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      From the drama of unoccupied time and isolation due to Covid-19’s pandemic to the need for person-centered care at residential care facilities in Portugal

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          Abstract

          During the pandemic, restrictive measures were implemented at Portuguese residential care facilities (PRCF), such as isolating residents and ceasing collective activities. It is important to understand how PRCF are implementing activities that allow residents to occupy their time and fight isolation. As such, we aim to analyze whether: 1. new activities were implemented for residents (identifying which were carried out); 2. occupation activities were provided to isolated residents in their rooms (identifying which were carried out); 3. the implementation of activities is associated with variables like the amount of staff. This is an exploratory, quantitative, and cross-sectional study. An online questionnaire was sent by email to 2325 PRCF and entities were asked to share it with their workers. The study was also divulged on social networks. Data collection occurred between July 8th and October 18th, 2020. The study had 784 staff members participating and 90.8% reported that new activities were implemented at their facilities, predominantly videocalls. Concerning isolated residents most respondents (64.4%) stated that providing activities was impossible. Results showed that those PRCF that expanded teams had a higher percentage of new activities and activities with residents isolated in bedrooms. These results are alarming because while residents should have had more resources to cope with the pandemic, higher risks of unoccupied time and isolation existed, a dramatic situation for its potentially harmful consequences. Focusing on sanitary issues (and less on older adults) may reinforce traditional care models that had shown negative impacts before the pandemic. This highlights the need to evolve the care paradigm during and beyond the pandemic at PRCF: with Person-Centered Care as an option.

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          Most cited references30

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          Older people and COVID-19: Isolation, risk and ageism

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            Social isolation and loneliness among older adults in the context of COVID-19: a global challenge

            Bei Wu (2020)
            We are experiencing a historical moment with an unprecedented challenge of the COVID-19 global pandemic. The outbreak of COVID-19 will have a long-term and profound impact on older adults’ health and well-being. Social isolation and loneliness are likely to be one of the most affected health outcomes. Social isolation and loneliness are major risk factors that have been linked with poor physical and mental health status. This paper discusses several approaches that may address the issues of social isolation and loneliness. These approaches include promoting social connection as public health messaging, mobilizing the resources from family members, community-based networks and resources, developing innovative technology-based interventions to improve social connections, and engaging the health care system to begin the process of developing methods to identify social isolation and loneliness in health care settings.
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              Impact of sedentarism due to the COVID-19 home confinement on neuromuscular, cardiovascular and metabolic health: Physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures

              The COVID-19 pandemic is an unprecedented health crisis as entire populations have been asked to self-isolate and live in home-confinement for several weeks to months, which in itself represents a physiological challenge with significant health risks. This paper describes the impact of sedentarism on the human body at the level of the muscular, cardiovascular, metabolic, endocrine and nervous systems and is based on evidence from several models of inactivity, including bed rest, unilateral limb suspension, and step-reduction. Data form these studies show that muscle wasting occurs rapidly, being detectable within two days of inactivity. This loss of muscle mass is associated with fibre denervation, neuromuscular junction damage and upregulation of protein breakdown, but is mostly explained by the suppression of muscle protein synthesis. Inactivity also affects glucose homeostasis as just few days of step reduction or bed rest, reduce insulin sensitivity, principally in muscle. Additionally, aerobic capacity is impaired at all levels of the O2 cascade, from the cardiovascular system, including peripheral circulation, to skeletal muscle oxidative function. Positive energy balance during physical inactivity is associated with fat deposition, associated with systemic inflammation and activation of antioxidant defences, exacerbating muscle loss. Importantly, these deleterious effects of inactivity can be diminished by routine exercise practice, but the exercise dose-response relationship is currently unknown. Nevertheless, low to medium-intensity high volume resistive exercise, easily implementable in home-settings, will have positive effects, particularly if combined with a 15-25% reduction in daily energy intake. This combined regimen seems ideal for preserving neuromuscular, metabolic and cardiovascular health.
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                Author and article information

                Contributors
                mariambc@live.com.pt
                Journal
                Curr Psychol
                Curr Psychol
                Current Psychology (New Brunswick, N.j.)
                Springer US (New York )
                1046-1310
                1936-4733
                5 August 2022
                5 August 2022
                : 1-10
                Affiliations
                [1 ]GRID grid.7427.6, ISNI 0000 0001 2220 7094, Health Sciences Research Centre of the University of Beira Interior (CICS-UBI) - Faculdade de Ciências da Saúde, ; Av. Infante D. Henrique, 6201-506 Covilhã, Portugal
                [2 ]GRID grid.5808.5, ISNI 0000 0001 1503 7226, CINTESIS@RISE, ICBAS, University of Porto, ; Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
                [3 ]GRID grid.5808.5, ISNI 0000 0001 1503 7226, Instituto de Ciências Biomédicas Abel Salazar, School of Medicine and Biomedical Sciences, , University of Porto, ; Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
                [4 ]Aubixa Fundazioa, San Sebastián, Spain
                [5 ]GRID grid.7427.6, ISNI 0000 0001 2220 7094, Faculdade de Ciências Sociais e Humanas, , University of Beira Interior, ; Estrada do Sineiro, s/n, 6200-209 Covilhã, Portugal
                Author information
                http://orcid.org/0000-0001-6838-4969
                http://orcid.org/0000-0002-9214-7805
                http://orcid.org/0000-0002-9276-3683
                http://orcid.org/0000-0002-8479-9934
                http://orcid.org/0000-0003-2111-6873
                Article
                3499
                10.1007/s12144-022-03499-9
                9361953
                2b57bc69-3183-4f0e-bef5-4aa68fcf07ad
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 14 July 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001871, Fundação para a Ciência e a Tecnologia;
                Award ID: SFRH/BD/138897/2018
                Award Recipient :
                Categories
                Article

                Clinical Psychology & Psychiatry
                covid-19 pandemic,older adults,person-centered care,residential care facilities,occupation activities,social isolation

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