COVID-19 Supplement to Strategic Approach to Facilitating Evacuation by Health Assessment of Vulnerable Elderly in Nursing Homes II (SAFE HAVEN II)

项目摘要/摘要 许多关于灾害对老年人影响的研究都集中在天气事件和 其他自然灾害。新冠肺炎紧急事件提供了关键证据，证明需要全方位的危害 这种方法包括对流行病进行更有力的规划。目前，养老院(NHS)和 生活社区(ALC)面临着来自新冠肺炎病毒的日益严峻的挑战。有关NH死亡的报告 增加了130万NH居民将是受影响最严重的人口的可能性。这个 ALC居民的风险也被认为很高，他们的敏锐度在过去十年里有所提高。危急关头 令人担忧的是对阿尔茨海默病和/或相关痴呆症(ADRD)的居民的护理，他们占50% NH居民和ALC居民分别为41%和41%。患有ADRD的居民可能面临极大的伤害风险 来自新冠肺炎，因为他们可能了解安全预防措施(例如，社交距离) 以及日常护理中断带来的创伤。我们建议补充我们目前的研究，以了解 通过检查新冠肺炎的影响和响应，应对飓风哈维(德克萨斯州)和伊尔玛(佛罗里达州) 佛罗里达州NHS和ALCS的紧急情况，重点是患有ADRD的居民。我们的总体目标是 目前的研究，避风港II，是为了更多地了解飓风对老年人的影响 住院式护理。它将灾害规划概念化于所有危害的框架内。城市发展中心 联邦医疗保险和医疗补助服务要求所有美国国民健康保险制度制定全面的灾难计划，包括 为大流行做好准备。然而，NH和ALC对新冠肺炎紧急情况的反应表明， 需要关于保护居民和工作人员、维持工作人员和管理因以下原因造成的压力的指导 社交距离要求和其他干扰。这项补充建议建立在父母的基础上 利用为避风港二号建立的研究基础设施，包括关系 与佛罗里达州的NHS和ALCS合作。通过本补充，我们提出了一种混合方法方法来 调查和采访NH和ALC管理人员，以更好地了解新冠肺炎紧急事件的影响 将其ADRD居民与其他未患ADRD的居民进行比较(Aim1)，并确定其发病率和 NH和ALC居民的死亡率以及患有ADRD的居民和没有ADRD的居民之间的差异(目标2)。目标 1个结果将用于提供保护居民免受新冠肺炎攻击的关键初始指导，此外 以产生关于长期护理中病毒的影响和反应的假设。量化数据 通过AIM 2收集和分析的数据将用于检验这些假设，并确认或改进指导 从定性分析上看。这些结果与父项目的工作相结合，有可能 大大加强NHS和ALCS保护和照顾最脆弱居民的能力。 研究结果将为患有ADRD的居民提供有价值的指导，这些居民在 由于暴露、干扰和隔离而导致的大流行。

PROJECT SUMMARY/ABSTRACT Much of the research concerning the effect of disasters on older adults has focused on weather events and other natural disasters. The COVID-19 emergency provides critical evidence of the need for an all-hazards approach that includes more robust planning for pandemics. Currently, nursing homes (NHs) and assisted living communities (ALCs) face a mounting challenge from the COVID-19 virus. The reports of NH deaths raise the prospect that the 1.3 million NH residents will be among the most severely affected population. The risk is also believed to be high for ALC residents, where acuity has increased in the past decade. Of critical concern is the care of residents with Alzheimer's disease and/or related dementias (ADRD), who make up 50% of NH residents and 41% of ALC residents. Residents living with ADRD are potentially at great risk of harm from COVID-19 because of difficulty they may have understanding safety precautions (e.g. social distancing) and the trauma of usual care disruptions. We propose to supplement our current research into the effects of Hurricanes Harvey (Texas) and Irma (Florida) by examining the effect of and response to the COVID-19 emergency among NHs and ALCs in Florida, with a focus on residents with ADRD. The overall goal of our current research, SAFE HAVEN II, is to understand more about the effect of hurricanes on older adults in residential care. It conceptualizes disaster planning within the all-hazards framework. The Centers for Medicare and Medicaid Services requires all US NHs to develop all-hazards disaster plans that include preparedness for a pandemic. However, NH and ALC responses to the COVID-19 emergency suggest a great need for guidance concerning protecting residents and staff, maintaining staff, and managing stress caused by social distancing requirements and other disruptions. This supplement proposal builds on the parent application by employing the research infrastructure established for SAFE HAVEN II, including relationships with NHs and ALCs across Florida. Through this supplement, we propose a mixed methods approach to survey and interview NH and ALC administrators to better understand the impact of the COVID-19 emergency on their ADRD residents compared to other residents without ADRD (Aim1), and to define the morbidity and mortality of NH and ALC residents and how this varies for residents with ADRD vs. those without (Aim 2). Aim 1 results will be used to provide critical initial guidance on protecting residents from COVID-19 and additionally to generate hypotheses concerning the effect of and response to the virus in long-term care. Quantitative data collected and analyzed through Aim 2 will be used to test these hypotheses and confirm or refine guidance from the qualitative analysis. These results, combined with work from the parent project, have the potential to substantially strengthen the ability of NHs and ALCs to protect and care for their most vulnerable residents. Results will provide valuable guidance concerning residents with ADRD, potentially at greater risk of harm in a pandemic due to exposure, disruptions, and isolation.