COVID-19 resources

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Loneliness, social isolation and COVID-19

Local Government Association

This briefing provides advice for Directors of Public Health and those leading the response to loneliness and social isolation issues arising from the COVID-19 pandemic. The advice highlights the importance in intervening early to tackle loneliness and social isolation to prevent more costly health and care needs from developing, as well as helping community resilience and recovery. This can only be done at the local level through partnerships, with councils playing a role, as they own most of the assets where community action could or should take place, such as parks, libraries and schools. A table summarises the main risk factors of loneliness and social isolation, including those specific to COVID-19. It then briefly sets out councils’ role in working with partners and using community assets to address and help prevent loneliness and social isolation; looks at the steps councils were taking prior to the pandemic; and the changes that may be needed as a result of COVID-19 and opportunities to embed positive changes, such as greater awareness about the impact of personal behaviours on mental wellbeing.

Last updated on hub: 26 January 2021

Loneliness, social isolation and COVID-19: practical advice

Local Government Association

This briefing provides advice for Directors of Public Health and those leading the response to loneliness and social isolation issues arising from the COVID-19 pandemic. The advice highlights the importance in intervening early to tackle loneliness and social isolation to prevent more costly health and care needs from developing, as well as helping community resilience and recovery. This can only be done at the local level through partnerships, with councils playing a role, as they own most of the assets where community action could or should take place, such as parks, libraries and schools. A table summarises the main risk factors of loneliness and social isolation, including those specific to COVID-19. It then briefly sets out councils’ role in working with partners and using community assets to address and help prevent loneliness and social isolation; looks at the steps councils were taking prior to the pandemic; and the changes that may be needed as a result of COVID-19 and opportunities to embed positive changes, such as greater awareness about the impact of personal behaviours on mental wellbeing.

Last updated on hub: 21 May 2020

Lonely and left behind: tackling loneliness at a time of crisis

British Red Cross

Findings from an in-depth qualitative research, exploring the experience of loneliness among people who had been isolating or shielding as a result of the pandemic. The research took a longitudinal, case study approach, engaging 16 participants from a range of backgrounds through a series of in-depth telephone interviews and written diary tasks between July and September 2020. Each of the participants had been, at the time of the research, isolating or shielding, with some starting to reintegrate throughout the period. The study reveals that: many participants were feeling lonely or isolated before the pandemic, often due to experiencing a degree of turbulence in their lives, and this has been compounded by the impacts of the pandemic and being less able to utilise previous coping strategies during lockdown; all participants reported experiencing loneliness more often as a result of the pandemic and lockdown; for participants who continue to shield as lockdown restrictions eased, feelings of loneliness either stayed the same or worsened as they watched others resume their social lives, and they reported feeling ‘left behind’; participants pointed to the heightened importance of technology and entertainment to try to cope with loneliness, rather than the physical social interactions that they would have been able to turn to prior to the pandemic; of the policy and practice solutions tested with participants, the most popular solution was investing in remote mental health and emotional support. It was felt any type of support would need to be delivered remotely, due to fear of COVID-19 and reluctance to access options that would require physical travel or mixing with others in person.

Last updated on hub: 17 December 2020

Lonely young people have an increased risk of mental health problems years later: research suggests lockdown could have a long term effect

National Institute for Health Research

Summarises findings of a rapid systematic review on the impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. This research amplifies concerns that COVID-19 containment measures harm young peoples’ mental health. The suggestion that the duration of loneliness has more impact than its intensity is important, given that COVID-19 measures have lasted for over a year. The research suggests that there could be a rise in depression and anxiety lasting long after the end of quarantine and social isolation. These results are in line with data from China during the COVID-19 pandemic, which reported an increase in anxiety including clinginess, distraction, fear and irritability among young people aged three to 18 years. In the UK, the Co-SPACE study seeks to understand the ongoing needs of children, young people, and their families in the current pandemic. Participants complete regular online questionnaires to offer a snapshot of how they are coping. The Co-SPACE study has found high levels of worries and fears, especially in children under 10 years. Mental health services will need to be prepared to meet increased need.

Last updated on hub: 24 February 2021

Long-stay mental health care institutions and the COVID-19 crisis: identifying and addressing the challenges for better response and preparedness

World Health Organization

This report presents the results of a survey with 169 long-stay institutions to assess the impact of the COVID-19 pandemic on services, staff, service users and residents with psychosocial and intellectual disabilities. Specific themes explored in this report are how well the institutions were prepared for the crisis by authorities, the quality of communications, the availability of personal protective equipment, and the impact of the risk of infection and protective measures on staff and residents. The report finds that there were significant differences between the types of institution reporting, which included psychiatric hospitals; care homes; and other settings for mental health care. Responses from psychiatric, intellectual disability and autism services were broadly consistent with those from social care homes, except for the following significant areas of difference: social care homes were happier with information from the authorities and the information they provided for residents in accessible formats; care home staff reported challenges with more workload, stress, frustration and burnout; care homes were less likely to use discharge to reduce numbers and manage the virus; and more likely to report an increase in the use of restrictive measures. The analysis highlights the need to put in place comprehensive and practical plans to facilitate management and day-to-day operations under crisis conditions. The keys to this are: having clear guidelines and tested systems in place; ensuring clarity of communication; implementing a comprehensive and facility-based infection prevention and control plan; establishing clear procedures and protocols to ensure safe environments; being able to increase staff capacities according to need; and having a clear focus on ensuring person-centred and human rights-based care in all decision-making.

Last updated on hub: 05 October 2020

Long-term care facilities and the coronavirus epidemic: practical guidelines for a population at highest risk

Journal of the American Medical Directors Association

Editorial. Considers why long-term care preparedness for COVID-19 is important. Comments on the practical considerations for reducing the risk of transmission in the workplace; ensuring protection of healthcare workers; maintaining health care infrastructure; the assisted living experience; the blame game and what next? Suggests that appropriate preparedness includes five key elements: 1) reduce morbidity and mortality among those infected; 2) minimize transmission; 3) ensure protection of health care workers; 4) maintain health care system functioning; and 5) maintain communication with worried residents and family members

Last updated on hub: 13 November 2020

Long-term care settings in the times of COVID-19: challenges and future directions

International Psychogeriatrics

Commentary that makes the point that 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. Discusses the reasons why long-term care institutions as a high-risk environment for older adults during the COVID-19 outbreak; emotional threats to older adults in long-term care settings during the COVID-19 outbreak; the emotional threats to long-term care staff during the COVID-19 outbreak. Also considers what should we do next?

Last updated on hub: 21 December 2020

Long-term care, residential facilities, and COVID-19: an overview of federal and state policy responses

Journal of the American Medical Directors Association

The COVID-19 pandemic has disproportionately affected residents and staff at long-term care (LTC) and other residential facilities in the United States. The high morbidity and mortality at these facilities has been attributed to a combination of a particularly vulnerable population and a lack of resources to mitigate the risk. During the first wave of the pandemic, the federal and state governments received urgent calls for help from LTC and residential care facilities; between March and early June of 2020, policymakers responded with dozens of regulatory and policy changes. This article provides an overview of these responses by first summarizing federal regulatory changes and then reviewing state-level executive orders. The policy and regulatory changes implemented at the federal and state levels can be categorized into the following 4 classes: (1) preventing virus transmission, which includes policies relating to visitation restrictions, personal protective equipment guidance, and testing requirements; (2) expanding facilities' capacities, which includes both the expansion of physical space for isolation purposes and the expansion of workforce to combat COVID-19; (3) relaxing administrative requirements, which includes measures enacted to shift the attention of caretakers and administrators from administrative requirements to residents' care; and (4) reporting COVID-19 data, which includes the reporting of cases and deaths to residents, families, and administrative bodies (such as state health departments). These policies represent a snapshot of the initial efforts to mitigate damage inflicted by the pandemic. Looking ahead, empirical evaluation of the consequences of these policies- including potential unintended effects - is urgently needed. The recent availability of publicly reported COVID-19 LTC data can be used to inform the development of evidence-based regulations, though there are concerns of reporting inaccuracies. Importantly, these data should also be used to systematically identify hot spots and help direct resources to struggling facilities.

Last updated on hub: 13 November 2020

Loss and resilience in the time of COVID‐19: meaning making, hope, and transcendence

Family Process

This article addresses the many complex and traumatic losses wrought by the COVID‐19 pandemic. In contrast to individually‐based, symptom‐focused grief work, a resilience‐oriented, systemic approach with complex losses contextualizes the distress and mobilizes relational resources to support positive adaptation. Applying a family resilience framework to pandemic‐related losses, discussion focuses on the importance of shared belief systems in (1) meaning‐making processes; (2) a positive, hopeful outlook and active agency; and (3) transcendent values and spiritual moorings for inspiration, transformation, and positive growth. Practice guidelines are offered to facilitate adaptation and resilience.

Last updated on hub: 17 September 2020

Maintaining resident social connections during COVID-19: considerations for long-term care

Citation: Ickert, C. et al. Maintaining Resident Social Connections During COVID-19: Considerations for Long-Term Care. Gerontology and Geriatric Medicine, 6. Worldwide, long-term care (LTC) homes have been heavily impacted by the coronavirus disease 2019 (COVID-19) pandemic. The significant risk of COVID-19 to LTC residents has resulted in major public health restrictions placed on LTC visitation. This article describes the important considerations for the facilitation of social connections between LTC residents and their loved ones during the COVID-19 pandemic, based on the experiences of 10 continuing care homes in Alberta, Canada. Important considerations include: technology, physical space, human resource requirements, scheduling and organization, and infection prevention and control. This paper describes some of the challenges encountered when implementing alternative visit approaches such as video and phone visits, window visits and outdoor in-person visits, and share several strategies and approaches to managing this new process within LTC.

Last updated on hub: 13 November 2020

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