Nursing Home Environments and COVID Related Outcomes for Persons with Dementia

SUMMARY PA-20-272 provides for administrative supplements for costs that were unforeseen when the original grant was submitted. The impact of COVID-19 on nursing home residents across North American was not anticipated, but has been unprecedented. The safety measures necessary to prevent or reduce infections (e.g. social distancing, isolation, judicious use of personal protective equipment) require a strong understanding of the reasons for such measures as well as factors affecting compliance. Residents who are experiencing memory loss may not possess the capacity to independently engage in these practices and may be highly confused by them. In addition, these protocols have created additional challenges for many providers as they work to also support quality-of-life for their residents. Emerging evidence is suggesting that the nursing home setting, its scale, mechanical systems design and operational practices may be significant factors in reducing infection rates. This project "Nursing Home Environments and COVID Related Outcomes for Persons with Dementia" will supplement the existing research initiative, "Validation of the Environmental Audit Scoring Evaluation (EASE) Tool", to collect additional data to determine if residents experiencing dementia differed in their infection rates based on the scale and several additional design features of their living areas as well as the operational practices for staffing these living areas. Using a sample of 15 nursing homes that are all moderate to deep adopters of person-centered care and which are stratified to reflect three distinct design styles (traditional/institutional, partial household/neighborhood, and full household model), three living areas within each location will be evaluated based on the living area type, consistency of staffing, differences in rates of COVID by private versus shared bedrooms, and description of HVAC zoning to provide preliminary information about the associations between living environment and COVID-19 rates.