The COVID-19 pandemic has had a devastating effect on long-term care facilities across the country, with residents in nursing homes and other long-term care settings accounting for up to one-half of the reported deaths nationwide. Yet, UNC researchers say this latest virus and what they hope to learn from two new studies could help to strengthen industry policies and procedures to ensure that older residents receive the care they need and deserve.
Both studies were recently awarded a combined total of more than $700,000 from the National Institute of Health. They will focus on residential long-term care in nursing homes, assisted living communities, and community-based long-term care where older adults, especially those with chronic health conditions such as heart disease and diabetes, are often most at-risk for infection. UNC School of Social Work distinguished professor Sheryl Zimmerman will be among the team of researchers directing the studies.
In the first investigation, Zimmerman and other researchers from UNC, Brown University, and Portland State University will examine COVID-19 prevention, outbreaks, responses, and experiences in 250 assisted living communities across seven states: Arkansas, Louisiana, New Jersey, New York, Oklahoma, Pennsylvania, and Texas.
In the second study, Zimmerman and colleagues from the UNC Cecil G. Sheps Center for Health Services Research and the UNC School of Medicine plan to focus on North Carolina. Specifically, the team will examine and compare COVID-19 prevention, outbreaks, responses, and experiences in 36 nursing homes, assisted living communities, and community-based programs known as PACE, which provide all-inclusive care to the elderly. These programs enable older adults who qualify for nursing homes to remain at home or within their preferred communities. Funding for this project is through NC TraCS and includes community partners representing all three settings.
Research has shown that long-term care has faced numerous challenges long before the pandemic. Further, poor health outcomes among residents have been attributed to a number of factors, Zimmerman noted, including understaffing, insufficient financing, and the percentage of residents with dementia.
Although these factors, coupled with the effects of a pandemic, have deepened the crisis for improved care, there is also the potential to shift care in a positive direction, she said.
“Despite committed workers, disparities in care and poor outcomes still exist,” Zimmerman said. “We’ve needed an impetus to truly change policy and funding so that all older adults receive the care and support they need in settings in which they want to live . For better or for worse, COVID may well be that impetus. The evidence that we compile will help inform and promote those changes.”
Impact of COVID-19 on services for victims of violence
UNC School of Social Work researchers were also recently awarded $25,000 from the NC TraCS COVID-19 Pilot Grant awards for a study that will explore how the current global pandemic is affecting access to and delivery of services for victims of intimate partner violence (IPV), sexual violence and assault (SVA), and human trafficking (HT).
Although measures such as sheltering in place and social distancing were intended to help reduce the spread of the virus, these rules have also created unintended consequences for victims of violence, including closer contact with individuals who continue to harm them, increased economic stress, and limited access to critical health and safety resources.
Through their study, the School’s research team plans to further examine these repercussions and how to better ensure that victims of violence still have access to critical services during public health emergencies.
“COVID-19 has interrupted delivery of critical IPV, SVA, and HT services in a time of global crisis when the risk of violence victimization may be exacerbated,” said assistant professor Cynthia Fraga Rizo, one of the study’s researchers.
With those challenges in mind, the study will focus on developing guidelines for maintaining services for victims of violence through current and resurgent waves of COVID-19, as well as through other public health emergencies, added clinical associate professor Tonya B. Van Deinse, another of the study’s researchers.
Distinguished professor Rebecca J. Macy, post-doctoral scholar Jeongsuk Kim, and faculty research associate Christopher J. Wretman are collaborating with Van Deinse and Fraga Rizo on this study.
Long-term, the research team intends to use their findings to pursue additional external funding for a larger national study.