Long-term care staffs' experience in facilitating the use of videoconferencing by cognitively impaired long-term care residents during the COVID-19 pandemic: a mixed-methods study.

BACKGROUND: During the COVID-19 pandemic, numerous long-term care (LTC) homes faced restrictions that prevented face-to-face visits. To address this challenge and maintain family connections, many LTC homes facilitated the use of electronic tablets to connect residents with their family caregivers. Our study sought to explore the acceptability of this practice among staff members and managers, focusing on their experiences with facilitating videoconferencing. METHODS: A convergent mixed method research was performed. Qualitative and quantitative data collection through semi-structured interviews to assess the acceptability of videoconferencing in long-term care homes and to explore the characteristics of these settings. Quantitative data on the acceptability of the intervention were collected using a questionnaire developed as part of the project. The study included a convenience sample of 17 staff members and four managers. RESULTS: Managers described LTC homes' characteristics, and the way videoconferencing was implemented within their institutions. Affective attitude, burden, ethicality, opportunity costs, perceived effectiveness, and self-efficacy are reported as per the constructs of the Theoretical Framework of Acceptability. The results suggest a favorable acceptability and a positive attitude of managers and staff members toward the use of videoconferencing in long-term care to preserve and promote contact between residents and their family caregivers. However, participants reported some challenges related to the burden and the costs regarding the invested time and staff shortage. CONCLUSIONS: LTC home staff reported a clear understanding of the acceptability and challenges regarding the facilitation of videoconferencing by residents to preserve their contact with family caregivers.

[Problématiques d'accumulation chez les aînés : l'expérience de proches aidants québécois au sein des services communautaires et publics].

Cette recherche qualitative traite de la situation des proches aidants des aînés composant avec une problématique d'accumulation (trouble d'accumulation compulsive, autonégligence, syndrome de Diogène). Il s'agit d'un contexte de la proche aidance qui a été jusqu'à maintenant peu étudié, où les réalités du vieillissement et de la santé mentale sont en interaction. Onze proches aidants et huit intervenants sociaux des régions de la Capitale-Nationale et de Chaudière-Appalaches ont participé à des entretiens semi-dirigés, lesquels ont été soumis à une analyse thématique de contenu. Nos résultats indiquent que malgré l'interaction du vieillissement et de problématiques de santé mentale, ce sont les enjeux liés au vieillissement qui déclenchent le début de la proche aidance, puis le maintien de cet engagement dans la durée. Ils nous montrent aussi que des efforts de concertation et de coordination devraient être déployés afin que les différents acteurs interpellés prévoient des trajectoires de services pour la personne âgée et les proches avant que le problème d'accumulation engendre des enjeux de sécurité importants. Dans ces trajectoires, les organisations sociosanitaires gagneraient à davantage reconnaître les savoirs des proches et à mettre à leur disposition les services requis pour répondre à leurs besoins spécifiques.

Acceptability of videoconferencing to preserve the contact between cognitively impaired long-term care residents and their family caregivers: A mixed-methods study.

Visiting restrictions had to be imposed to prevent the spread of the COVID-19 virus and ensure the safety of long-term care home (LTCH) residents. This mixed method study aimed to explore residents' and family caregivers' acceptability of electronic tablets used to preserve and promote contact. Semi-structured individual interviews with 13 LTCH residents and 13 family caregivers were done to study their experiences, as well as the challenges and resources encountered in the implementation and use of videoconferencing. They had to rate, on a scale from 0 to 10, each of the 6 Theoretical Framework of Acceptability' constructs of the acceptability of the intervention. The results confirm acceptability of videoconferencing, giving residents and caregivers the opportunity to talk to and see each other during the pandemic. Videoconferencing had some benefits, such as being less expensive, and taking less time and effort for family caregivers.

[Hope, Involvement and Commitment: Provider's Perspective on Supporting Persons with Severe Mental Disorder to their Recovery in Long-Term Psychiatric Unit]. / Croire, s'impliquer, s'attacher : perspectives d'intervenants d'unités de longue durée en psychiatrie sur l'expérience d'accompagnement vers le rétablissement.

The aim of this qualitative study is to explore the experience of supporting persons with severe mental disorder to their recovery in long-term psychiatric unit of the Institut universitaire en santé mentale de Québec. Semi-structured interviews were conducted with nine inpatient mental health providers and they answered the Recovery attitude questionnaire (RAQ-7).Results The comments gathered point to three central components of the experience, namely hope, involvement and commitment to the person. The link between those components is, however, not a closed dynamic because contextual, environmental and interpretive factors are also involved including being confronted to inpatient with significant symptoms and the culture of the organization, the provider's attitude toward the concept of recovery and its definition of the concept. Consideration of these factors can promote a successful implementation of favourable modes of intervention in the recovery of users in residential and long-term psychiatric care environments.

[Co-construction of a program to promote community participation among seniors living with psychosocial issues, with or without mental health problems]. / Participe-présent : co-construction d'un programme visant la participation communautaire des aînés qui vivent des difficultés psychosociales.

Objectives A significant proportion of Quebec seniors are living with mental health problems or psychosocial issues such as isolation, bereavement, and psychological distress. These people face many forms of exclusion and are likely to have limited social participation. This paper describes the co-construction steps of a program aimed at promoting community participation among this population.Methods A method for the co-construction of innovative practices in health promotion was used to develop a program that is relevant, rigorous and feasible in diverse settings. The process included several steps, notably: need analysis among seniors and practitioners, development of a logical model for the program, preparation of the leader's manual, validation of the manual by experts, and pilot testing of the program among groups of seniors.Results The goal of the Count me in! program is to promote utilization of the resources of the community that can provide seniors living with mental health conditions or psychosocial issues with activities and positive social contact. The intervention is based on the Strength Model. It includes an individual interview, an eight-meeting workshop, visits to community resources, and collective production of media communication.Conclusion A co-construction process allowed the program to be continuously adjusted in response to stakeholders' feedback. The most important lever for the co-construction was the reconciliation of the partners' practical, conceptual, and experiential expertise. However, contextual factors such as the organization and the availability of mental health services for seniors constituted important barriers to the process.

[Specialized mental health services for the elderly: a pilot study of the evaluation process]. / Services spécialisés en santé mentale pour les personnes de 60 ans et plus. Étude pilote de l'évaluation du processus.

In Quebec, the Centre de santé et services sociaux (CSSS) Cavendish offers specialized services for the elderly with mental health problems (SSSM 60+) (Nour et al., 2011a). This article describes a targeted segment of the population reached (considering the exclusion criteria, only 50% of the elderly receiving services from the SSSM 60+ were followed). The article presents the model of individual changes relating to services, and explores the psychosocial mediators that influence the efficiency of services. This population experiences various psychosocial problems, the most important being mild to moderate symptoms of depression. Services and interventions by the SSSM 60+ team appear to increase significantly the therapeutic alliance and the feeling of empowerment in this clientele. Prioritizing these two concepts during service delivery appears to be an avenue to consider.

[Progress and living situations among the elderly with severe mental illness: perspectives of psychosocial services]. / Cheminements et situations de vie des personnes âgées présentant des troubles mentaux graves : perspectives d'intervenants psychosociaux.

Services for elders with severe mental illness (SMI) have major deficiencies, among them a lack of adequate psychosocial services. Some analysts have attributed this situation to "double stigmatization" targeting both ageing and mental illness in our societies. Using qualitative methods (23 semi-directed interviews, theme-based content analysis), our exploratory research aims to understand better the perceptions of psychosocial practitioners working in community and institutional settings about the elderly with SMI and their living situations. Our informants evoke living situations marked by a lack of support (isolation), of resources (financial precariousness/poverty) and of power (learned passivity), traits that are related not only to mental illness per se, but also to long term psychiatric institutionalization. For them, the current situation of elders with SMI is the end product of biographies in which life-course, illness-course and life in services and/or institutions join and, sometimes, become indistinguishable. Implications for psychosocial practices are discussed.