Care disruptions among the homebound during the COVID-19 pandemic: An analysis of the role of dementia.
Care disruptions among the homebound during the COVID-19 pandemic: An analysis of the role of dementia.
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DOI：
10.1111/jgs.18008
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发表时间：
2022-12
影响因子：
6.3
通讯作者：
Ornstein, Katherine A.
中科院分区：
文献类型：
--
作者：
Reckrey, Jennifer M.;Kim, Patricia S.;Zhao, Duzhi;Zhang, Meng;Xu, Emily;Franzosa, Emily;Ornstein, Katherine A.
住在家里的痴呆症重病患者在危机时期可能特别容易受到护理中断的影响。这项研究试图描述在新冠肺炎大流行期间，纽约市那些接受家庭初级护理的人的护理经历，并比较患有痴呆症和非痴呆症的人的护理经历。我们对2020年3月1日至2020年12月30日期间的所有电子病历记录进行了回顾，样本为以家庭为基础的初级保健接受者(n=228)，包括发生在2020年春季的所有死亡。我们从管理记录中提取数据，并使用包括结构化(例如，记录的新冠肺炎暴露)和非结构化(例如，描述照顾者负担的文本段落)数据的抽象工具，确定了显著的新冠肺炎相关护理体验，并对护理中的主要中断进行了识别和分类。在新冠肺炎大流行期间，痴呆症患者和非痴呆症患者都经历了付费护理、家庭护理和家庭服务的严重中断。虽然痴呆症患者的付费照顾者报告说，与非痴呆症患者相比，家庭初级保健团队的负担更大，但我们发现几乎没有证据表明，与痴呆症状态相关的新冠肺炎相关中断的数量或类型存在差异。虽然痴呆症患者有不同的护理需求，但我们的发现强调，痴呆症可能是严重疾病的更大临床图景中的一部分。为了在危机中支持所有有高度护理需求的患者，我们需要了解临床护理、长期护理和家庭护理支持对老年人的相互依存关系，并将痴呆症放在严重疾病和护理需求的更大背景下看待。
Seriously ill people with dementia living at home may be particularly vulnerable to disruptions in their care during times of crisis. The study sought to describe care experiences of those receiving home-based primary care in New York City during the COVID-19 pandemic and compare the experiences of people with and without dementia. We conducted a retrospective review of all electronic medical record notes between March 1, 2020 and December 30, 2020 among a sample of home-based primary care recipients (n = 228), including all deaths that occurred in the spring of 2020. Drawing from administrative records and using an abstraction tool that included both structured (e.g., documented COVID-19 exposure) and unstructured (e.g., text passage describing caregiver burden) data, we identified salient COVID-19 related care experiences and identified and categorized major disruptions in care. Both people with and without dementia experienced significant disruptions of paid caregiving, family caregiving, and home-based services during the COVID-19 pandemic. While the paid caregivers of people with dementia reported more burden to the home-based primary care team as compared to people without dementia, we found little evidence of differences in quantity or type of COVID-19 related disruptions relative to dementia status. While those with dementia have distinct care needs, our findings emphasize the way that dementia may be one piece of a larger clinical picture of serious illness. In order to support all patients with high care needs in crisis, we need to understand the interdependence of clinical care, long-term care, and family caregiving support for older adults and view dementia within the larger context of serious illness and care need.
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DOI：
10.1016/j.jalz.2017.10.006
发表时间：
2018-01
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
Samus QM;Black BS;Bovenkamp D;Buckley M;Callahan C;Davis K;Gitlin LN;Hodgson N;Johnston D;Kales HC;Karel M;Kenney JJ;Ling SM;Panchal M;Reuland M;Willink A;Lyketsos CG
通讯作者：
Lyketsos CG
DOI：
10.1377/hlthaff.2019.01537
发表时间：
2020-08
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Reckrey JM;Yang M;Kinosian B;Bollens-Lund E;Leff B;Ritchie C;Ornstein K
通讯作者：
Ornstein K
影响因子：
6.3
作者：
Franzosa E;Gorbenko K;Brody AA;Leff B;Ritchie CS;Kinosian B;Ornstein KA;Federman AD
通讯作者：
Federman AD
影响因子：
2.4
作者：
Polacsek, Meg;Goh, Anita;Dow, Briony
通讯作者：
Dow, Briony
影响因子：
6.3
作者：
Edes, Thomas;Kinosian, Bruce;Hossain, Monir
通讯作者：
Hossain, Monir