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

项目总结/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上， 其他自然灾害。2019冠状病毒病紧急情况提供了关键证据，表明需要采取所有危害 这一方法包括对流行病进行更有力的规划。目前，养老院（NH）和援助 生活社区（ALC）面临着COVID-19病毒带来的日益严峻的挑战。关于死亡的报道 提高了130万新罕布什尔州居民将成为受影响最严重的人口的前景。的 对于ALC居民，也认为风险很高，在过去的十年中，这些居民的敏锐度增加了。关键 关注的是老年痴呆症和/或相关痴呆症（ADRD）居民的护理，他们占50%， 的居民和41%的ALC居民。患有ADRD的居民可能面临很大的伤害风险 由于他们可能难以理解安全预防措施（例如保持社交距离）而免受COVID-19感染 以及日常护理中断造成的创伤我们建议补充我们目前的研究， 飓风哈维（得克萨斯州）和厄玛（佛罗里达）通过检查COVID-19的影响和应对 佛罗里达的NHS和ALC之间的紧急情况，重点是ADRD居民。我们的总体目标是 目前的研究，安全港II，是为了了解更多关于飓风对老年人的影响， 住宿照顾。它在所有灾害框架内使灾害规划概念化。中心的 医疗保险和医疗补助服务要求所有美国国家卫生机构制定所有危害的灾难计划，包括 为大流行做好准备。然而，NH和ALC对COVID-19紧急情况的反应表明， 需要指导有关保护居民和工作人员，维护工作人员，并管理压力所造成的 社交距离要求和其他干扰。这一补充建议建立在家长 通过使用为SAFE HAVEN II建立的研究基础设施，包括关系， 与佛罗里达的健康中心和医疗中心联系通过这个补充，我们提出了一个混合方法的方法， 调查和采访NH和ALC管理人员，以更好地了解COVID-19紧急情况的影响 与其他无ADRD的居民相比，其ADRD居民（Aim 1），并定义发病率和 NH和ALC居民的死亡率以及ADRD居民与非ADRD居民的死亡率差异（目标2）。目的 1个结果将用于提供保护居民免受COVID-19影响的关键初步指导， 以产生关于长期护理中病毒的影响和反应的假设。定量数据 通过目标2收集和分析的数据将用于检验这些假设，并确认或完善指导 从定性分析。这些结果与父项目的工作相结合，有可能 大大加强国家卫生机构和地方卫生中心保护和照顾最弱势居民的能力。 结果将为ADRD患者提供有价值的指导， 由于暴露、中断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.