AI Article Synopsis
- The study aimed to assess how the prescribing of medications for end-of-life symptom management in long-term care homes changed during the COVID-19 pandemic in Ontario, Canada.
- Researchers examined data from residents who died between 2017 and 2021, comparing periods before and during the pandemic.
- The findings revealed significant differences in medication prescribing rates across various long-term care homes, with lower prescribing rates correlating with higher rates of COVID-19 outbreaks and negative outcomes for residents.
Article Abstract
Objective: To examine changes in the prescribing of end-of-life symptom management medications in long-term care (LTC) homes during the COVID-19 pandemic.
Design: Retrospective cohort study using routinely collected health administrative data in Ontario, Canada.
Setting And Participants: We included all individuals who died in LTC homes between January 1, 2017, and March 31, 2021. We separated the study into 2 periods: before COVID-19 (January 1, 2017, to March 17, 2020) and during COVID-19 (March 18, 2020, to March 31, 2021).
Methods: For each LTC home, we measured the percentage of residents who died before and during COVID-19 who had a subcutaneous symptom management medication prescription in their last 14 days of life. We grouped LTC homes into quintiles based on their mean prescribing rates before COVID-19, and examined changes in prescribing during COVID-19 and COVID-19 outcomes across quintiles.
Results: We captured 75,438 LTC residents who died in Ontario's 626 LTC homes during the entire study period, with 19,522 (25.9%) dying during COVID-19. The mean prescribing rate during COVID-19 ranged from 46.9% to 79.4% between the lowest and highest prescribing quintiles. During COVID-19, the mean prescribing rate in the lowest prescribing quintile increased by 9.6% compared to before COVID-19. Compared to LTC homes in the highest prescribing quintile, homes in the lowest prescribing quintile experienced the highest proportion of COVID-19 outbreaks (73.4% vs 50.0%), the largest mean outbreak intensity (0.27 vs 0.09 cases/bed), the highest mean total days with a COVID-19 outbreak (72.7 vs 24.2 days), and the greatest proportion of decedents who were transferred and died outside of LTC (22.1% vs 8.6%).
Conclusions And Implications: LTC homes in Ontario had wide variations in the prescribing rates of end-of-life symptom management medications before and during COVID-19. Homes in the lower prescribing quintiles had more COVID-19 cases per bed and days spent in an outbreak.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jamda.2024.01.024 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Behind the Frontlines: Insights for Supporting Mental Health and Staff Retention in the Long-Term Care Workforce.
Healthcare (Basel)
December 2024
Innovation in Dementia and Aging (IDEA) Lab, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
: Canada's long-term care (LTC) sector is struggling with a significant staffing crisis related to shortages, high-turnover rate, and challenging working conditions. The COVID-19 pandemic exacerbated these issues and emphasized the need for improved mental health support for LTC staff. Understanding and addressing the wellbeing of staff is important for ensuring quality of care and promoting a positive work environment for a healthy workforce.
View Article and Find Full Text PDFIntroduction: Long-term care (LTC) residents require extensive assistance with daily activities due to physical and cognitive impairments. Medical treatment for LTC residents, when not aligned with residents' wishes, can cause discomfort without providing substantial benefits. Predictive models can equip providers with tools to guide treatment recommendations that support person-centred medical decision-making.
View Article and Find Full Text PDFRelationship-Centered Care for Older Adults in Long-Term Care Homes: A Scoping Review.
J Appl Gerontol
January 2025
Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada.
This scoping review, following Levac et al.'s methodology, examines the implementation and impact of relationship-centered care (RCC) in long-term care (LTC) settings for older adults. Peer-reviewed articles from AgeLine, CINAHL Complete, MEDLINE, PsycINFO, and Web of Science were included if published after 2000, involved older adults in LTC homes, focused on RCC, and conducted in Australia, Europe, New Zealand, or North America.
View Article and Find Full Text PDFBackground: Nearly 90% of nursing homes in the US experienced severe staffing shortages during COVID-19, which disproportionately affected over 50% of nursing home residents living with Alzheimer's Disease and Related Dementia (ADRD). One major federal policy to support the maintenance of staffing levels during the COVID-19 pandemic was the Paycheck Protection Program (PPP), a $75 billion program that provided loans to small businesses, including nursing homes. Loans were forgivable if at least 60 percent of the loan was spent on payroll providing an incentive to apply resources toward staffing.
View Article and Find Full Text PDFDementia Care Research and Psychosocial Factors.
Alzheimers Dement
December 2024
Camden and Islington NHS Foundation Trust, London, United Kingdom; University College London, London, United Kingdom.
Background: Long-term care (LTC) home residents may be isolated or lonely. Social connection is important for their physical, mental and cognitive health, quality of life and care. However, measuring social connection in LTC residents is challenging and there are no existing measures with adequately established psychometric properties.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!