In the midst of COVID-19, the nation has become increasingly aware of the impact of social isolation on physical, social, spiritual, and psychological health. Older adults, especially those who are nearing the end of life, are already at higher risk of the detrimental effects of social isolation and loneliness. Novel social distancing rules imposed by governments and agencies during the COVID-19 pandemic have caused older adults to experience a degree of social isolation and loneliness that is unprecedented. This article highlights aspects of the social isolation and loneliness literature. Three cases of elderly patients who required medical care during the COVID-19 pandemic are presented. Common themes of factors contributing to social isolation in each of the health care delivery settings are described, and opportunities for creative interventions by health care providers are identified. As the pandemic continues to unfold and evolve, providers should aim to regularly assess patient risk of isolation and be proactive in preventing negative effects. Additionally, what is learned from health care providers' experiences delivering palliative care during a pandemic can be incorporated into daily practice as social isolation and loneliness are long-standing challenges for the elderly population.
As healthcare delivery continues to evolve and expand, nurse educators must prepare advanced practice registered nursing (APRN) students to use telehealth technology safely, effectively, and confidently. The aims of this study were to describe APRN students' beliefs and confidence regarding the delivery of care via telehealth in their future practice. To evaluate these aims, a single group comparison study was conducted. APRN students received an intervention comprised of multimodal telehealth instruction, which involved the simulated application of telehealth with standardized patients. Students' beliefs regarding telehealth did not significantly change between the pre‐ and post‐intervention, in which all areas were rated high pre‐intervention. Students reported an increase in their perception and confidence post‐intervention. Integration of telehealth into the APRN curriculum is essential to instil knowledge and confidence as healthcare technology advances.
Type 2 diabetes mellitus is a major chronic disease worldwide. Over the next decade, the largest increase in diabetes prevalence is expected to be in those > 75 years old. Diabetes self-care and prevention of complications can be challenging, but, when combined with the demands of self-care for other chronic conditions, it can become overwhelming to patients and caregivers. The glycemic targets and treatment options are unique to older adults. Clinicians should treat elderly patients with diabetes based on comorbid conditions, functional status, and life expectancy using a person-centered, team-based approach.
The 3Ds (diversity, disparities, and determinants) that serve as a framework for this supplement are concepts that are key foundations of nursing education, practice, and research. Despite this fact, however, the nursing profession has faced challenges recognizing the full potential of these concepts. While their importance is documented and acknowledged, they are not clearly evident or easily recognized within the nursing profession. In fact, there are many barriers to the integration of these concepts. We identify and address two barriers to addressing health disparities and increasing diversity: disconnects and discrimination. Furthermore, we discuss three factors-dissemination, durability, and data-that may facilitate nursing's efforts to integrate the 3Ds into the profession. Five pivotal models that address these barriers and facilitators are presented as exemplars that have the potential to guide efforts to address diversity, disparities, and social determinants of health and act as catalysts for change within the nursing profession.
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