Vipperman Andrew, Zimmerman Sheryl, Sloane Philip D
School of Medicine, University of Virginia, Charlottesville, VA, USA.
Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, USA; Schools of Social Work and Public Health, University of North Carolina, Chapel Hill, NC, USA.
J Am Med Dir Assoc. 2021 May;22(5):933-938.e5. doi: 10.1016/j.jamda.2021.02.021. Epub 2021 Feb 25.
Assisted living (AL) emerged over 2 decades ago as a preferred residential care option for older adults who require supportive care; however, as resident acuity increased, concern has been expressed whether AL sufficiently addresses health care needs. COVID-19 amplified those concerns, and an examination of recommendations to manage COVID-19 may shed light on the future of AL. This review summarizes recommendations from 6 key organizations related to preparation for and response to COVID-19 in AL in relation to resident health and quality of life; compares recommendations for AL with those for nursing homes (NHs); and assesses implications for the future of AL.
Nonsystematic review involving search of gray literature.
Recommendations from key governmental bodies and professional societies regarding COVID-19 in AL, long-term care facilities (LTCFs) in general, and NHs.
We collected, categorized, and summarized these recommendations as they pertained to quality of life and health care.
Many recommendations for AL and NHs were similar, but differences provided insight into ways the pandemic was recognized and challenged AL communities in particular: recommending more flexible visitation and group activities for AL, providing screening by AL staff or an outside provider, and suggesting that AL staff access resources to facilitate advance care planning discussions. Recommendations were that AL integrate health care into offered services, including working with consulting clinicians who know both the residents and the LTC community.
Long-term care providers and policy makers have recognized the need to modify current long-term care options. Because COVID-19 recommendations suggest AL communities would benefit from the services and expertise of social workers, licensed nurses, and physicians, it may accelerate the integration and closer coordination of psychosocial and medical care into AL. Future research should investigate different models of integrated, interdisciplinary health care in AL.
辅助生活（AL）在20多年前出现，成为需要支持性护理的老年人首选的居住护理选择；然而，随着居民护理需求的增加，有人担心辅助生活是否足以满足医疗保健需求。新冠疫情加剧了这些担忧，审视应对新冠疫情的建议可能会为辅助生活的未来发展带来启示。本综述总结了6个主要组织提出的与辅助生活机构应对新冠疫情相关的建议，这些建议涉及居民健康和生活质量；将辅助生活机构的建议与养老院（NHs）的建议进行比较；并评估其对辅助生活未来发展的影响。
涉及灰色文献检索的非系统性综述。
主要政府机构和专业协会针对辅助生活机构、一般长期护理机构（LTCFs）和养老院中的新冠疫情提出的建议。
我们收集、分类并总结了这些与生活质量和医疗保健相关的建议。
许多针对辅助生活机构和养老院的建议是相似的，但差异揭示了疫情的认知方式，特别是对辅助生活社区的挑战：建议辅助生活机构提供更灵活的探访和集体活动，由机构工作人员或外部供应商进行筛查，并建议辅助生活机构的工作人员获取资源以促进提前护理规划讨论。建议辅助生活机构将医疗保健纳入所提供的服务中，包括与了解居民和长期护理社区的咨询临床医生合作。
长期护理提供者和政策制定者已经认识到需要调整当前的长期护理选择。由于新冠疫情相关建议表明，辅助生活社区将从社会工作者、执业护士和医生的服务及专业知识中受益，这可能会加速心理社会护理和医疗护理在辅助生活中的整合及更紧密协调。未来的研究应调查辅助生活中综合、跨学科医疗保健的不同模式。
