A study reveals a surge in the deaths of assisted residents during the COVID-19 pandemic

Rhode Island Providence [Brown University] — Although considerable attention has been paid to COVID-19 deaths in elderly housing with care, public health leaders do not fully understand the effects of the virus in long-term care communities. While these environments are also home to the elderly, who are often at high risk of illness, they are importantly different from elderly housing with care and pose a greater challenge for data collectors.

To address this gap in COVID-19 data, researchers at Brown University and the University of North Carolina conducted what they said was the first national survey on COVID-related mortality in the US-supported living community. Did.Their results announced in JAMA network open, Showed that the number of deaths in these situations was significantly higher in 2020 than in 2019.

“Our research emphasizes the importance of understanding the unique challenges facing the living support community during pandemics and other emergencies,” said Kali Thomas, associate professor at the Browns School of Public Health. The professor says. “When responding to a pandemic, supported living communities need their own preparatory plans. The guidance provided to special needs nursing homes needs to be tailored specifically to this population.”

According to Thomas, one of the key differences between the Assisted Living community and long-term care facilities is that it is based on social models of care rather than medical models. Communities are designed to resemble a home-like environment, and residents can often come and go as they please and accept visitors, which can increase the risk of viral infection.

Also, because social models emphasize choice and independence, residents and their families may usually be expected to schedule and access their own medical supplies and even purchase their own medical supplies.

“Access to PPEs such as masks, gowns and gloves is not as common as living in a long-term care facility,” said Thomas.

In addition to these differences, she said that unlike nursing homes, which are often charged for Medicare and Medicaid, the care of the Assisted Living community is usually paid at their own expense, so it is more stringent. Must obey the federal regulations. the study According to Thomas co-authored, Elderly Housing with Care has federally regulated infection prevention and control guidelines and annual surveys of compliance, but state regulations for long-term care communities provide details, requirements, and support. It turns out that the levels of life-supporting housing are very different and can be confusing. The payment structure of life-supporting homes also makes it difficult to track mortality.

To investigate the impact of COVID-19 on this population, researchers conducted a retrospective cohort study using data from the Medicare and Medicaid Service Centers from 2018 to 2020. I live in a licensed living support facility with more than 25 beds in 49 states and the District of Columbia. They also analyzed data from the 10 states with the highest cases of COVID-19 (as of August 11, 2020).

According to the survey, the mortality rate of residents of nursing homes was 17% higher than the previous year in 2020, and the 10 states with the largest COVID-19 community during the January-August 2020 survey period Mortality rate increased by 24%. According to the authors, the results are consistent with the observed increase among long-term care residents, suggesting that long-term care residents experienced an increase in mortality during the COVID-19 pandemic. ..

Researchers have found that the observed increase in resident mortality is an overall increase during the pandemic, given the end date of the study, which does not include the delay in data availability and the surge since August 2020. He said he was likely to underestimate the over-mortality rate.

Co-authored by Thomas in March 2020 STAT News Opinion Piece It explains some of the unique risks COVID-19 poses to the supportive life community and provides supporters and policy makers with steps to mitigate the widespread and catastrophic effects of the virus. I asked you to take it.

“Data from our new study suggests that many of our concerns are valid and likely contributed to these mortality displacements,” said Thomas.

This study was funded by an existing National Institute on Aging grant. This allowed the same team to study how COVID-19 affects individuals living with dementia differently. This is a significant population to watch, as 40% to 60% of caregivers have dementia, Thomas said.

Wenhan Zhang and David M. Dosa of Brown University, Philip Sloane and Sheryl Zimmerman of the University of North Carolina at Chapel Hill, and Paula Carder of the Portland State University Institute for Aging also contributed to the study.The study was nominated as follows Best abstract The theme is aging, disability, and end of life with AcademyHeath.