Caregiving in long-term care before and during the COVID-19 pandemic: a scoping review.

PURPOSE: The COVID-19 pandemic magnified pre-existing socioeconomic, operational, and structural challenges in long-term care across the world. In Canada, the long-term care sector's dependence on caregivers as a supplement to care workers became apparent once restrictive visitation policies were employed. We conducted a scoping review to better understand the associations between caregiving and resident, formal and informal caregiver health in long-term care before and during the COVID-19 pandemic. METHODS: A literature search was performed using MEDLINE, AgeLine, Google Advanced, ArXiv, PROSPERO, and OSF. Pairs of independent reviewers screened titles and abstracts followed by a review of full texts. Studies were included if they reported biological, psychological, or social health outcomes associated with caregiving (or lack thereof). RESULTS: After screening and reviewing 252 records identified by the search strategy, a total of 20 full-text records were eligible and included in this review. According to our results, research on caregiving increased during the pandemic, and researchers noted restrictive visitation policies had an adverse impact on health outcomes for residents and formal and informal caregivers. In comparison, caregiving in long-term care prior to the pandemic, and once visitation policies became less restrictive, led to mostly beneficial health outcomes. CONCLUSION: Caregiver interventions, for the most part, appear to promote better health outcomes for long-term care residents and formal and informal caregivers. Suggestions to better support caregiving in long-term care settings are offered.

Adverse childhood experiences (ACEs), resilience, and outcomes in older adulthood: A scoping review.

BACKGROUND: Previous research has demonstrated a dose-response relationship between exposure to adverse childhood experiences (ACEs) and adverse outcomes in adulthood. Despite widely known associations, previous reviews have primarily focused on outcomes in younger and middle-aged adults exposed to ACEs to the exclusion of older adults and do not consider the potential role of resilience for understanding outcomes in older adulthood. OBJECTIVE: The present scoping review aimed to examine the extent and nature of existing literature on the influence of ACEs and resilience on the cognitive, physical, mental, and social health outcomes among older adults. METHODS: We conducted a search of five electronic databases (CINAHL, MEDLINE, PsycINFO, AgeLine, Scopus) using the following keywords: adversity, resilience, aging, and older adults. We limited our inclusion criteria to works published in English or French after 1998 as Felitti et al. published the first study describing ACEs in this year. RESULTS: Of the 4926 studies screened, 27 studies met the inclusion criteria. Overall, results from the included studies indicated that exposure to adversity during childhood was associated with worse outcomes in older adulthood. Additionally, we found that resilience and resiliency-related factors (e.g., problem-focused coping strategies) mitigated or reduced harms associated with ACEs to improve outcomes in older adulthood. CONCLUSIONS: Exposure to ACEs is associated with reduced functioning in later adulthood. Findings from this review indicate a need for further exploration into the role of ACEs, and the potential effects of resilience, on health outcomes in older adults to develop better individual- and population-level interventions for this group.

Group Psychological Treatment Preferences of Individuals Living With Chronic Disease: Brief Report of a Saskatchewan-Based Cross-Sectional Survey.

Given that individuals with chronic diseases comorbid with psychological distress experience worse clinical outcomes than those without psychological distress, treatment of the psychological sequalae that accompanies chronic diseases is of utmost importance. Thus, the present study aimed to examine group treatment preferences among adults living with chronic disease in Saskatchewan, Canada. An online survey regarding group treatment preferences was administered to 207 participants living with chronic disease comorbid with psychological distress. The most often reported treatment scenario was virtual sessions (45%) lasting 1 h (51%) and occurring every other week (45%) in the evening (63%) for 3 to4 months (40%). Preferences included a medium group (48%), a relatively closed group nature (ie, only occasional new members; 44%), and group leadership including at least 1 professional living with chronic disease (54%). Future-oriented (81%), supportive (83%), skill-based (95%), and group discussions (78%) were desired treatment characteristics among participants. Survey results showed clear preferences on treatment content and session logistics. Slight variations exist by gender and age, but a consensus can be identified and act as a preliminary treatment plan. This study contributes to the body of literature on psychological treatment preferences for individuals living with chronic disease by outlining the preferred format and composition of groups according to those with lived experience. Group-based psychological treatment for chronic disease patients should account for these preferences to improve its acceptability and usefulness among patients.

Designing a virtual course for essential care partners (ECPs) in long-term care (LTC): a pre-implementation study.

Objectives: We describe our co-design process aimed at supporting the reintegration of essential care partners into long-term care homes during the COVID-19 pandemic.Methods: More specifically, using a co-design process, we describe the pre-design, generative, and evaluative phases of developing a virtual infection prevention and control course for essential care partners at our partnering long-term care home. For the evaluative phase, we also provide an overview of our findings from interviews conducted with essential care partners on the expected barriers and facilitators associated with this virtual course.Results: Results from these interviews indicated that the virtual course was viewed as comprehensive, detailed, engaging, refreshing, and reliable, and that its successful implementation would require appropriate resources and support to ensure its sustainability and sustainment. Findings from this study provide guidance for the post-design phase of our co-design process.Conclusion: Our careful documentation of our co-design process also facilitates its replication for other technological interventions and in different healthcare settings. Limitations of the present study and implications for co-designing in the context of emergent public health emergencies are explored in the discussion.