The COVID-19 pandemic severely impacted the social health of nursing home residents with dementia due to social isolation. Consequently, the frequency of Behavioral and Psychological Symptoms in Dementia (BPSD) might increase. Technological solutions might help safeguard the social health of nursing home residents with dementia. This study investigates the impacts of the COVID-19 pandemic on clinical outcomes and the availability of social activities and technology to promote social participation in nursing home residents with dementia. The study analyzed cross-sectional data from a follow-up questionnaire nested in a larger national survey of care facilities in Germany. A mixed-methods approach integrated statistical analyses of closed-ended responses and thematic analysis of free-text responses. A total of 417 valid individual responses were received, showing an overall increase in observed BPSD—with anxiety and depression most frequently occurring. Many nursing homes canceled all social activities for residents with dementia, though a few had established procedures to facilitate social participation using technology. Requirements to promote social participation in this population using technology were identified at the micro-, meso-, and macro levels. Technology requirements permeated all three levels. During and beyond the COVID-19 pandemic, technology-driven solutions to promote social health among nursing home residents with dementia should be integrated into caregiving procedures.

The COVID-19 pandemic placed the United States of America (U.S.) under enormous strain, leaving it with higher deaths during the first wave of the outbreak compared to all other advanced economies. Blacks and Hispanics were among those hardest hit by the virus—a fact attributed to enduring problems related to the social determinants of health adversely affecting Communities of Color (CoC). In this study, we ask which distinct factors relating to policy stringency and community vulnerability influenced COVID-19 mortality among Whites, Blacks, and Hispanics during the first year of the pandemic. To address this question, we utilized a mix of correlational and regression analyses. Findings point to the highly divergent impact of public policy and vulnerability on COVID-19 mortality. Specifically, we observed that state-led measures aimed at controlling the spread of the virus only improved mortality for Whites. However, pre-existing social determinants of health (i.e., population density, epidemiological and healthcare system factors) played a significant role in determining COVID-19 outcomes for CoC, even in the face of stringent containment measures by states. This suggests that state-led policy to address present and/or future public health crises need to account for the particular nature of vulnerability affecting Blacks and Hispanics in the U.S.

The COVID-19 pandemic constitutes an exceptional risk to people living and working in nursing homes (NHs). There were numerous cases and deaths among NH residents, especially at the beginning of the pandemic when no vaccines had yet been developed. Besides regional differences, individual NHs showed vast differences in the number of cases and deaths: while in some, nobody was affected, in others, many people were infected or died. We examine the relationship between facility structures and their effect on infections and deaths of NH residents and infections of staff, while considering the influence of COVID-19 prevalence among the general population on the incidence of infection in NHs. Two nationwide German surveys were conducted during the first and second pandemic waves, comprising responses from n = 1067 NHs. Different hurdle models, with an assumed Bernoulli distribution for zero density and a negative binomial distribution for the count density, were fitted. It can be shown that the probability of an outbreak, and the number of cases/deaths among residents and staff, increased with an increasing number of staff and the general spread of the virus. Therefore, reverse isolation of NH residents was an inadequate form of protection, especially at the beginning of the pandemic.

Zusammenfassung: Einleitung: In der COVID-19-Pandemie zählen Pflegebedürftige zu den besonders vulnerablen Bevölkerungsgruppen. Ambulante Pflegedienste befanden sich gerade zu Beginn der Pandemie in einer Ausnahmesituation. In dieser Arbeit sollen die Situation und die Probleme der Pflegedienste und der versorgten Pflegebedürftigen in den ersten beiden Wellen der Pandemie in Deutschland untersucht werden. Methoden: Während der ersten beiden COVID-19-Wellen wurden zwei Querschnittstudien durchgeführt (erste Befragung: 28.04.–12.05.2020, zweite Befragung: 12.01.–07.02.2021). Insgesamt wurden Daten aus N = 1029 ambulanten Pflegediensten in die Analyse einbezogen. Die Analyse erfolgte anhand deskriptiver Maßzahlen. Ergebnisse: Die Klient:innen von Pflegediensten waren in den ersten beiden Wellen der Pandemie stark belastet. Dies zeigt sich einerseits an einem erhöhten Erkrankungsrisiko und einer erhöhten Mortalität und andererseits am Wegfall verschiedener Versorgungs- und Unterstützungsangebote. Letzteres hat z. B. auch negative Auswirkungen auf die psychosoziale Verfassung der Pflegebedürftigen. Die Pflegedienste waren von hohen Personalausfällen und zusätzlicher Arbeit durch Schutzmaßnahmen betroffen. Diskussion: Die COVID-19-Pandemie führte zu großen Belastungen von Pflegebedürftigen und ambulanten Pflegediensten und zu einer Reduzierung der Versorgungsangebote. Die Verschlechterung der Versorgung traf auf eine bereits angespannte Situation. Es zeigt sich, dass die Versorgung Pflegebedürftiger durch ambulante Pflegedienste nicht krisensicher gestaltet ist und dass zusätzliche Herausforderungen wie die einer Pandemie dramatische Folgen haben können. Zukünftig sollte es verlässliche Strukturen und schnell verfügbare Notfallpläne mit konkreten Handlungsanweisungen geben.

Definition of the problem: Obesity is a burgeoning challenge for healthcare systems worldwide. In times of demographic change, it also affects an increasing number of older persons, presenting substantial challenges to delivering health and nursing care in both acute and long-term care (LTC) settings. So far, a detailed analysis of the diverse group of 65+ in this field is missing, particularly in the area of LTC. The needs of neither care recipients, nor those of nurses and institutions are monitored, analyzed, or systematically evaluated. Moreover, ethical implications of professional care for older persons with obesity have not yet been discussed in research and policy. Arguments: We argue that a needs-based approach is appropriate to address these ethical complexities. We further argue that a comprehensive mapping of the ethical terrain is best from an interdisciplinary and mixed methods perspective. For this, we conduct a scoping review to synthesize the state-of-the-art in both the healthcare and LTC settings; and we focus on challenges reported in case studies from professional care settings in European and North American institutions. Conclusion: Our findings point to a lack of research on ethical issues related to the LTC needs of older persons living with obesity and the challenges faced by their professional carers. From the limited number of (case) studies that can be found, however, a series of ethical concerns emerge that have direct import for access, utilization, and quality of care. Accordingly, a new research agenda is needed to inform an ethical approach for policy and practice. It must be rooted in a concern for both care recipients and caregivers in mixed methods studies. Future research should provide criteria for balancing needs, allocating resources and developing practical solutions for people who are confronted with multiple stigma.

Background: Long-term care in Germany lags behind other countries, when it comes to adopting scientific knowledge into daily practice and vice versa. Structures for transferring technological innovations from science into practice or organizational development in nursing homes are missing, although comparable structures in the medical sector exist. Ensuring high-quality care remains one of the key challenges for the future in Germany, which can only be met by creating and implementing such transfer structures in the form of the “Transfer Cluster of Academic Teaching Nursing Homes” in order to make working in long-term care more attractive. Methods: The aim of the Transfer Cluster is (a) implementing three Academic Teaching Nursing Homes in Bremen with (b) a nationwide rollout after nine years. An explanatory sequential mixed-methods design with an embedded quasi-experimental long-term study is used for the evaluation of the “Transfer Cluster of Academic Teaching Nursing Homes” initiative. In three nursing homes, different elements of the Transfer Cluster (e.g., digitalization) will be implemented and evaluated (intervention group). The main outcomes of the summative evaluation are job satisfaction of employees and quality of care of residents. The formative evaluation includes research diaries and focus groups. Results will be compared with three matched nursing homes as a control group. Dissemination material will be developed and a concept for the nationwide rollout will be derived. Discussion: Long-term care faces different challenges in the next years, including the realization and connectivity to research, especially to digitalization and the growing decline in staff. The close exchange with employees of the Academic Teaching Nursing Homes and their management provides important insights into everyday practice and leads to development of innovations which are really needed and therefore more accepted by employees and are tailored to their working conditions. Clear strength of the “Transfer Cluster of Academic Teaching Nursing Homes” initiative is the duration of up to nine years and a nationwide rollout which is thought of from the beginning. A successful nationwide rollout of Academic Teaching Nursing Homes will be a great milestone in nursing science and practice. Trial registration: German Clinical Trials Register DRKS00035292 (Date of registration: December 9, 2024).