Purpose: Through an evolutionary concept analysis, social isolation (SI) was defined as lack of social belonging and engagement with others, minimal number of social contacts, and insufficient quality relationships. This definition represents broader understanding of most contributing factors to SI and supports the concepts of reduced communication and socialization experienced during the COVID-19 pandemic. The COVID-19 pandemic served to heighten this problem, including communication challenges, and brought negative outcomes of SI to light. The overall research question examined the impact of communication challenges and SI on OAs with Alzheimer's disease, related dementias, and subjective cognitive changes (2020-2021). This scoping literature review was developed to compare the psychosocial and mental health of older adults between prepandemic and pandemic lockdown of 2020-2021.Design and Methods: This review followed the procedures for scoping review reporting as stated by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews (PRISMA-ScR). In collaboration with an expert scientific information specialist assigned to the college of nursing, the literature was queried through MEDLINE(R) and Epub Ahead of Print,

Type 2 diabetes mellitus (T2DM) incidence continues to rise in the United States, and T2DM prevalence in Hispanics living in the United States is 16.7% in men and 17.2% in women, compared to 8.6% in non-Hispanic White men and 6.6% in non-Hispanic White women. Among adults ≥ 18 years, 4.9 million Hispanic Americans are diagnosed with T2DM (Centers for Disease Control & Prevention [CDC], 2020). T2DM prevalence among Hispanic older adults (> 65 years) is not specified by the CDC, but this group is disproportionately affected by the micro-and macrovascular complications of T2DM (Beard et al., 2009).T2DM ranked seventh as a leading cause of death in the United States in 2017 (CDC, 2020). For individuals living with T2DM, common complications include kidney disease, visual impairment, peripheral circulatory disease, and functional disability (Beard et al., 2009). In adults diagnosed with T2DM, 12% experience vision disability, and 25% have severe stages (3 and 4) of chronic kidney disease (CDC, 2020). The rate of insulin resistance is higher among Mexican Americans compared to non-Hispanic Whites, and the higher rate of obesity among all Hispanics in the United States contributes to a compounded set of risk factors for T2DM complications (Aguayo-Mazzucato et al., 2019). In the contemporary context of the coronavirus pandemic, obese individuals who were diagnosed with T2DM, pharmacologically managed with insulin, and who contracted COVID-19 had a higher mortality rate (Agarwal et al., 2020).Diabetes-related distress (DRD) is a concept that encompasses the burden of lifestyle changes such as diet modification and carbohydrate reduction, the increased difficulty of obtaining healthier, unprocessed foods, daily needle sticks for blood glucose monitoring, the cost of medications and insulin supplies, and the psychological stress from long-term T2DM complications such as kidney failure and limb amputations. In this article, discrimination is conceptualized as "differential and negative treatment of individuals on the basis of their race, ethnicity, gender or other group membership" (Smedley et al., 2003, p. 95). While evidence supporting the relationship between DRD and adverse diabetes-related health outcomes mounts, there is little attention in the literature to the synergistic impact of discrimination and diabetes-related distress on health outcomes in Hispanic adults with T2DM.An anti-immigration sociopolitical climate and hostility towards immigrants, especially those of Hispanic origin, have increased in recent years (Newman et al., 2018) and have been reflected in poor psycho-and physiological outcomes (Andrade et al., 2021). When viewed in comparison to other ethnic minority groups such as non-Hispanic Black Americans, Hispanic Americans experience more negative effects of perceived discrimination (Paradies et al., 2015). In a study of patient-reported experiences of discrimination in the US healthcare system, it was found that 96% of Hispanic participants experienced discrimination, and Hispanic patients were 1.16 t...

Prevalence of chronic illnesses, including type 2 diabetes (T2DM), is increasing disproportionately among Latinx adults in the United States. Health care inequities such as health care discrimination contribute to the disparities in this population. Academic and clinical nurses must address health care discrimination from a strong theoretical framework. In this article, we integrate the minority stress theory and ecosocial theory of disease distribution to offer a whole-person model that identifies the concepts most relevant to Latinx older adults who function at multiple levels of intersectionality. This paper uses T2DM as an exemplar of chronic illness. The integrated model depicts possible pathways of physiological and psychological embodiment of lived experiences of minoritized older persons managing chronic illness who are living in a society deeply embedded with structural racism and oppression. This model may guide future research aimed at elucidating the social and structural determinants that impact health-related outcomes among Latinx older adults.

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Purpose Describe outcomes of an equity-centered community design (ECCD) project examining the impact of COVID-19 restrictions and social isolation on nursing home (NH) owners, administrators, community leaders, clergy, and urban homeless shelter staff. • Methods 3-phase, ECCD project. Key informants (KI) were recruited through snowball sampling if experienced in caring for older adults (OA) in NH, in the community, or were engaged in spiritual care of OA.• Results Perceptions of fear, anger, frustration, sadness, and concern. Categories of Lost Communication and Socialization Strategies, Lost Freedom, Residents’ Dying Alone and Inability to Pause to Grieve, Helplessness and Hopelessness, Inability to Take Time to Grieve, and Behavior Changes. KI offered New Ways of Communicating, and interventions and solutions were generated in Phase III.• Implications. Understanding of Stakeholder experiences and perceptions is important to achieving inclusive, equity-centered solutions. Future policy decisions must consider what matters most to those most directly impacted by those decisions.