Search

Background: Care aides (certified nursing assistants, personal support workers) are the largest workforce in long‐term care (LTC) homes (nursing homes). They provide as much as 90% of direct care to residents. Their health and well‐being directly affect both quality of care and quality of life for residents. The aim of this study was to understand the impact of COVID‐19 on care aides working in LTC homes during the first year of the pandemic. Methods: We conducted semi‐structured interviews with a convenience sample of 52 care aides from 8 LTC homes in Alberta and one in British Columbia, Canada, between January and April 2021. Nursing homes were purposively selected across: (1) ownership model and (2) COVID impact (the rate of COVID infections reported from March to December 2020). Interviews were recorded and analyzed using inductive content analysis. Results: Care aides were mainly female (94%) and older (74% aged 40 years or older). Most spoke English as an additional language (76%), 54% worked full‐time in LTC homes, and 37% worked multiple positions before "one worksite policies" were implemented. Two themes emerged from our analysis: (1) Care aides experienced mental and emotional distress from enforcing resident isolation, grief related to resident deaths, fear of contracting and spreading COVID‐19, increased workload combined with staffing shortages, and rapidly changing policies. (2) Care aides' resilience was supported by their strong relationships, faith and community, and capacity to maintain positive attitudes. Conclusions: These findings suggest significant, ongoing adverse effects for care aides in LTC homes from working through the COVID‐19 pandemic. Our data demonstrate the considerable strength of this occupational group. Our results emphasize the urgent need to appropriately and meaningfully support care aides' mental health and well‐being and adequately resource this workforce. We recommend improved policy guidelines and interventions. [ABSTRACT FROM AUTHOR]

Objectives To compare the fall characteristics of individuals with and without Parkinson's disease ( PD) through the analysis of real-life falls captured on video. Design Observational cohort study. Setting Two long-term care facilities in British Columbia, Canada. Participants Individuals living in long-term care (N = 306; 16 with PD). Measurements Falls captured on video and analyzed (N = 906; 71 in participants with PD). Generalized estimating equation models were used to examine differences in fall characteristics between participants with and without PD. Results Individuals with PD were 1.3 times as likely as those without PD to fall because of incorrect weight shifting (95% confidence interval ( CI) = 1.03-1.65). Secondary steps during the fall event were 1.5 times as likely to be short in individuals with PD as in those without (95% CI = 1.23-1.78). Individuals with PD were also 1.6 times as likely to attempt to recover balance by reaching to grasp an external object (95% CI = 1.13-2.15) and 5.0 times as likely to secure grasp of the object (95% CI = 1.23-20.0). Conclusion Along with greater likelihood for individuals with PD to fall because of incorrect weight shifting, differences between groups were found in reactive stepping responses. This first detailed evidence of the characteristics of falls in PD should help to inform fall and injury prevention approaches for clinicians and rehabilitation professionals working with individuals with PD. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the effect of medical Primary Integrated Interdisciplinary Elder Care at Home ( PIECH) on acute hospital use and mortality in a frail elderly population. Design Comparison of acute hospital care use for the year before entering the practice (pre-entry) with the most-recent 12-month period ( May 1, 2010- April 30, 2011, postentry) for active and discharged patients. Setting Community. Participants All 248 frail elderly adults enrolled in the practice for at least 12 months who were living in the community and not in nursing homes in Victoria, British Columbia. Intervention Primary geriatric care provided by a physician, nurse, and physiotherapist in participants' homes. Measurements Acute hospital admissions, emergency department ( ED) contacts that did not lead to admission, reason for leaving practice, and site of death. Results There was a 39.7% (116 vs 70; P = .004) reduction in hospital admissions, 37.6% (1,700 vs 1,061; P = .04) reduction in hospital days, and 20% (120 vs 95; P = .20) reduction in ED contacts after entering the practice. Fifty participants were discharged from the practice, 64% (n = 32) of whom died, 20% (n = 10) moved, and 16% (n = 8) were admitted to nursing homes. Fifteen (46.9%) deaths occurred at home. Conclusion Primary Integrated Interdisciplinary Elder Care at Home may reduce acute hospital admissions and facilitate home deaths. [ABSTRACT FROM AUTHOR]