Search

• Providing empirical evidence that the GH model is more effective in preventing COVID-19 cases and deaths compared to traditional NHs. • Identifying and discussing barriers to broader GH adoption, including market demand, costs, reimbursement, and regulations. This study compares COVID-19 case and mortality rates in Green Houses (GHs) and traditional nursing homes (NHs) during the COVID-19 pandemic. CMS data from 10 states (June 2020 to September 2022) were analyzed for GHs (n = 19), small NHs (n = 266), and large NHs (n = 2,932). Multivariate Poisson regressions with GEE were used. Participants (mean age 73.4) were predominantly female (57.8 %) and White (78.2 %). Small and large NHs had a significantly higher COVID-19 case risk (RR = 1.61; 95 % CI 1.25–2.08 and RR = 1.75; 95 % CI 1.36–2.24, respectively) compared to GHs. Large NHs also had an increased mortality risk (RR = 1.67; 95 % CI 1.01–2.77) compared to GHs, with no difference found between GHs and small NHs. After adjusting for age, gender, and ADL disability, GHs demonstrated lower COVID-19 case and mortality rates than traditional NHs, likely due to their unique features, including person-centered care, size, and physical structure. [ABSTRACT FROM AUTHOR]

• Green House residents are older and sicker than traditional nursing homes (NHs). • COVID-19 case rates in Green Houses (GHs) were half that of NHs. • COVID-19 mortality rates in GHs were less than half that of small NHs. • GH residents were shielded from COVID-19 due to facility size (10–12 beds). • GHs' care model and efficient communication may contribute to the positive outcome. [ABSTRACT FROM AUTHOR]

• As one of the world's fastest-aging societies, Taiwan prioritizes aging-in-place. • Administrative data and generalized estimating equations (GEE) were used to identify determinants of more resource-intensive medical-related LTC services. • Higher literacy, CHD, diabetes, vision impairment, prior hospitalization, and ADL disability associated with usage of medical-related LTC services. • Early community-based interventions, such as better diabetes care and vision impairment screenings, could help community-dwelling older adults manage these risk factors. Medical-related long-term care (LTC) service use among community-dwelling older adults in Taiwan is resource-intensive, and planning is essential to promote aging-in-place. Administrative data from 4/1/2017 to 11/26/2019 among more than 14,000 residents were analyzed with generalized estimating equations (GEEs) to identify determinants of medical-related LTC service use. Older adults using medical-related LTC services tended to be younger (79.9 vs. 80.7; p<.0001), male (42.7% vs. 38.5%; p<.0001), multi-morbid (3.1 vs. 2.5; p<.0001), and higher mean activities of daily living (ADL) disability (8.2 vs. 4.2; p<.0001), instrumental ADL (IADL) disability (11.0 vs. 9.1; p<.0001), and hospitalizations (1.1 vs. 0.4; p<.0001). Significant determinants of medical-related LTC services include age, education, stroke, coronary heart disease, diabetes, vision impairment, ADL disability, and prior hospitalization. The success of LTC 2.0 will depend on ADL support and care coordination to manage chronic conditions such as diabetes, vision impairment, coronary heart disease, and stroke. [ABSTRACT FROM AUTHOR]

• This study examine determinants associated with the permanent transition to nursing home among home care recipients with dementia. We identified two potentially preventable risk factors associated with permanent transition to nursing homes: depression and incontinence. In addition, having hip fracture and higher number of hospitalizations necessitated the transition. • Decision to make permanent transition from homes in the community to nursing homes is often not a personal choice, but driven by other factors, such as cognitive impairment, severe functional disabilities, availability of informal caregivers, cost, etc. The burden of disease and human toll of dementia is not only affected the individual with dementia, their caregivers, but also the society as well. • We anticipate that this study will refocus attention on the early diagnosis and treatment of depression and incontinence among older adults with dementia. Intervention strategies designed to prevent falls and hospitalizations may delay permanent transition to nursing homes. This retrospective cohort study uses the Minimum Data Set (MDS) and Outcome and Assessment Information Set (OASIS) to determine predictors associated with permanent transition to nursing homes among home care recipients with dementia. Study participants include older adults age 65+ with dementia who received home health services in New York State for at least 2 months prior to permanent transition to nursing homes. Multivariate logistic regression was used to quantify the association between predictors and permanent transition to nursing homes. Risk factors associated with permanent transition included increasing age (OR = 1.1; 95% CI 1.03-1.18); white compared to black (OR = 1.25; 95%CI 0.83-0.94), urinary and bowel incontinence vs. continence (OR = 1.46; 95% CI 1.37-1.56); depression vs. no depression (OR = 1.2; 95% CI 1.11-1.25); hip fracture vs. no hip fracture (OR = 2.63; 95% CI 2.27-3.05), and 3+ hospitalizations vs. no hospitalizations (OR = 3.02; 95% CI 2.77-3.29). Early diagnosis and treatment may delay or avert nursing home entry. [ABSTRACT FROM AUTHOR]