Background The COVID‐19 pandemic has significant impact on long‐term care (LTC) residents’ health and well‐being. Objectives This study investigated resident experiences of loneliness during the COVID‐19 pandemic in Canadian LTC homes to offer lessons learned and implications. Methods 15 residents and 16 staff members were recruited from two large urban Canadian LTC homes with large outbreaks and fatalities. We used a telepresence robot to conduct one‐on‐one semi‐structured interviews with participants remotely. We applied the Collaborative Action Research (CAR) methodology and report the early phase of CAR focused on collecting data and reporting findings to inform actions for change. Thematic analysis was performed to identify themes. Results Four themes were identified. The first two themes characterise what commonly generated feelings of loneliness amongst residents, including (1) social isolation and missing their family and friends and (2) feeling hopeless and grieving for lives lost. The second two themes describe what helped residents alleviate loneliness, including (3) social support and (4) creating opportunities for recreation and promoting positivity. Conclusions Residents living in LTC experienced significant social isolation and grief during the pandemic that resulted in loneliness and other negative health consequences. Implications for practice Promoting meaningful connection, safe recreational activities and a positive atmosphere in LTC homes during the pandemic may help mitigate residents’ experiences of loneliness due to social isolation and/or grief and enhance their quality of life.

Social isolation has been a significant issue in aged care settings, particularly during the COVID-19 pandemic, and is associated with adverse outcomes, including loneliness, depression, and cognitive decline. While robotic assistance may help mitigate social isolation, it would be helpful to know how to adopt technology in aged care. This scoping review aims to explore facilitators and barriers to the implementation of telepresence robots in aged care settings. Following the Joanna Briggs Institute scoping review methodology and the PRISMA extension for scoping reviews reporting guidelines, we searched relevant peer-reviewed studies through eight databases: CINAHL, MEDLINE, Cochrane, PsychINFO (EBSCO), Web of Science, ProQuest Dissertations and Theses Global, IEEE Xplore, and ACM Digital Library. Google was used to search gray literature, including descriptive, evaluative, quantitative, and qualitative designs. Eligibility includes: studies with people aged 65 years and older who interacted with a telepresence robot in a care setting, and articles written in English. We conducted a thematic analysis to summarize the evidence based on the constructs in the Consolidated Framework of Implementation Research. Of 1183 articles retrieved, 13 were included in the final review. The analysis yielded three themes: relative advantages, perceived risks and problems, and contextual considerations. The key facilitators to telepresence robot adoption are as follows: a feeling of physical presence, ease of use, mobility, and training. The barriers to implementation are as follows: cost, privacy issues, internet connectivity, and workflow. Future research should investigate the role of leadership support in implementation and practical strategies to overcome barriers to technology adoption in aged care settings.

As of October 1, 2007, 25 North American medical institutions and one European islet transplant center reported detailed information to the Registry on 315 allograft recipients, of which 285 were islet alone (IA) and 30 were islet after kidney (IAK). Of the 114 IA recipients expected at 4 years after their last infusion, 12% were insulin independent, 16% were insulin dependent with detectable C-peptide, 40% had no detectable C-peptide, and 32% had missing C-peptide data or were lost to follow-up. Of the IA recipients, 72% achieved insulin independence at least once over 3 years and multiple infusions. Factors associated with achievement of insulin independence included islet size >1.0 expressed as IEQs per islet number [hazard ratio (HR) = 1.5, p = 0.06], additional infusions given (HR = 1.5, p = 0.01), lower pretransplant HbA(1c) (HR = 1.2 each %-age unit, p = 0.02), donor given insulin (HR = 2, p = 0.003), daclizumab given at any infusion (HR = 1.9, p = 0.06), and shorter cold storage time (HR = 1.04, p = 0.03), mutually adjusted in a multivariate model. Severe hypoglycemia prevalence was reduced from 78-83% preinfusion to less than 5% throughout the first year post-last infusion, and to 18% adjusted for missing data at 3 years post-last infusion. In Year 1 post-first infusion for IA recipients, 53% experienced a Grade 3-5 or serious adverse event (AE) and 35% experienced a severe AE related to either an infusion procedure or immunosuppression. In Year 1 post-first infusion, 33% of IA subjects and 35% of IAK subjects had an AE related to the infusion procedure, while 35% of IA subjects and only 27% of IAK subjects had an AE related to the immunosuppression therapy. Five deaths were reported, of which two were classified as probably related to the infusion procedure or immunosuppression, and 10 cases of neoplasm, of which two were classified as probably related to the procedure or immunosuppression. Islet transplantation continues to show short-term benefits of insulin independence, normal or near normal HbA(1C) levels, and sustained marked decrease in hypoglycemic episodes.

IntroductionSocial isolation is a significant issue in aged care settings (eg, long-term care (LTC) and hospital) and is associated with adverse outcomes such as reduced well-being and loneliness. Loneliness is linked with depression, anxiety, cognitive decline, weakened immune system, poor physical health, poor quality of life and mortality. The use of robotic assistance may help mitigate social isolation and loneliness. Although telepresence robots have been used in healthcare settings, a comprehensive review of studies focusing on their use in aged care for reducing social isolation requires further investigation. This scoping review will focus on the use of telepresence robots to support social connection of older people in care settings.Methods and analysisThis scoping review will follow Joanna Briggs Institute scoping review methodology. The review team consists of patient partners and family partners, a nurse researcher and a group of students. In the scoping review, we will search the following databases: MEDLINE (Ovid), CINAHL, PsycINFO (EBSCO), Web of Science and ProQuest Dissertations & Theses Global. Google and Google Scholar will be used to search for additional literature. A handsearch will be conducted using the reference lists of included studies to identify additional relevant articles. The scoping review will consider studies of using a telepresence robotic technology with older adults in care settings (ie, LTC and hospital), published in English.Ethics and disseminationSince the methodology of the study consists of collecting data from publicly available articles, it does not require ethics approval. By examining the current state of using telepresence to support older people in care settings, this scoping review can offer useful insight into users’ needs (eg, patients’ and care providers’ needs) and inform future research and practice. We will share the scoping review results through conference presentations and an open access publication in a peer-reviewed journal.

Context: Despite being widely used with older adults in the community, there is limited literature on using the de Jong Gierveld Loneliness Scale with older adults living in long-term care (LTC). Objective:The purpose of this article is to discuss the considerations of using this scale with older adults in LTC.Method: Our team consisted of older person and family partners, a clinician, and academic researchers working together in all stages of research using the Loneliness scale to conduct individual interviews with 20 older adults in LTC in Vancouver, Canada, as part of a study exploring the experience of loneliness during the COVID-19 pandemic. Team reflection was embedded in the research process, with reflection data consisting of data transcripts, field notes, and regular team meeting notes. Thematic analysis was employed to identify lessons learned and implications.Findings: Participants had various challenges responding to the scale. Our analysis identified five themes: a) diverse meanings of loneliness, b) multi-faceted factors of loneliness, c) technical challenges, d) social desirability, and e) situational experience. We also offer five recommendations to consider when using this scale with older adults in LTC. Limitations:We used this scale with a small sample of older adults in LTC, which is a more time and labour-intensive population. Data on marital status and educational background was not collected but might help in understanding considerations for using the scale with older adults in LTC. Implications:We offer practical recommendations for using the scale with older adults in LTC, especially how qualitative open-ended questions can complement the scale by providing useful insights into context and complex experiences.