Care continuity may have a big impact on whether long-term care facility residents’ severe anxiety levels rise or fall during major events such as disasters or pandemics, investigators say.
Anecdotal reports have noted that LTC residents suffered negative mental health consequences from pandemic exposure to illness and excess death, lockdown restrictions and lack of access to routine care. But research on older adults and pandemic mental health has produced discrepant results, with some evidence of worsening mental health, and other evidence showing elders’ resilience, investigators wrote in an article published April 2 in JAMDA.
Behavioral health data
To further investigate the issue, the researchers examined the impact of pandemic lockdowns on residents’ anxiety symptoms. To do so, they used clinical data for 1,149 residents, with permission from a company that provides behavioral health services to LTC and assisted living facilities.
Overall, anxiety severity decreased over time, both before and after the onset of the pandemic, they found. Pandemic-related factors such as telehealth availability did not affect this trajectory. Instead, individual treatment-related factors had an impact, including initial anxiety severity, diagnosis of obsessive-compulsive disorder (OCD) or bipolar disorder, and prescriptions for anti-anxiety drugs and antipsychotic medications.
Prior to the pandemic, for example, residents with more severe anxiety at baseline and prescriptions for anti-anxiety medications showed less increase in anxiety symptoms over time. This suggests that the use of these drugs may be beneficial for such residents in the event of a major event such as a pandemic, the researchers wrote. Residents with OCD-related diagnoses, on the other hand, had increased anxiety symptoms over time, “suggesting that treatment addressing OCD symptoms will be particularly important for these individuals at times of a major stressor,” they theorized.
Treatment variables
The takeaway? The impact of the COVID-19 pandemic on long-term care facility residents may be better observed using treatment variables, such as diagnosis, symptom severity and medication use, rather than pure symptom severity, Savannah Rose, MS, of Palo Alto University in CA, and colleagues wrote.
“These findings may help guide responses to future pandemics and suggest that residents with premorbid severe anxiety and OCD diagnoses should be monitored carefully and offered mental health services,” the authors wrote.
“In preparation for future pandemics or other large-scale disasters potentially impacting service delivery, facilities should continue to prioritize continuity of care or a timely resumption of services attending to individual treatment factors,” they concluded.
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