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Mizzou researchers investigate nursing home care during pandemic

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COLUMBIA, MO. — Missouri currently has the lowest vaccination rate for nursing home workers in the country as researchers at the University of Missouri start investigating how the state’s nursing homes respond to the pandemic. 

More than 3,800 nursing homes residents have died from COVID-19 during the past 18 months. Over the next year, investigators will be going into nursing homes in all parts of the state looking at how residents were cared for. The research includes interviewing staff, residents, and family members. 

“I think we learned some hard lessons and human beings paid the prices with their lives,” associate professor at the Sinclair School of Nursing at Mizzou said. “They [nursing home staff] were being asked to do things at a level they have never been asked to do previously.”

Since the start of the pandemic, more than 23,000 nursing homes residents have tested positive for COVID. Popejoy, along with another associate professor at Sinclair School of Nursing, Amy Vogelsmeier, are behind the research. 

“We expect to see that some nursing homes were able to manage better than others,” Vogelsmeier said. “To take what we learn and figure out how can we develop strategies that nursing homes across the country could basically implement should this happen again.”

Missouri has more than 500 nursing homes, but the research Vogelsmeier and Popejoy plan to do is investigate 24 of them throughout urban, suburban, and rural parts of the state. 

“We anticipate that people, residents, did not get the care that they probably needed to the degree that they probably needed or quickly enough,” Popejoy said. “During the pandemic, they [residents] were assigned to their rooms and nursing homes were not developed for that kind of care.”

Popejoy and Vogelsmeier along with other researchers will be comparing residents’ data from before the pandemic to now, like weight loss and depression. Part of the investigation includes interviewing families and residents. 

“We’ll be talking with nursing home leaders, staff, we’ll be talking with the infection preventionist which is on-site,” Vogelsmeier said. 

Vogelsmeier said nursing homes deal with viral outbreaks all the time, like the flu, so this research could in more than one way. 

The search is still on for the 24 facilities that will be investigated. Vogelsmeier said they are taken into consideration nursing homes with both high COVID-19 infection rates and facilities with low infection rates, along with how many cases were in the county. 

“What we’ll be able to find out is what was working and what wasn’t working, what didn’t work, and what potentially could have caused more problems,” Vogelsmeier said. 

The overall goal of the study is to prevent a repeat of the past 18 months from happening again. 

“The idea being, what can we learn from what happened in Missouri,” Vogelsmeier said. “How did they [staff] communicate between residents and families in creative ways?”

Popejoy said this research is personal to her because her father was in the nursing home over the summer and was not allowed to see him when he was very ill. 

“It was very, very hard to be isolated from my father who I knew was really sick,” Popejoy said. “I developed a lot more understanding of what families went through during that time.”

The study recently received a 4-year $1.9 million grant from the Agency for Healthcare Research and Quality. Popejoy expects interviews to be complete by this time next year and then will use the remaining time to sift through the data and publish their findings. 

“We can prepare for it differently so that we are never separate families again,” Popejoy said. “Because we never ever want to go through what we went through for the last year and a half in the same way.”

Both nurses, who previously have worked closely with nursing homes said families are the eyes and ears for residents and staff. 

“We have to learn from our experiences and do not understand this experience fully is such a lost opportunity,” Popejoy said. 

Popejoy said another part of the research will be vaccinations inside facilities.

According to the Centers for Medicare and Medicaid Services (CMS), 86% of residents in nursing homes are vaccinated, while only 56% of staff are vaccinated, the lowest in the country. 

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