Effect of Covid-19 on Caregivers of Persons with Dementia

美国及其医疗保健系统正在经历一场前所未有的危机， 2019冠状病毒病大流行正在对残疾人、他们的家庭照顾者以及 支持他们的前线专业人员。在许多社区，新冠肺炎的死亡率- 19不成比例地涉及老年人和残疾人，特别是那些生活在辅助生活中的人 设施和疗养院。这些设施中的卫生工作者， 在家中，也有感染、发病甚至死亡的危险。感染控制指南和 特派团关闭了机构接触来访者机会，并制定了审查程序， 进一步隔离PWD。缺乏结构化活动、就地避难、护理人员压力源 就业、财务和风险缓解等方面的问题都有可能加剧行为风险， PWD的问题。大流行病的性质也需要作出紧急、实时的决定， 面对一种不断演变的高度传染性传染病， 不可预测的急剧下降，而且没有治愈或疫苗。 具体目标： 这项研究的目的是让家庭和专业（CNAs，LPNs，RNs）照顾者参与其中， 整个护理体系中的残疾人（疗养院、辅助生活设施和社区） 为研究COVID-19对残疾人士及其照顾者的健康和福祉的影响， 护理经验以及COVID-19对患者行为和工作/家庭的影响 关系。通过一项混合方法研究，涉及600名正式和非正式的照顾者， 对于居于社区、辅助生活设施及护养院的残疾人士，我们会 通过以下目标实现这一目标： 目标1：描述护理人员在COVID-19大流行期间的生活经历 目标2：研究COVID-19相关因素（包括隔离、隔离等）有 影响照顾者的压力。 目的3：探索COVD-19相关因素的作用（即，PPE，看护者压力）对行为的影响 PWD的变化和严重程度。 目标4：评估COVID-19对护理人员规划和医疗保健决策的影响

The US and its healthcare systems are experiencing an unprecedented crisis through the COVID-19 pandemic that is having a major impact on PWD, their family caregivers, and the front- line professional staff who support them. In many communities, death rates from COVID- 19 disproportionately involve older adults and PWD, especially those living in assisted living facilities and nursing homes. Health workers in these facilities, and caring for older adults at home, are also at risk of infection, morbidity and even mortality.Infection control guidelines and mandates have shut down institutional access to visitors and instituted quarantining procedures that further isolate PWD. Lack of structured activities, sheltering in place, caregiver stressors around employment, finances, and risk mitigation all have the potential to exacerbate behavioral issues in PWD. The nature of the pandemic also creates the need for urgent, real-time decision- making, in the face of an evolving infectious disease that is highly communicable, leads to unpredictable and precipitous declines and for which there is no cure or vaccine. Specific Aims: The goal of this study is to engage family and professional (CNAs,LPNs, RNs) caregivers of PWD across the care continuum (nursing homes, assisted living facilities, and in the community) to study the impact of COVID-19 on the health and well-being of PWD and their caregivers, the caregiving experience and the impact of COVID-19 on patient behaviors and work/family relationships. Through a mixed-methods study involving 600 formal and informal caregivers of PWD residing in the community, in assisted living facilities (ALF) and nursing homes, we will accomplish this goal through the following aims: Aim 1: Describe the caregiver lived experience during the COVID-19 pandemic Aim 2: Examine how COVID-19 related factors (including quarantining, isolation, etc.) have affected caregiver stress. Aim 3: Explore the role of COVD-19 related factors (i.e., PPE, caregiver stress) on behavior changes and severity in PWD. Aim 4: Assess the impact of COVID-19 on caregiver planning and health care decision-making