NBER Center for Aging and Health Research-ADRD Care at Nursing Homes During COVID

其他项目信息-项目概要/摘要 COVID-19大流行期间养老院AD/ADRD护理的变化情况 本补充文件探讨了COVID-19大流行对食品的特性、质量和 老年痴呆症或老年痴呆症患者的养老院护理中的种族/民族不平等- 相关性痴呆（AD/ADRD）。在大流行之前存在的许多护理缺陷， 一些设施-人员配备不足，现场缺乏强大的临床医生，过度使用物理和化学（即， 抗精神病药物）限制，频繁转移到医院，高福尔斯率和压力 溃疡-可能因大流行而加剧，因为设施实施了新的感染控制措施 和游客限制，以及处理员工中的COVID保护（和感染），以及恶化 人员短缺。这些影响可能对患有AD/ADRD的疗养院居民特别严重，他们是 特别脆弱，难以保护免受COVID的影响，因为坚持掩蔽，物理距离， 隔离协议对于那些认知和记忆缺陷的人来说更困难。我们先来分析一下 在基线时，在治疗前，影响AD/ADRD居民健康结局的疗养院护理方面 2019冠状病毒病疫情。设施的关键特征包括其人员配备水平、组成和员工的一致性 分配;财务资源和管理;设施布局，基础设施，私人房间的可用性，以及 健康检查和其他质量措施的绩效。AD/ADRD的重要健康结局 住院患者包括住院、死亡、认知功能、情绪和行为问题。二是 分析ADRD住院患者的养老院护理的这些关键方面在治疗期间（和之后）是如何变化的 COVID-19大流行。我们还将研究大流行如何影响先前存在的沿着种族， 在获得和接受高质量的SNF护理方面， AD/ADRD。特别是，我们将研究是否流行驱动的变化，在养老院的运作（例如， 工作人员的水平、工作人员的经验和财务状况）造成了获得服务方面的差距扩大， 质量. NBER老龄化和健康研究中心的母基金支持以下方面的新研究开发： 与老年人健康有关的重要问题。虽然父母补助金并不集中在老年痴呆症上， 疾病，这一补充将增加越来越多的收集中心支持的研究活动，对长期 医疗保健和医疗保健不公平，特别是在认知能力下降的人群中。

OTHER PROJECT INFORMATION – Project Summary/Abstract The Changing Landscape of AD/ADRD Care at Nursing Homes During the COVID-19 Pandemic This supplement examines the long-term impact of the COVID-19 pandemic on the characteristics, quality, and racial/ethnic inequities in nursing home care for individuals with Alzheimer Disease or Alzheimer’s Disease- Related Dementia’s (AD/ADRD). Many of the deficiencies in care delivery that existed prior to the pandemic at some facilities – understaffing, lack of a strong clinician presence onsite, overuse of physical and chemical (i.e., antipsychotic medications) restraints, frequent transfers to the hospital, and high rates of falls and pressure ulcers – may have been compounded by the pandemic, as facilities implemented new infection control practices and visitor restrictions, alongside dealing with COVID protections (and infections) among staff, and worsening staff shortages. These impacts were likely particularly acute for nursing home residents with AD/ADRD, who are especially vulnerable and difficult to protect from COVID, since adherence to masking, physical distancing, and isolation protocols is more difficult for those with cognitive and memory deficits. We will first analyze the key aspects of nursing home care affecting health outcomes for residents with AD/ADRD at baseline, prior to the COVID-19 pandemic. Key features of a facility include its staffing levels, composition, and consistency of staff assignment; financial resources and management; facility layout, infrastructure, availability of private rooms, and performance on health inspections and other quality measures. Important health outcomes for AD/ADRD residents include hospitalizations, mortality, cognitive function, mood, and behavioral issues. Second, we will analyze how these same key aspects of nursing home care for residents with ADRD changed during (and after) the COVID-19 pandemic. We will also examine how the pandemic affected pre-existing disparities along racial, ethnic, and socioeconomic dimensions in access to and receipt of high-quality SNF care for individuals with AD/ADRD. In particular, we will examine whether pandemic driven changes in nursing home functioning (e.g., staffing levels, staffing experience, and financial health) have contributed to widening disparities in access and quality. The parent grant, NBER Center for Aging and Health Research, supports new research development on important questions relating to health at older ages. While the parent grant is not focused on Alzheimer's Disease, this supplement would add to a growing collection of Center-supported research activity on long-term care, and health care inequities, particularly among those with cognitive decline.