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Too Much Sleep Not Good for Those 80 and Older: Study<p>Too much sleep for people between 80 and 105 years old is tied to higher mortality rates, according to a research paper published in&#160;<em>JAMDA</em>.<br></p><p>While both too much and not enough sleep can have negative ramifications for people of all ages, like obesity, cardiovascular disease, and diabetes mellitus, sleeping too much seems to have a negative impact for the oldest age cohorts, authors said.<br></p><p>While cognitive impairment contributes to higher mortality in this population, the research in “The Role of Cognitive Impairment, Physical Disability, and Chronic Conditions on the Association of Sleep Duration with All-Cause Mortality Among the Very Old” said this is not the only factor.<br></p><p>“A possible explanation is that poor quality of sleep, such as sleep fragmentation, waking after sleep onset, sleep latency, and feelings of fatigue and lethargy after a long sleep may induce sleep extension and decrease resistance to disease,” researchers said. This, in turn, may lead to increased mortality.<br></p><p>The authors collected sleep data on nearly 20,000 Chinese adults between the ages of 80 and 105 for up to 10 years. They uncovered a relationship between longer periods of sleep (more than nine hours per night) and mortality, with a significant relationship between longer sleep and cognitive impairment on mortality.<br></p><p>However, the risk of death did not differ much for people with various physical disabilities and chronic conditions.<br></p><p>“These findings suggest that health practitioners and families should be aware of the potential adverse prognosis associated with long sleep,” the authors said. <br></p><p>While getting a full night’s sleep is important for older adults and can contribute to health and quality of life, poor sleep—whether too much or too little—should be considered a red flag worth reporting to the physician or other practitioner. This is particularly true for older adults with cognitive impairment.<br></p><p>This study was conducted by researchers at the School of Public Health, Tianjin Medical University, Tianjin, P.R. China; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinksa Institute and Stockholm University; and Department of Biostatisticians, School of Public Health, Yale University, New Haven, Conn.​</p>2020-12-01T05:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/senior_nurse_1.jpg" style="BORDER&#58;0px solid;" />CaregivingWhile both too much and not enough sleep can have negative ramifications for people of all ages, like obesity, cardiovascular disease, and diabetes mellitus, sleeping too much seems to have a negative impact for the oldest age cohorts, authors said.
Expert Tips on Preventing COVID Infections During Thanksgiving<p>With the number of COVID-19 cases across the country rising at an alarming rate, resulting in a correlating spike in cases in long term care settings, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) is sharing important advice on how to best stop infections over the Thanksgiving holiday. </p><p>Recent <a href="https&#58;//">data</a> from the Centers for Medicare &amp; Medicaid Services (CMS) show that nursing homes continue to see a record number of weekly new cases, surpassing previous peaks since CMS started tracking nursing home cases. The Midwest region in particular has seen a staggering 275 percent increase since September, ACHA/NCAL said.</p><p>The association said while long term care workers continue to do everything they can to keep their residents safe, they cannot fight the battle alone. With Thanksgiving so close, the public must exercise caution and discipline as they partake in their celebrations.</p><p>David Gifford, MD, chief medical officer for AHCA/NCAL, said, “We understand everyone wants to see their family and friends during the holidays, but we really need to consider our parents and grandparents who are living in our nation’s long term care facilities.”</p><p>He said even though “you may feel fine, more than half of people who have COVID-19 are asymptomatic, and the people you encounter at the Thanksgiving table or out at the grocery store may work in a nursing home or assisted living community. Wearing a mask and practicing physical distancing not only protects you, but it is sign of respect for our elders and our health care heroes who care for them.”</p><p>The Centers for Disease Control and Prevention (CDC) has issued <a href="https&#58;//">guidance</a> around hosting or attending holiday gatherings, including&#58;</p><p>•&#160;Checking the COVID-19 infection rates in areas where attendees live on state, local, territorial, or tribal health department websites.</p><p>•&#160;Limiting the number of attendees as much as possible to allow people from different households to remain at least six feet apart at all times.</p><p>•&#160;Hosting outdoor rather than indoor gatherings as much as possible.</p><p>&#160;•&#160;Avoiding holding gatherings in crowded, poorly ventilated spaces with persons who are not in your household.</p><p>&#160;•&#160;Requiring guests to wear masks.</p><p>&#160;•&#160;Encouraging attendees to wash their hands often with soap and water for at least 20 seconds.</p><p>&#160;•&#160;Provide guests information about any COVID-19 safety guidelines and steps that will be in place at the gathering to prevent the spread of the virus.</p><p>&#160;•&#160;Cleaning and disinfecting commonly touched surfaces and any shared items between use when feasible.<br></p>2020-11-25T05:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/mask_2.jpg" style="BORDER&#58;0px solid;" />COVID-19Patrick ConnoleWhile communities and nursing homes continue to see record numbers of new cases, the public must exercise caution and discipline as they partake in their celebrations.
AHCA, NCAL Chart Record Number of COVID Cases in Nursing Homes<p></p><p>The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) released a <a href="https&#58;//">report</a> showing nursing homes continue to see a record number of weekly new cases this month due to the community spread among the general population, surpassing previous peaks since the Centers for Medicare &amp; Medicaid Services (CMS) started tracking cases in nursing homes.</p><p>Recent data released by Johns Hopkins University and the Centers for Medicare &amp; Medicaid Services (CMS) show that with the recent spike in new COVID cases in the general U.S. population, weekly nursing home cases are also on the rise. </p><p>According to Johns Hopkins University, weekly new COVID cases in the general U.S. population rose by 229 percent to 796,761 new cases the week of Nov. 8. A correlating uptick in new cases in nursing homes occurred when cases in the surrounding community started rising back in mid-September.</p><p>As <a href="https&#58;//">experts</a> have repeatedly said, a high number of COVID-19 cases in a surrounding community is a top factor in outbreaks in nursing homes. Tamara Konetzka, a long term care expert at the University of Chicago, recently <a href="https&#58;//">said,</a> “Trying to protect nursing home residents without controlling community spread is a losing battle.” </p><p>And, Mark Parkinson, president and chief executive officer of AHCA/NCAL said, “Our worst fears have come true as COVID runs rampant among the general population, and long term care facilities are powerless to fully prevent it from entering due to its asymptomatic and pre-symptomatic spread.”</p><p>He added that “Our health care heroes are doing everything they can to prevent it from spreading further, but this level of COVID nationwide puts serious strain on our workforce, supplies, and testing capacity. If everybody would wear a mask and social distance to reduce the level of COVID in the community, we know we would dramatically reduce these rates in long term care facilities.”</p><p>During the second week of November, nearly half (49 percent) of new COVID cases in nursing homes were from Midwest states, with major spikes in community spread in the upper parts of the region. As a result, the Midwest region has seen a 275 percent increase in weekly COVID cases in nursing homes since mid-September.</p><p>After seven weeks of declining cases in nursing homes through mid-September, nursing home cases began to increase as nearly all 50 states have started to see rising levels of COVID cases. New weekly cases in nursing homes grew by more than 110 percent nationwide between mid-September and the week of Nov. 8.</p><p>The report also showed COVID-related deaths in nursing homes are increasing, with a 69 percent jump since late September. </p><p>Residents of long term care facilities account for only 8 percent of the nation’s cases, yet 40 percent of its deaths. While mortality rates have decreased compared with those in the spring due to a better understanding of the virus, better treatments, and government resources to help reduce spread, industry leaders remain deeply concerned that the rising number of new COVID cases in facilities will ultimately lead to an increasing number of deaths.</p><p>“We are especially concerned that this situation will only get worse with Thanksgiving just around the corner,” Parkinson said. “The public must realize that their actions not only endanger our nation’s most vulnerable, but also trigger government lockdowns of facilities, keeping these residents from their loved ones. This is detrimental to their health, well-being, and happiness. We urge everyone to do their part to slow the spread immediately and <a href="/Breaking-News/Pages/CMS-Clarifies-Holiday-Visitation-Via-New-Alert.aspx">exercise caution when celebrating Thanksgiving.”</a></p><p>With rising new COVID cases across the country, Parkinson said Congress must prioritize frontline health care workers and long term care residents during the lame duck session. Last week AHCA/NCAL released a <a href="https&#58;//">list of actions</a> that Congress should urgently take to help nursing homes and assisted living communities respond to the uptick in new cases.</p><p>Most of the $175 billion Provider Relief Fund provided by the CARES Act back in April has already been distributed, and Parkinson said health care providers, including long term care facilities, will need additional funds to continue the response to the COVID pandemic heading into the cold and flu season. The financial aid is crucial in helping long term care facilities acquire personal protective equipment, conduct regular testing, and hire additional staff or reward current caregivers for their heroic efforts, he said.</p><p>“Congress must fulfill its duty,” he said. “Without adequate funding and resources, the U.S. is repeating the same mistakes made during the initial outbreak last spring and the major spike over the summer. We need Congress to prioritize our vulnerable seniors and their caregivers in long term care facilities, by passing another COVID relief package during the lame duck session in Congress.”</p><p>For more information, please visit <a href="https&#58;//"></a><br></p>2020-11-24T05:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/0120_News1.jpg" style="BORDER&#58;0px solid;" />COVID-19Patrick ConnoleLong term care expert says community spread must be controlled in order to keep nursing home residents safe.
CMS Clarifies Holiday Visitation Via New Alert<p>The Centers for Medicare &amp; Medicaid Services (CMS) has released an <a href="https&#58;//">alert </a>regarding holiday visitation in skilled nursing facilities, according to the latest COVID-19 update from the American Health Care Association/National Center for Assisted Living (AHCA/NCAL). </p><p>During the holidays, facilities, residents, and visitors should continue to follow the <a href="https&#58;//">guidelines for visitation </a>and adhere to the core principles of infection prevention, such as remaining six feet or more apart, wearing a face covering at all times, and limiting the number of visitors in the nursing home at any one time, CMS said.</p><p>Families, residents, and providers need to work together to take precautions during the holidays to help reduce the risk of spread while supporting family and resident engagement as much as possible using these core infection prevention practices. </p><p>CMS recommends against residents leaving the nursing home during the public health emergency because it increases the resident’s risk for exposure to COVID-19.</p><p>The risk may be further increased by factors such as a resident’s health status, the spread of COVID-19 in the community (for example, cases or positivity rate), or attendance at large gatherings, the agency said. <a href="https&#58;//">Read more.</a></p><p>In other developments, AHCA/NCAL said it has released an updated 3-Day Stay and Benefit-Period Waivers for Medicare Part A SNF PPS Fact Sheet <a href="https&#58;//">here,</a> as well as the accompanying webinar, <a href="https&#58;//">here.&#160;</a></p><p>Also, the association said there is a COVID-related webinar coming up on the calendar. On Nov. 23, at 2 p.m. (ET), AHCA/NCAL is hosting a discussion on the COVID-19 Monoclonal Antibody. <a href="https&#58;//">Register here.</a></p><p></p>2020-11-20T05:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/mask_5.jpg" style="BORDER&#58;0px solid;" />COVID-19Patrick ConnoleFamilies, residents, and providers need take precautions during the holidays to reduce the risk of spread.



Innovative Training Program Open to Help Caregivers Combat COVID Training Program Open to Help Caregivers Combat COVID<p>​<br></p> <p><img src="/Topics/Guest-Columns/PublishingImages/1120_JaneDavis.jpg" alt="Jane Davis " class="ms-rtePosition-1" style="margin:5px;width:270px;height:347px;" />I had little idea what I was getting into when I agreed to participate in an innovative pilot program to help nursing home administrators and frontline staff combat the spread of COVID-19.</p><p>But I was willing to try almost anything to prevent another wave of sickness, suffering, stress, and uncertainty like the one that hit our facility in April and May.</p><h2>All Are Welcome to Join</h2><p>Now that effort’s gone national. The AHRQ [Agency for Healthcare Research and Quality] ECHO National Nursing Home COVID-19 Action Network launched this month with training centers and nursing homes around the country joining new virtual communities of practice.</p><p>And, after participating in the pilot program, I’ve signed up again, because what the COVID-19 Action Network offers—not only education but mentoring and a peer community—is that valuable right now.</p><p>Working at nursing homes during this pandemic, so many of us feel like we’re carrying the weight of the world on our shoulders, with hardly any support. The stress takes a terrible toll. Even worse, because there’s so much still unknown about this virus, we worry that we’re missing things—things that could help keep our residents safe. </p><h2>Support and Mutual Respect</h2><p>Participating in the COVID-19 Action Network brought me to a new place—a place where I could share my perspective and experiences, where I could learn from the experiences of my peers, where I could hear new ideas and think differently. It was a place of collaboration and mutual respect where I didn’t just passively receive wisdom and best practices from the experts. I contributed my own, and it was valued.</p><p>And, perhaps most of all, it was a place where I felt supported. My staff and I were not alone—far from it. Being in the Network reinforced that we truly are all in this fight together.</p><h2>A Collaborative Approach</h2><p>The Network is led by three organizations: the federal AHRQ, the Institute for Healthcare Improvement (IHI), and Project ECHO. Together, they created the initiative to prevent and reduce COVID-19 in nursing homes—not through regulation or compulsory programs but through voluntary, collaborative learning.</p><p>Here’s how it works: Training centers across the country—mainly academic medical centers or large health systems—run virtual communities of practice on Zoom that are staffed by experts in infection control and gerontology. Staff from up to 35 nursing homes participate in these communities of practice.</p><p>Each Zoom session (there are 16) kicks off with a quick lecture on a topic like Personal Protective Equipment (PPE) use and then moves on to real-life case presentations that spark a lot of hands-on discussion and problem solving.</p><p>Everyone participates in the sessions. Everyone’s experience, observations, and questions are honored and valued. That’s what made it so different. We weren’t just there to learn. We were there to share with each other, and even teach each other—as well as the experts, who wanted to know about our on-the-ground experiences to inform their own perspectives.</p><h2>More Than Worth It</h2><p>After only one or two sessions, I was hooked. I didn’t want to miss a single session because of what I was learning, the support I was receiving, and the relationships I was building. After the 16-session program ended, I found myself missing it.</p><p>People sometimes ask me what it was like when the pandemic peaked this spring. I tell them I never experienced anything like it before and never want to again.</p><p>That’s why I “re-upped.” As a nursing home administrator, I want to do everything in my power to beat this scourge and protect our residents and our staff. I’ve learned that when we come together to learn with and from each other, we can create something powerful: the knowledge and support to move forward and succeed.</p><p>We are not alone—and we shouldn’t be. I urge others to join the COVID-19 Action Network now.</p><p>To learn more about the AHRQ ECHO National Nursing Home COVID-19 Action Network, visit <a href="" target="_blank"></a>. </p><p><em>Jane Davis is administrator for Hyatt Family Facilities at Landmark Care & Rehabilitation in Yakima, Wash. Starting out in assisted living in 1993, Davis has been a licensed nursing home administrator since 1998 with licenses in six states. She has practiced in Washington state, Texas, and South Carolina during her career. She can be reached at </em><a href="" target="_blank"><em></em></a><em>.</em></p>The AHRQ ECHO National Nursing Home COVID-19 Action Network launched this month with training centers and nursing homes around the country joining new virtual communities of practice.2020-11-23T05:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/nurse_computers.jpg" style="BORDER:0px solid;" />Technology;COVID-19Jane Davis


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