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Healthy ageing in long-term care? Lessons learned from the COVID-19 pandemic : A position paper

Jacobsen, Frode F. ; Glasdam, Stinne LU orcid ; Haukelien, Heidi ; Van Den Muijsenbergh, Maria E.T.C. and Ågotnes, Gudmund (2024) In Primary Health Care Research and Development 25.
Abstract

Aim: This position paper focuses on healthy ageing for the frailest and institutionalized older adults in the context of the recent pandemic. The paper aims to identify and discuss hindering and promoting factors for healthy ageing in this context, taking both health safety and a meaningful social life into account, in a pandemic situation and beyond. Background: The recent COVID-19 pandemic has highlighted the vulnerability of frail older adults residing in long-term care institutions. This is a segment of the older population that does not seem to align well with the recent policy trend of healthy and active ageing. The need for healthy ageing in this population has been voiced by professionals and interest organizations alike,... (More)

Aim: This position paper focuses on healthy ageing for the frailest and institutionalized older adults in the context of the recent pandemic. The paper aims to identify and discuss hindering and promoting factors for healthy ageing in this context, taking both health safety and a meaningful social life into account, in a pandemic situation and beyond. Background: The recent COVID-19 pandemic has highlighted the vulnerability of frail older adults residing in long-term care institutions. This is a segment of the older population that does not seem to align well with the recent policy trend of healthy and active ageing. The need for healthy ageing in this population has been voiced by professionals and interest organizations alike, alluding to inadequate support systems during the pandemic, conditioned by both previous and newly emerging contextual factors. Supporting healthy ageing in older adults in nursing homes and other residential care settings calls for attending to meaningful social life as well as to disease control. Methods: Findings and early conclusions leading up to the position paper were presented with peer discussions involving healthcare professionals and researchers at two joint EFPC PRIMORE workshops 2021 and 2022, as well as other international research seminars on long-term care. The following aspects of long-term care and COVID-19 were systematically discussed in those events, with reference to relevant research literature: 1. Long-term care policies, 2. pre-COVID state of long-term care facilities and vulnerability to the pandemic, 3. factors influencing the extent of spread of infection in long-term care facilities, and 4. the challenge of balancing between strict measures for infection control and maintaining a meaningful social life for residents and their significant others. Findings: A policy shift towards ageing at home and supporting the healthiest of older adults seems to have had unwarranted effects both for frail older adults, their significant others, and professional care staff attending to their needs. Resulting insufficient investment in primary health care staff and in the built environment for frail older adults in nursing homes were detrimental both for the older adults living in nursing homes, their significant others, and staff. More investment in staff and in physical surroundings might improve the quality of care and the social life of older adults in nursing homes in a non-pandemic situation and be a resource for primary health care staff ensuring both protection from health hazards and a meaningful social life for frail older adults in a pandemic or epidemic situation. As for investing in the physical surroundings, smaller nursing homes are advantageous, with singular resident rooms and for developing out-and indoor spaces for socializing and for meeting with families and other visitors. Regarding investment in staff, there is a documented need for educated staff in full-time positions. Use of part-time or temporary staff should be limited.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
built environment, Healthy ageing, long-term care, meaningfulness, older adults, pandemic, safety, staffing
in
Primary Health Care Research and Development
volume
25
article number
e66
publisher
Cambridge University Press
external identifiers
  • scopus:85210745951
  • pmid:39610162
ISSN
1463-4236
DOI
10.1017/S1463423624000598
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s), 2024.
id
1fca658c-4cad-4c0d-91e9-a675ccb40ef7
date added to LUP
2025-01-10 15:05:08
date last changed
2025-01-14 16:05:31
@article{1fca658c-4cad-4c0d-91e9-a675ccb40ef7,
  abstract     = {{<p>Aim: This position paper focuses on healthy ageing for the frailest and institutionalized older adults in the context of the recent pandemic. The paper aims to identify and discuss hindering and promoting factors for healthy ageing in this context, taking both health safety and a meaningful social life into account, in a pandemic situation and beyond. Background: The recent COVID-19 pandemic has highlighted the vulnerability of frail older adults residing in long-term care institutions. This is a segment of the older population that does not seem to align well with the recent policy trend of healthy and active ageing. The need for healthy ageing in this population has been voiced by professionals and interest organizations alike, alluding to inadequate support systems during the pandemic, conditioned by both previous and newly emerging contextual factors. Supporting healthy ageing in older adults in nursing homes and other residential care settings calls for attending to meaningful social life as well as to disease control. Methods: Findings and early conclusions leading up to the position paper were presented with peer discussions involving healthcare professionals and researchers at two joint EFPC PRIMORE workshops 2021 and 2022, as well as other international research seminars on long-term care. The following aspects of long-term care and COVID-19 were systematically discussed in those events, with reference to relevant research literature: 1. Long-term care policies, 2. pre-COVID state of long-term care facilities and vulnerability to the pandemic, 3. factors influencing the extent of spread of infection in long-term care facilities, and 4. the challenge of balancing between strict measures for infection control and maintaining a meaningful social life for residents and their significant others. Findings: A policy shift towards ageing at home and supporting the healthiest of older adults seems to have had unwarranted effects both for frail older adults, their significant others, and professional care staff attending to their needs. Resulting insufficient investment in primary health care staff and in the built environment for frail older adults in nursing homes were detrimental both for the older adults living in nursing homes, their significant others, and staff. More investment in staff and in physical surroundings might improve the quality of care and the social life of older adults in nursing homes in a non-pandemic situation and be a resource for primary health care staff ensuring both protection from health hazards and a meaningful social life for frail older adults in a pandemic or epidemic situation. As for investing in the physical surroundings, smaller nursing homes are advantageous, with singular resident rooms and for developing out-and indoor spaces for socializing and for meeting with families and other visitors. Regarding investment in staff, there is a documented need for educated staff in full-time positions. Use of part-time or temporary staff should be limited.</p>}},
  author       = {{Jacobsen, Frode F. and Glasdam, Stinne and Haukelien, Heidi and Van Den Muijsenbergh, Maria E.T.C. and Ågotnes, Gudmund}},
  issn         = {{1463-4236}},
  keywords     = {{built environment; Healthy ageing; long-term care; meaningfulness; older adults; pandemic; safety; staffing}},
  language     = {{eng}},
  month        = {{11}},
  publisher    = {{Cambridge University Press}},
  series       = {{Primary Health Care Research and Development}},
  title        = {{Healthy ageing in long-term care? Lessons learned from the COVID-19 pandemic : A position paper}},
  url          = {{http://dx.doi.org/10.1017/S1463423624000598}},
  doi          = {{10.1017/S1463423624000598}},
  volume       = {{25}},
  year         = {{2024}},
}