Psychosocial intervention makes a vital contribution to dementia care. However, the lack of consensus about which outcome measures to use to evaluate effectiveness prevents meaningful comparisons between different studies and interventions. This study used an iterative collaborative, evidence-based approach to identify the best of currently available outcome measures for European psychosocial intervention research. This included consensus workshops, a web-based pan-European consultation and a systematic literature review and a rigorous evaluation against agreed criteria looking at utility across Europe, feasibility and psychometric properties. For people with dementia the measures covered the domains of quality of life, mood, global function, behaviour and daily living skills. Family carer domains included mood and burden, which incorporated coping with behaviour and quality of life. The only specific staff domain identified was morale, but this included satisfaction and coping with behaviour. In conclusion twenty-two measures across nine domains were recommended in order to improve the comparability of intervention studies in Europe. Areas were identified where improved outcome measures for psychosocial intervention research studies are required.

Objective: The vaccination of skilled nursing facility (SNF) staff is a critical component in the battle against COVID-19. Together, residents and staff constitute the single most vulnerable population in the pandemic. The health of these workers is completely entangled with the health of those they care for. Vaccination of SNF staff is key to increasing uptake of the vaccine, reducing health disparities, and reopening SNFs to visitors. Yet, as the vaccine rollout begins, some SNF staff are declining to be vaccinated. The purpose of this article is to describe reasons for COVID-19 vaccine hesitancy reported by staff of skilled nursing facilities and understand factors that could potentially reduce hesitancy. Design: Five virtual focus groups were conducted with staff of SNFs as part of a larger project to improve vaccine uptake. Setting and Participants: Focus groups with 58 staff members were conducted virtually using Zoom. Measures: Focus groups sought to elicit concerns, perspectives, and experiences related to COVID-19 testing and vaccination. Results: Our findings indicate that some SNF staff are hesitant to receive the COVID-19 vaccine. Reasons for this hesitancy include beliefs that the vaccine has been developed too fast and without sufficient testing; personal fears about pre-existing medical conditions, and more general distrust of the government. Conclusions and Implications: SNF staff indicate that seeing people like themselves receive the vaccination is more important than seeing public figures. We discuss the vaccination effort as a social enterprise and the need to develop long-term care provider-academic-community partnerships in response to COVID-19 and in expectation of future pandemics.Ó 2021 AMDA e The Society for Post-Acute and Long-Term Care Medicine.Coronavirus (COVID-19) has disproportionately affected skilled nursing facility (SNF) residents and staff in the United States, with the highest rates of infection and mortality in both groups. 1 Since the pandemic began, approximately 40% of all US coronavirus fatalities are in SNFs or similar long-term care facilities. One month before COVID-19 vaccine distribution began in the United States, an estimated 100,000 residents and staff at long-term care facilities had died with the virus, 2 likely an undercount. Despite efforts to control virus spread by locking down facilities and restricting access to outside visitors, 3 COVID-19 outbreaks in SNFs persist, largely due to unintentional asymptomatic transmission from exposed SNF staff who live in the larger community. 4,5 Vaccination of these workers is critical for several reasons. First, the vaccine protects staff personally and against compounding existing health disparities. SNF staff are often disadvantaged. Nursing assistants comprise 53% of the SNF workforce. More than 90% are women, 49% black or Latino, 44% live in low-income households, and 36% are uninsured or on public health care. 6 Thus, nursing assistants are among the most vulnerable groups at risk of contracting COVID-19 in the co...

Close to 6 million Americans have Alzheimer's disease (AD) or Alzheimer's disease and related dementia (AD/ADRD). These high-need, high-cost patients are vulnerable to receiving poor quality uncoordinated care, ultimately leading to adverse health outcomes, poor quality of life, and misuse of resources. Improving the care of persons living with dementia (PLWD) and their caregivers is an urgent public health challenge that must be informed by high-quality evidence. Although prior research has elucidated opportunities to improve AD/ADRD care, the adoption of promising interventions has been stymied by the lack of research evaluating their effectiveness when implemented under real-world conditions. Embedded pragmatic clinical trials (ePCTs) in healthcare systems have the potential to accelerate the translation of evidence-based interventions into clinical practice. Building from the foundation of the National Institutes of Healthcare Systems Collaboratory, in September 2019 the National Institute on Aging Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) Collaboratory was launched. Its mission is to build the nation's capacity to conduct ePCTs within healthcare systems for PLWD and their caregivers by (1) developing and disseminating best practice research methods, (2) supporting the design and conduct of ePCTs including pilot studies, (3) building investigator capacity through training and knowledge generation, (4) catalyzing collaboration among stakeholders, and (5) ensuring the research includes culturally tailored interventions for people from diverse backgrounds. This report presents the rationale, structure, key activities, and markers of success for the overall NIA IMPACT Collaboratory. The articles that follow in this special Issue describe the specific work of its 10 core working groups and teams.

Purpose With increased focus on resident‐centered care (RCC) as an organizational imperative and a guiding principle of culture change for long‐term care communities, evaluation of its success has centered primarily on the organizational perspective. Methods For this case report, we examine resident perspectives of RCC in 10 nursing homes across the United States that had adopted RCC as a philosophy and model of care for at least 12 months with a maximum engagement of 3 years using a phenomenological approach. Findings Qualitative findings from 20 focus groups with residents in 10 nursing homes suggest that RCC has meaning in ways that are consistent with intentions at the national and state levels to advance culture change in nursing homes, including efforts to create a more homelike environment, increase resident decision making and direction of his or her lifestyle, and put residents first. Clinical Relevance Residents attribute increased choice in wake and bed times, being heard by organizational leaders, and consistent staff assignment as positive changes since RCC began. However, according to residents, aspects of institutional life in nursing homes, inconsistent with RCC, remain. Residents identified three areas of improvement that would make nursing homes more resident centered. The three areas are response time, access to nature, and transparency about illness and death in the community.