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ICAA Research Review, Volume 21, Issue 01

ICAA Research Review is published monthly for ICAA members. Complimentary issues are sent periodically to people who register.

In this issue

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Stats: 56% of assisted living providers may not make it due to COVID

The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) recently released a survey showing what NCAL executive director Scott Tittle referred to as "the gravity of the situation we are facing with this deadly virus and its impact on our vulnerable community." The organizations are calling on the US congress to provide more funding.

Key survey findings include:

  • 56% of assisted living providers say they won’t make it another year given current operating pace due to increased COVID costs.
  • 55% are currently operating at a loss.
  • PPE and staffing have been the top costs in response to COVID, with nearly 80% of assisted living providers saying PPE was a top cost.
  • 65% said additional staff pay and hiring new staff was a top cost incurred due to COVID.
  • 61% have hired additional staff and 90% have asked current staff to work overtime and provided hero pay.

"Hundreds of facilities are in danger of closing their doors permanently and uprooting the frail seniors they care for," Tittle said.

SOURCE: American Health Care Association/National Center for Assisted Living (December 23. 2020). State of Assisted Living Communities: Facing financial crisis and staffing challenges.

KEYWORDS: Assisted Living, COVID-19, Financial crisis, Staffing
For an infographic of the key findings, click here

Food insecurity rising among US older adults

Food insecurity—or limited access to nutritious foods because of a lack of financial resources—increased significantly among older US adults from 2007 to 2016 and the increase was more pronounced among individuals with lower income. The increase - from 5.5% to 12.4% - was reported in a recent study that drew from data from National Health and Nutrition Examination Surveys. The findings are important for all active-aging providers, but particularly those working in seniors centers and other community-based programs – and especially now, as COVID-19 is likely to have increased the number of low-income older adults.

The survey, which included close to 5,100 adults ages 60 and older, also found that individuals affected by food insecurity also tended to have lower quality diets.

“Our results provide further evidence that food insecurity is a serious health concern among older adults. Continued investment in public health programs and policies are needed to simultaneously improve food security and nutritional intake for older Americans, all of which has become more urgent during the current COVID-19 pandemic,” said co-author Cindy Leung, ScD, MPH, of the University of Michigan, Ann Arbor.

SOURCE: Journal of the American Geriatrics Society (January 5, 20201). Leung CW and Wolfson JA. Food Insecurity Among Older Adults: 10‐Year National Trends and Associations with Diet Quality; https://doi.org/10.1111/jgs.16971

KEYWORDS: Food insecurity, Nutrition, Low income
To read the abstract, click here

Sturdy, not flexible, shoes best for knee pain

A randomized controlled trial found that sturdy supportive shoes improve knee pain on walking and knee-related quality of life compared with flat flexible shoes. This evidence supports recommendations that previously had been based on expert opinion in the absence of data, and overturn the idea that flat flexible shoes that allow more of a “barefoot” experience may provide more benefit. Organizations can use this information to help constituents and staff who report knee pain, and for educational programming around footwear and foot conditions.

Researchers from The University of Melbourne randomly assigned 164 patients with moderate-to-severe knee osteoarthritis (mean age, 65; about 32% men) to wear either sturdy supportive shoes or flat flexible shoes for at least six hours daily for six months to compare pain and the ability to participate in activities, such as walking.

The researchers used standard instruments to measure pain, activity levels, and quality of life at the beginning and end of the study. At six months, they found no evidence that flat flexible shoes were better than sturdy supportive shoes. In fact, those in the stable sturdy shoe group reported greater improvements in pain when walking and knee-related quality of life compared to the flat flexible shoe group.

The authors conclude, “Contrary to our hypothesis, stable supportive shoes improved knee pain on walking more than flat flexible shoes, (providing) the first randomized, controlled trial evidence to suggest that stable supportive shoes may be a useful self-management strategy, (and) supporting clinical practice guideline recommendations.”

SOURCE: Annals of Internal Medicine. Paterson KL, et al (January 11, 2021). The Effect of Flat Flexible Versus Stable Supportive Shoes on Knee Osteoarthritis Symptoms A Randomized Trial; https://doi.org/10.7326/M20-6321

KEYWORDS: Knee pain, Osteoarthritis, Shoes
To read the abstract, click here

Looking ahead boosts wellbeing during COVID lockdowns

Practicing gratitude and looking to the future can help safeguard mental wellbeing during Covid-19 lockdowns, a recent study reveals. The findings point to the direction organizations can take to help boost wellbeing during restrictions.

The researchers investigated the effectiveness of three psychological interventions -- nostalgia, a sentimentality for the past; gratitude, recognizing the good things currently in our life; and best possible self, thinking about positive elements of the future -- and how they each affect wellbeing during lockdowns.

The team worked with 216 participants ages 18-63 assigned to one of four groups, each one practicing either nostalgia, gratitude or best possible self, plus a control group.

Those practicing a nostalgic approach were instructed to think of a sentimental memory in their life that occurred before the lockdown; for gratitude, participants were encouraged to list three things that went well in their day and why; and for best possible self, participants were asked to think about where they imagine themselves in the future after lockdown has lifted. Control group members were asked to recall the plot of a recent television or film they had viewed. Participants were then asked about their thoughts and feelings.

The researchers found that those who participated in the best possible self and gratitude interventions reported higher levels of social connectedness than those who practiced nostalgia. Those in the best possible self group also experienced significantly more positive emotions than those in the nostalgia group.

"The current restrictions and any future lockdowns have removed our sense of control of our lives. For the sake of our wellbeing, we need to acknowledge what we do have rather than regretting what we have lost," said lead study author Amelia Dennis, a postgraduate researcher at the University of Surrey.

SOURCES: University of Surrey, UK (January 5, 2021). Dennis A, et al. Evaluating the impact of a time orientation intervention on well-being during the COVID-19 lockdown: past, present or future? The Journal of Positive Psychology, DOI: 10.1080/17439760.2020.1858335

KEYWORDS: Lockdown, COVID-19, Wellbeing, Gratitude
To read the study, click here

WHO releases latest infection prevention, control guidance

On January 8, 2021, the World Health Organization released an update to its March 8, 2020 guidance on infection prevention and control for long-term care facilities during the pandemic. ICAA CEO Colin Milner was among those who reviewed the guidelines prior to publication. All organizations with assisted living/dementia care communities and similar venues should be familiar with, and make every effort to implement, the latest guidelines, which include the following:

  • updated results from published studies on the epidemiology and extent of SARS-CoV-2 infection among residents and staff in long-term care facilities (LTCFs);
  • the effectiveness of infection prevention and control (IPC) precautions to prevent SARS-CoV-2 transmission in LTCFs;
  • the impact of IPC precautions on mental and physical health and wellbeing of older people, and in particular people with dementia or other mental health or neurological disorders;
  • updated advice on IPC precautions to prevent the spread of SARS-CoV-2 and to protect health workers and caregivers of patients with suspected or confirmed COVID-19 in LTCFs;
  • advice on early detection of and testing for SARS-CoV-2 among residents and staff in LTCFs; and
  • advice on policies for visitors to LTCFs and additional considerations on minimizing the mental and physical health impacts of restrictions and IPC precautions implemented in the context of COVID-19.

WHO notes, "IPC measures may affect the mental and physical health and consequently the well-being of residents and staff –in particular the use of personal protective equipment (PPE) and restrictions of visitors and group activities. Thus, compassionate, respectful, people-centered care should be provided consistently, while ensuring adequate protection of residents, visitors and staff from COVID-19."

SOURCE: World Health Organization (January 8, 2021). Infection prevention and control guidance for long-term care facilities in the context of COVID-19.

KEYWORDS: COVID-19, Infection prevention, SARS-C0V-2, Assisted living
To access the guidance, click here

Tech Talk: Biogen, Apple to tackle cognitive impairment

Biotech company Biogen, in collaboration with Apple, will be launching a study to to identify digital biomarkers to help monitor cognitive performance and health, including potentially detecting mild cognitive impairment, an early indicator of certain forms of dementia such as Alzheimer’s disease As readers are likely to know, cognitive health — the ability to think clearly, to learn and to remember — is an indicator of brain health and important to performing daily activities. This collaborative study is the beginning of a trend that is bound to increase going forward.

The multi-year, observational research study will be launched later in 2021 and will enroll participants, including young and aging adults, with a range of cognitive abilities. The study has been designed with customer privacy, control and transparency in mind as well as data security. Participants, who can stop taking part in the study at any time, will complete a detailed consent form listing the collected data types and how each may be used and shared. Data will be stored in an encrypted manner and in systems with strong security controls designed to protect the data.

“Strategies that optimize brain health and improve cognitive function are the key to reducing the risk of dementia and this study has the potential to discover transformative ways to monitor and assess brain health,” Nora Super, executive director of the Milken Institute Alliance to Improve Dementia Care, said in a statement.

SOURCES: Biogen (January 11, 2021); Mobihealthnews (January 11, 2021). Muo D. Biogen, Apple to launch virtual study on cognitive decline. Mobihealthnews.

KEYWORDS: Cognitive decline, Biogen, Apple, Alzheimer’s disease, Digital health
To read an article that puts the collaboration in context, click here

--reported by Marilynn Larkin

Suggestions? Email mlarkin@icaa.cc


ICAA Research Review shares knowledge and information. The newsletter is not intended to replace a one-on-one relationship with a qualified health care professional and is not medical advice. The ICAA encourages you to make health and business decisions based upon your own research and in partnership with a qualified professional.

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