approaches. Linking‐Lives Storython, created specifically to utilize our Covid shelter‐in‐place experience; Re‐Authoring Teaching: Creating a Collaboratory , begun 12 years ago to meet the needs of a wide‐spread community; and Witness‐to‐Witness , a current response to contemporary disastrous situations—all have utilized technology to open possibilities for those who are helped as well as those who are helpers. The article shows how each program has specifically flipped more traditional ways of responding, but also how this “flip” employs a practice of “disciplined improvisation.” Each program has a built‐in structure that depends on technology to make it work; each has a disciplined approach that allows the helpers to improvise to meet the needs of the receivers. It is this “flip,” this way of thinking, that can sustain us and our work in times of great complexity and multiplicity.

Last updated on hub: 21 August 2020

Family science in the context of the COVID‐19 pandemic: solutions and new directions

Family Process

The coronavirus disease 2019 (COVID‐19) pandemic has precipitated substantial global disruption and will continue to pose major challenges. In recognition of the challenges currently faced by family scientists, the authors share their perspectives about conducting family research in the context of the COVID‐19 pandemic. There are two primary issues addressed in this article. First, a range of potential solutions to challenges in research are presented, resulting from the pandemic, and strategies for preserving ongoing research efforts are discussed. This paper discusses approaches to scaling back existing protocols, share ideas for adapting lab‐based measures for online administration (e.g., using video chat platforms), and suggest strategies for addressing missing data and reduced sample size due to lower participation rates and funding restrictions. This paper also discusses the importance of measuring COVID‐19 relevant factors to use as controls or explore as moderators of primary hypotheses. Second, this paper discusses how the COVID‐19 pandemic represents a scientifically important context for understanding how families adjust and adapt to change and adversity. Increased stress precipitated by the pandemic, varying from acute stress associated with job loss to more chronic and enduring stress, will undoubtedly take a toll. This paper discusses ways that family scientists can contribute to pandemic‐related research to promote optimal family functioning and protect the health of family members.

Last updated on hub: 21 August 2020

Amid the COVID-19 pandemic, meaningful communication between family caregivers and residents of long-term care facilities is imperative

Journal of Aging and Social Policy

Older adults residing in long-term care facilities are especially vulnerable for severe illness or death from COVID-19. To contain the transmission of the virus in long-term care facilities, federal health officials have issued strict visitation guidelines, restricting most visits between residents and all visitors, including family members. Yet, many older adults rely on family care for social support and to maintain their health, well-being, and safety in long-term care facilities, and therefore need to stay connected to their families. The federal government, state and local leaders, and long-term care facilities should take further actions to enable the relationship between residents of long-term care facilities and families during the COVID-19 pandemic.

Last updated on hub: 21 August 2020

Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: experiences of frontline workers in the English Midlands region, UK

Journal of Interprofessional Care

The first cases of Coronavirus (COVID-19) were reported in Wuhan, China in December 2019. Globally millions of people have been diagnosed with the virus whilst thousands have died. As the virus kept spreading health and social care frontline workers (HSCFW) were faced with difficulties when discharging their duties. This paper was set out to explore the challenges faced by different frontline workers in health and social care during the COVID-19 pandemic. The research utilized an explorative qualitative approach. A total of forty (N = 40) in-depth one-to-one semi-structured interviews were undertaken with HSCFW who included support workers (n = 15), nurses (n = 15), and managers (N = 10). Health and social care workers were drawn from domiciliary care and care homes (with and without nursing services). All the interviews were done online. The data were thematically analyzed, and the emergent themes were supported by quotes from the interviews held with participants. Following data analysis the research study found that lack of pandemic preparedness, shortage of Personal Protective Equipment (PPE), anxiety and fear amongst professionals, challenges in enforcing social distancing, challenges in fulfilling social shielding responsibility, anxiety and fear amongst residents and service users, delay in testing, evolving PPE guidance and shortage of staff were challenges faced by frontline health and social care workers during COVID-19 pandemic. The results of the current study point to a need for adequate pandemic preparedness within the health and social care sector to protect both frontline workers and the individuals they look after.

Last updated on hub: 21 August 2020

Impact of infection outbreak on long-term care staff: a rapid review on psychological well-being

Journal of Long-Term Care

Context: Older people and people with an intellectual disability who receive long-term care are considered particularly vulnerable to infection outbreaks, such as the current Coronavirus Disease 2019. The combination of healthcare concerns and infection-related restrictions may result in specific challenges for long-term care staff serving these populations during infection outbreaks. Objectives: This review aimed to: (1) provide insight about the potential impact of infection outbreaks on the psychological state of healthcare staff and (2) explore suggestions to support and protect their psychological well-being. Method: Four databases were searched, resulting in 2,176 hits, which were systematically screened until six articles remained. Thematic analysis was used to structure and categorise the data. Findings: Studies about healthcare staff working in long-term care for people with intellectual disabilities were not identified. Psychological outcomes of healthcare staff serving older people covered three themes: emotional responses (i.e., fears and concerns, tension, stress, confusion, and no additional challenges), ethical dilemmas, and reflections on work attendance. Identified suggestions to support and protect care staff were related to education, provision of information, housing, materials, policy and guidelines. Limitations: Only six articles were included in the syntheses. Implications: Research into support for long-term care staff during an infection outbreak is scarce. Without conscious management, policy and research focus, the needs of this professional group may remain underexposed in current and future infection outbreaks. The content synthesis and reflection on it in this article provide starting points for new research and contribute to the preparation for future infection outbreaks.

Last updated on hub: 21 August 2020

Loneliness and isolation in long-term care and the COVID-19 pandemic

Journal of the American Medical Directors Association

Editorial. In all countries affected by COVID-19, the message that is being sent by government officials and medical experts is “stay at home” and “isolate in place.” The isolation is especially difficult for people living in nursing homes and assisted living communities. This article provides some easy to implement ideas, with little or no cost or hiring additional staff, and can decrease the loneliness of residents in nursing homes or assisted living communities The article concludes that preventing loneliness in institutionalized persons is at least as important as helping them with personal hygiene. This is especially important during the COVID-19 pandemic when residents must be protected from contact with other individuals to reduce the risk of infection. Implementation of some of the strategies listed in this article requires education of staff members and supply of required items; however, this effort can significantly improve the quality of life of residents affected by pandemic restrictions.

Last updated on hub: 21 August 2020

Solving the COVID-19 crisis in post-acute and long-term care

Journal of the American Medical Directors Association

This special article presents five keys to solving the COVID-19 crisis in post-acute and long-term care, related to policy, collaboration, individualization, leadership, and reorganization. Taking action during this crisis may prevent sinking back into the complacency and habits of our pre-COVID-19 lives. Suggests that the nursing home industry has been in need of overhaul for decades—a situation made all the more evident by COVID-19. The editorial is from the AMDA–The Society for Post-Acute and Long-Term Care Medicine.

Last updated on hub: 21 August 2020

Allowing visitors back in the nursing home during the COVID-19 Crisis: a Dutch national study into first experiences and impact on well-being

Journal of the American Medical Directors Association

Objectives: To prevent and control COVID-19 infections, nursing homes across the world have taken very restrictive measures, including a ban for visitors. These restrictive measures have an enormous impact on residents' well-being and pose dilemmas for staff, although primary data are lacking. A Dutch guideline was developed to cautiously open nursing homes for visitors during the COVID-19 pandemic. This study reports the first findings on how the guideline was applied in the local context; the compliance to local protocols; and the impact on well-being of residents, their family caregivers, and staff. Design: A mixed-methods cross-sectional study was conducted. Setting and Participants: In total, 26 nursing homes were permitted to enlarge their possibilities for allowing visitors in their facility. These nursing homes were proportionally representative of the Netherlands as they were selected by their local Area Health Authority for participation. At each nursing home, a contact person was selected for participation in the current study. Methods: A mixed-methods cross-sectional study was conducted, consisting of questionnaire, telephone interviews, analyses of documentation (ie, local visiting protocols), and a WhatsApp group. Results: Variation in local protocols was observed, for example, related to the use of personal protective equipment, location, and supervision of visits. In general, experiences were very positive. All nursing homes recognized the added value of real and personal contact between residents and their loved ones and indicated a positive impact on well-being. Compliance with local guidelines was sufficient to good. No new COVID-19 infections were reported during this time. Conclusions and Implications: These results indicate the value of family visitation in nursing homes and positive impact of visits. Based on these results, the Dutch government has decided to allow all nursing homes in the Netherlands to cautiously open their homes using the guidelines. More research is needed on impact and long-term compliance.

Last updated on hub: 21 August 2020

Is there a link between nursing home reported quality and COVID-19 cases? Evidence from California skilled nursing facilities

Journal of the American Medical Directors Association

Objectives: During the Coronavirus disease 2019 (COVID-19) outbreak in the United States, nursing homes became the hotbed for the spread of COVID-19. States developed different policies to mitigate the COVID-19 risks at nursing homes, including limiting nursing home visitation and mandating staff screening. The purpose of this study is to examine whether COVID-19 cases and deaths are related to the nursing home reported quality. Design: This study combined the COVID-19 data reported by the California Department of Public Health, quality ratings provided by Nursing Home Compare, and patient racial information from Long-Term Care Focus to examine the association between nursing home reported quality and COVID-19 cases and deaths. Settings and Participants: Cross-sectional data from 1223 California skilled nursing facilities with reported quality and longitudinal data of COVID-19 cases were used. Methods: The dependent variable is COVID-19 residents’ cases and deaths. The main independent variable is nursing home reported quality. Nursing home ownership, size, years of operation, and patient race composition are also included. Results: Nursing home star ratings and greater percentage of residents from different racial and ethnicity groups were significantly (P < .01) related to increased probability of having a COVID-19 residents’ case or death. Conclusions and Implications: Nursing homes with 5-star ratings were less likely to have COVID-19 cases and deaths after adjusting for nursing home size and patient race proportion.

Last updated on hub: 21 August 2020