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Background: Relocations within and between nursing homes often induce stress, anxiety, and depression in residents and cause additional workload for and burnout in staff. To prevent this, many nursing homes deploy pre-transition initiatives, bridging initiatives, and post-transition initiatives to support residents and staff during the relocation process. As little is known about these initiatives, this study aims to explore the pre-relocation, bridging and post-relocation initiatives used for relocations within and between nursing homes. Methods: In seven Dutch nursing homes, eight focus groups were conducted with two to six participants (N = 37) who were actively involved in relocation processes in different roles (i.e., managers, healthcare professionals, support staff, client council members, residents and family). The focus groups were conducted based on a predefined topic list and lasted approximately 60 min. The transcripts were recorded, transcribed verbatim and analysed using thematic coding. Results: Nursing homes had to be inventive in developing relocation initiatives as neither shared guidelines nor knowledge exchange on this topic were available. A total of thirty-seven relocation initiatives were identified in these seven nursing homes. Nineteen pre-relocation initiatives were identified, of which eight emphasized information and engagement, three highlighted training and practice and eight stressed orientation and visualization. Seven bridging initiatives were identified, of which four emphasized coordination and continuity and three highlighted entertainment and celebration. Eleven post-relocation initiatives were identified, of which seven emphasized evaluation and troubleshooting and four highlighted change and adjustment. Conclusion: The identified relocation initiatives were developed unassisted by nursing homes, due to a lack of shared guidelines, knowledge exchange and mutual learning on this topic. Therefore, it may be expedient and more effective to develop general guidelines for relocations within and between nursing homes in collaboration with nursing homes. [ABSTRACT FROM AUTHOR]

Background and Objectives: COVID-19 disproportionally affects older adults living in nursing homes. The purpose of this review was to explore and map the scientific literature on the health impact of COVID-19 and related restrictive measures during the first and second wave among nursing home residents. A specific focus was placed on health data collected among nursing home residents themselves.Research Design and Methods: In this study, best practices for scoping reviews were followed. Five databases were systematically searched for peer-reviewed empirical studies published up until December 2020 in which data were collected among nursing home residents. Articles were categorized according to the type of health impact (physical, social and/or psychological) and study focus (impact of COVID-19 virus or related restrictive measures). Findings were presented using a narrative style.Results: Of 60 included studies, 57 examined the physical impact of COVID-19. All of these focused on the direct impact of the COVID-19 virus. These studies often used an observational design and quantitative data collection methods, such as swab testing or reviewing health records. Only three studies examined the psychological impact of COVID-19 of which one study focused on the impact of COVID-19-related restrictive measures. Findings were contradictory; both decreased and improved psychological wellbeing was found during the pandemic compared with before. No studies were found that examined the impact on social wellbeing and one study examined other health-related outcomes, including preference changes of nursing home residents in Advanced Care planning following the pandemic.Discussion and Implications: Studies into the impact of the first and second wave of the COVID-19 pandemic among nursing home residents predominantly focused on the physical impact. Future studies into the psychological and social impact that collect data among residents themselves will provide more insight into their perspectives, such as lived experiences, wishes, needs and possibilities during later phases of the pandemic. These insights can inform policy makers and healthcare professionals in providing person-centered care during the remaining COVID-19 pandemic and in future crisis periods. [ABSTRACT FROM AUTHOR]

Background: A wide range of initiatives on early detection and intervention have been developed to proactively identify problems related to health and wellbeing in (frail) older people, with the aim of supporting them to live independently for as long as possible. Nevertheless, it remains unclear what the best way is to design such initiatives and how older people's needs and preferences can be best addressed. This study aimed to address this gap in the literature by exploring: 1) older people's perspectives on health and living environment in relation to living independently at home; 2) older people's needs and preferences in relation to initiating and receiving care and support; and 3) professionals' views on what would be necessary to enable the alignment of early detection initiatives with older people's own needs and preferences.Methods: In this qualitative study, we conducted semi-structured interviews with 36 older people and 19 professionals in proactive elderly care. Data were analysed using the framework analysis method.Results: From the interviews with older people important themes in relation to health and living environment emerged, such as maintaining independence, appropriate housing, social relationships, a supporting network and a sense of purpose and autonomy. Older people preferred to remain self-sufficient, and they would rather not ask for help for psychological or social problems. However, the interviews also highlighted that they were not always able or willing to anticipate future needs, which can hinder early detection or early intervention. At the same time, professionals indicated that older people tend to over-estimate their self-reliance and therefore advocated for early detection and intervention, including social and psychological issues.Conclusion: Older people have a broad range of needs in different domains of life. Discrepancies exist between older people and professionals with regard to their views on timing and scope of early detection initiatives. This study aimed to reveal starting-points for better alignment between initiatives and older people's needs and preferences. Such starting points may support policy makers and care professionals involved in early detection initiatives to make more informed decisions. [ABSTRACT FROM AUTHOR]

Introduction: In the northwest of the Netherlands, health and social care professionals have sought to structure and coordinate care and support for older people living at home with multiple health and social care needs. The region was selected as one of the case sites of a European project called SUSTAIN, which aimed to facilitate and evaluate improvements to established integrated care initiatives for older people living at home. By participating in the SUSTAIN project, local stakeholders collaborated with researchers to further improve their way of working. This case study describes the process and outcomes of the development and implementation of improvements, as well as the factors that influenced this improvement process. Insight into this process may provide valuable lessons that could be transferable to other integrated care initiatives Methods: Using a participatory approach, guided by the Evidence Integration Triangle (Glasgow, 2012), local stakeholders defined and implemented a tailored intervention aimed at improving collaboration and communication between health and social care professionals. Researchers monitored and evaluated this improvement process. Multiple data sources were used, including the Team Climate Inventory (n=11), interviews with managers and professionals delivering health and social care (n=8), meeting minutes (n=10) and field notes. Results and Discussion: The tailored intervention consisted of regular intervision meetings (i.e. meetings consisting of peer supervision and methodical discussion to reflect on professional development) as well as workplace visits. According to professionals, the intervention resulted in improved communication and collaboration. Facilitating factors included the safe and informal setting in which the meetings took place and the personal relationships that developed during the project. Managers also valued the intervention, although they voiced concerns about the scale and sustainability of the implementation. Issues such as staff shortages, time constraints and privacy regulations made it difficult to implement the intervention on a larger scale. In addition, lack of ownership and accountability among managers and different organizational cultures and interests hindered the improvement process. Still, this bottom-up participatory approach encouraged the development of trust, shared goals and a shared sense of urgency on the level of both managers and professionals. Conclusions: A shared sense of urgency, personal relationships and trust on different organisational levels were important factors facilitating the improvement of an established integrated care initiative in the Netherlands. Lessons Learned: This case study highlights that participatory approaches, in which interventions are co-created and tailored to local priorities and needs, can help in the development of shared goals and trust between stakeholders with competing interests. Limitations: Our study sample is relatively smalldue to the limited number of participating stakeholders. Still, similar patterns were found in the different data sources. In addition, given the relatively short implementation period, we were not able to assess whether the improvement impacted older people's experiences with care and support. Suggestions for further research: Further research may focus on the sustainability of improvements to established integrated care initiatives, and look into possibilities to scale up these improvement activities. [ABSTRACT FROM AUTHOR]