Services For Older Adults Research Articles

Family Caregiving and Depression among Older Adults in Japan: A Cross-Sectional Study during the COVID-19 Pandemic

COVID-19 infections are particularly lethal in older adults; thus, social activities of older adults and their families in the community have been restricted. The threat of infection, restrictions on social activities, and limitations on the provision of care services for older adults could increase family caregivers’ burden and impact their mental health. This cross-sectional study examined the association between family caregiving and change in depression during the COVID-19 pandemic. In October 2020, we conducted a mailed questionnaire survey on a random sample of functionally independent community-dwelling older adults in a semi-urban area of Japan. Based on the depression status between March and October 2020, participants were classified into four groups: “consistently non-depressed,” “depression onset,” “recovering from depression,” and “remained depressed.” Participants were assessed for providing care for their family members or not. Caregiver participants were also assessed on their caregiving role (primary or secondary), the severity of their care-recipient’s needs, and an increased caregiver burden. Data from 957 older adults were analyzed. The participants’ mean age (SD) was 80.8 (4.8) years, and 53.5% were female. Multivariable multinomial logistic regression analysis revealed that family caregiving was associated with depression onset (OR=3.17 [95%CI=1.57-6.40], p=0.001) and remaining depressed (2.53 [1.36-4.71], p=0.004). Particularly, primary caregivers, those providing care for family members with severer care need-levels, and those with an increased caregiver burden had a higher risk of depression onset and remaining depressed. Family caregivers could have severe mental health conditions during the pandemic. Developing a support system is essential to protect their mental health.

Caregiving and COVID-19: Perspectives from a Care Coach

Family caregivers of community-dwelling older adults have faced unprecedented caregiving challenges during the COVID-19 pandemic. Examining the accumulated impact on family caregivers can help health and aging service providers design resources and supports that are resilient to emergency situations, and reduce negative psychological and physical consequences and risk of abuse within caregiving dyads. Data was collected as part of a pilot intervention in which “Care Coaches” provided telephonic coaching sessions to family caregivers of older adults. We examined Care Coach observations documented after coaching sessions with 24 family caregivers between March 2020 and February 2021. Two coders employed thematic analysis to generate codes and themes. The sample was 70% female, 80% were the spouse or significant other of their care receiver, the mean age was 61, and 53% were Non-Hispanic White. Themes and sub-themes included: (1) increased caregiver burden and diminished care networks due to fear of exposure to or contraction of COVID-19, (2) barriers to accessing in-home personal assistance services and home-delivered meals despite intervention efforts, and (3) the exacerbation of caregiver social isolation due to COVID-19 lockdown policies. Findings highlight the ways in which COVID-19 has amplified caregiver burden through the breakdown of formal and informal support systems. Potential adaptations of community-based services for older adults and their caregivers include remote service liaisons and need assessment of caregiver dyads to assure access to home-based personal assistance services and nutrition support for those at greatest risk of negative consequences during emergency service lapses.

Utility of the Late Life Function and Disability Instrument (LLFDI) in rehabilitation services for older adults

Employing Foreign Educated Nurses (FENs) helps address Registered Nurse (RN) shortages in long-term care (LTC) in the United States (US). However, examination of factors explaining differences in their employment outcomes relative to US Educated Nurses (USENs) is limited. This study uses 2018 National Sample Survey of Registered Nurses data to compare income, work hours, job satisfaction, and human capital, defined as personal characteristics (knowledge, work experience) and behaviors (job mobility), of FENS and USENs working full-time in LTC. A human capital score, consisting of highest nursing education, skill certifications, state licensures, years of experience, multi-state employment history, and multi-lingual status was constructed. Covariates included nurse demographics, direct care role, and ability to practice to full scope. Covariate-adjusted group differences in employment outcomes and human capital were compared using ANCOVA and logistic regression. Mediation analyses explored whether human capital explained FEN vs USEN differences. FENs earned higher hourly wages (p=0.0169), worked fewer hours annually (p=0.0163), and reported greater human capital (p<.0001) compared to USENs. FENs and USENs, however, had similar annual salaries (p=0.3101) and job satisfaction (p=0.1674). Human capital mediated FEN vs USEN effects on hourly wages but not annual work hours. FENs’ higher levels of human capital partially account for FEN vs USEN differences in hourly wages. Application of the human capital concept advanced our ability to examine differences in employment outcomes and highlight aspects of the value that FENs contribute to LTC settings.

Environmental Assessment of Housing for Older Adults Facing Housing Insecurity

The Aging in the Right Place Environmental Audit (AIRP-ENV) and Secondary Observation (AIRP-ENV-SO) tools were developed to conduct observation-based audit of the built environment in shelters, transitional housing, independent housing with offsite/onsite supports, and permanent supportive housing with onsite medical and/or specialized services for older adults experiencing (or at risk of) homelessness. The 241 item AIRP-ENV tool is used to audit the presence/absence of exterior and interior built environmental features that support housing stability. The seven open-ended questions in the AIRP-ENV-SO tool is used to collect contextual data on function, safety and land-use of surrounding neighborhood. Data were collected at four sites of a transitional housing program in Vancouver, Canada as part of a multi-year, multi-city partnership project on aging and homelessness. Preliminary results demonstrate that built environment and urban design features (e.g., access, privacy, flexible and supportive spaces) contribute towards tenants’ residential resiliency and aging in place.

Cross-Validation of the Financial Exploitation Vulnerability Scale

Despite plenty of reviews on the benefits of nonpharmacological interventions for dementia informal caregivers, large-scale review on the effects of these interventions on the care-recipients (CRs) is lacking. We searched PsycINFO, CINAHL with Full Text, MEDLINE, and PubMed from inception to end of 2020 and found 144 articles that reported randomized controlled trials of caregiver interventions using CR outcomes. Interventions were found to reduce neuropsychiatric symptoms and mood disturbance, enhance cognition and quality of life, and delay institutionalization and mortality, with care coordination/case management, educational intervention with psychotherapeutic components, and direct training of the care-recipient (with caregiver involvement) being the more potent interventions. However, the effects were generally small to very small. Together with existing findings on caregiver outcomes, a tripartite scaffolding model of caregiver support is proposed. Future directions in terms of developing consensual guidelines, a registry of intervention manuals, and family-centered programs are discussed.

Integrated primary care and social services for older adults with multimorbidity in England: a scoping review

BackgroundAs the prevalence of older adults with multimorbidity increases, greater integration of services is necessary to manage the physical and psycho-social needs of this cohort. This study describes and summarises current evidence, clinical provision and progress towards integrated primary care and social services for older adults with multimorbidity in England.MethodsA scoping review was conducted involving systematic searches of a range of electronic academic and policy databases. Articles were screened and extracted in duplicate by two independent reviewers. Data were extracted onto a charting sheet and thematic synthesis was used to summarise findings. Articles were included if published in English and related to primary care, social care and multimorbidity in older adults in England. Conceptually, the review was framed using the Rainbow Model of Integrated Care.ResultsThe search yielded 7656 articles of which 84 were included. Three themes were identified: (1) a focus on individual level services rather than multi-level or multi-sector integration, with an increasing emphasis on the need to consider broader determinants of population health as critical to integrated care for older adults with multimorbidity; (2) the need for policymakers to allow time for integration to embed, to enable new structures and relationships to develop and mature; and (3) the inherent tension between top-down and bottom-up driven approaches to integrated care requires a whole-systems structure, while allowing for local flexibilities.ConclusionsThere is limited evidence of multi-level and multi-sector integration of services for older adults with multimorbidity in England. The literature increasingly acknowledges wider determinants of population health that are likely to require integration beyond primary care and social services. Improving clinical care in one or two sectors may not be as effective as simultaneously improving the organisation or design across services as one single system of provision. This may take time to establish and will require local input.

Telehealth outreach programming in the Pacific island of Guam: Providing access to dementia care support services during the COVID-19 pandemic.

Background The COVID‐19 pandemic has led to heightened levels of isolation and loneliness for millions of individuals and families worldwide, resulting in adverse health and mental health outcomes. Persons with dementia and their family caregivers are particularly vulnerable due to the deleterious impact of social isolation on both dementia symptoms and caregiver burden. One of the greatest challenges for dementia patients has been accessing dementia care services during COVID‐19 lockdowns. In the Pacific island of Guam, the pandemic quickly led to the closure of senior centers, adult day care centers, family caregiver support programs, and other social services for older adults and their families in March 2020. As a result, persons with dementia suddenly found themselves isolated at home and dependent upon family members to provide round‐the‐clock care. This presentation will describe the development of an innovative telehealth outreach program that was launched in Guam in the summer of 2020, three months after the first COVID‐19 case had appeared on the island. The program was designed to provide improved access to social support and specialized community services for persons with dementia and their family caregivers. There are four components: (1) virtual family caregiver support groups where participants can share the stresses and challenges of caring for a loved one with dementia with others who are going through similar experiences; (2) virtual presentation and consultation sessions led by dementia care specialists from the community providing easy access to dementia care information and services; (3) 24/7 family caregiver support networks through mobile messaging apps to mitigate social isolation and ensure the availability of support in times of crisis; and (4) telehealth family counseling for persons with dementia and their family members employing narrative approaches that embrace the oral storytelling traditions of Pacific island cultures. The community response has been strong with approximately 50‐60 family caregivers and persons with dementia participating in the program monthly. Project outcomes suggest that telehealth outreach services represent an effective and sustainable approach to connecting persons living with dementia and their family caregivers to community resources during times of isolation.

The protective impact of telecare on persons with dementia and their caregivers during the COVID‐19 pandemic

BackgroundSocial distancing under the COVID‐19 pandemic has restricted access to community services for older adults with neurocognitive disorder (NCD) and their caregivers. Telehealth is a viable alternative to face‐to‐face service delivery. Telephone calls alone, however, may be insufficient. Here, we evaluated whether supplementary telehealth via video‐conferencing platforms could bring additional benefits to care‐recipient with NCD and their spousal caregivers at home.MethodSixty older adults NCD‐and‐caregiver dyads were recruited through an activity centre. The impact of additional services delivered to both care‐recipient and caregiver through video conference (n=30) was compared with telehealth targeted at caregivers by telephone only (n=30), over 4 weeks in a pretest‐posttest design. Interviews and questionnaires were conducted at baseline and study’s end.ResultSupplementary telemedicine had averted the deterioration in the Montreal Cognitive Assessment evident in the telephone‐only group (η p 2=0.50). It also reversed the falling trend in quality of life observed in the telephone only group (QoL‐AD, η p 2=0.23). Varying degrees of improvements in physical and mental health (Short‐Form 36 v2), perceived burden (Zarit Burden Interview Scale) and self‐efficacy (Revised Caregiving Self‐Efficacy Scale) were observed among caregivers in the video‐conferencing group, which were absent in the telephone‐only group (η p 2=0.23–0.51).ConclusionTelehealth by video conference was associated with improved resilience and wellbeing to both people with NCD and their caregivers at home. The benefits were visible already after 4 weeks and unmatched by telephone alone. Video conference as the modus operandi of telehealth beyond the context of pandemic‐related social distancing should be considered.

Effects of home visits on quality of life among older adults: a systematic review protocol

BackgroundHome visiting services for older adults have been offered for decades to maintain and promote health and independent functioning, thus enhancing quality of life. Previous systematic reviews have provided a mixed picture of the benefits of home visiting programmes in older adults, primarily because of heterogeneity in study designs, targeted populations, and intervention strategies. These reviews may also become out of date; thus, an updated synthesis of relevant studies is warranted. Our objective is to perform a systematic review of recently published primary studies on the effectiveness of multi-professional home visits on quality of life among older adults.MethodsWe will perform a comprehensive search for studies investigating the effect of a multi-professional home visit approach on quality of life among older adults. We will conduct the literature search in selected electronic databases and relevant research websites from January 2010 onwards. We will include randomised controlled trials (RCTs), cluster randomised controlled trials (cluster RCTs), and observational studies that enrolled older adults without dementia over 60 years old, along with studies involving multi-professional preventive–promotive home visit approaches not related to recent hospital discharge. We will report our planned review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We will retrieve and record relevant data in a standardised data extraction form and evaluate the quality of the included articles using the Cochrane risk of bias tool and the quality assessment tool for studies with diverse designs (QATSDD). Where appropriate, outcomes will be pooled for meta-analysis using a random-effects model. The main outcomes include quality of life, incidence of falls, depression, dementia, and emergency department admissions.DiscussionThis review may provide evidence for the effectiveness of home visits in improving older adults’ quality of life. It will potentially benefit health care professionals, policymakers, and researchers by facilitating the design and delivery of interventions related to older generations and improve service delivery in future.Systematic review registrationPROSPERO CRD42021234531.

Improving Long-Term Care Facilities’ Crisis Response: Lessons From the COVID-19 in Chile

<strong>Context:</strong> The COVID-19 pandemic hit Chile hard and affected older people the most. Through its National Service for Older Adults, the country implemented a strategy to prevent and mitigate infection and spread in long-term care facilities (LTCF), reaching regulated and registered residences and, for the first time, informal and unregistered residences. <strong>Objective:</strong> Identify the challenges and lessons from the COVID-19 response in LTCF with respect to the support received, the implementation of infection control measures, workforce challenges experienced and the measures adopted to promote residents’ wellbeing. <strong>Methods:</strong> An online questionnaire was sent to all LTCF managers (N = 385, Response Rate = 32.4%). Statistical tests compare results to identify differences across LTCF characteristics: residence size, location and management type (private, public or subsidized, or informal). <strong>Findings:</strong> Irrespective of their location, size or management, managers highlight common challenges during the crisis. They include limited personal protective equipment (PPE) availability, staff shortages, low quality of replacement staff, reduced staff mental health, and the difficulty to understand and implement protocols. Managers acknowledge receiving institutional support in the form of PPE provision and opportunities for staff training, but managers noted the need to expand this support to cover staffing surge needs, staff psychological needs, and ensure the continuity of clinical support for residents as well. Managers share a common demand for a more coordinated response from public institutions. Managers recognize that the pandemic and the measures implemented to mitigate it negatively affected staff morale and residents’ wellbeing. Many noted that peer-to-peer support was a mechanism to support staff. <strong>Limitations:</strong> Results might be subject to selection bias. Data collection covered a limited period of time at the early stage of the pandemic. <strong>Implications:</strong> Findings are relevant to assess the COVID-19 response and to better prepare for another COVID-19 wave or similar health or environmental threats in the future.

A Scoping Review of the Implementation of Local Health and Social Services for Older Adults.

Background:Implementing elder-dedicated local health and social services (LHSS) is primary for older Canadian adults to age in place. However, there is currently no synthesis of the factors (barriers and facilitators) involved in LHSS implementation.Objective:This study aimed to synthesize current knowledge about the institutional factors involved in elder-dedicated LHSS implementation by describing them and their influence.Methods:A scoping review was conducted using eight databases and the grey literature. Data were analyzed thematically.Results:A total of 23 documents led to the identification of 15 inter-influencing factors (12 barriers and 11 facilitators). Indeed, 20 connections were noted among factors, mostly among barriers.Discussion and implication:Although some barriers and facilitators also affect the implementation of services dedicated to the general population in Canada, the interplay between agism and power issues needs to be taken into consideration for a successful elder-dedicated LHSS implementation.

178 A RETROSPECTIVE EVALUATION OF PROCESS OUTCOMES OF OLDER ADULTS REFERRED TO A COMMUNITY RE-ENABLEMENT TEAM FROM THE EMERGENCY DEPARTMENT

Abstract Background Emergency Departments (ED) are complex and challenging environments to provide care to older adults. There is currently a paucity of high quality methodological research investigating the effectiveness of interventions focused on transitions of care from the ED to primary care services (Hughes et al, 2019). This study aims to evaluate the impact of a collaborative model of care between primary and secondary care services for older adults discharged home following ED index visit. Methods This was an observational retrospective study. Participants aged ≥65 years discharged home from the ED of a University Teaching Hospital and referred to a Multidisciplinary Community Intervention Team (MDCIT) were included. Referral pathways were via the OPTIMEND team (Cassarino et al, 2021) and MDCIT, which is a rapid access re-enablement team based in the community and compromises nursing staff, an occupational therapist, physiotherapist, therapy and healthcare assistants. Descriptive statistics were used to profile the baseline characteristics of study participants and to summarise data related to process outcomes. Ethical approval was granted for this study (020/2021). Results In the study period, January—December 2020, 54 patients were referred to the MDCIT. The mean age of participants was 80.1 years (SD 8.2), 57% were female, and the most common Manchester Triage System presenting complaint was ‘limb problems’. The median Patient Experience Time within the ED was 7.4 hours (IQR 13.1); 55% of participants were seen in their home within 24 hours of discharge. A mean of 10 interventions were delivered by the MDCIT. A 9.1% incidence rate of 30 day unscheduled hospital readmission was recorded. Conclusion Integrated care programmes have been advocated to improve the continuum of care from the ED into the community. This evaluation has demonstrated the feasibility of implementing such a model of care. However, further methodologically robust research is required to advance the evidence base and should also focus on patient outcomes.

Navigating re-entry with older adults using ecosystems perspective and the eco-map

Currently, the population of older adults is growing at a rapid rate. The number of older adults in America is similarly represented in the justice system with the number of older adults aged 56 and older accounting for 11.8 percent of the total federal prison population. Older adults in the criminal justice system are at heightened risk for poor health, mental illness, and accelerated aging. For those exiting the carceral system, many older adults may not have community connections to aid in re-entry. Social service providers and community agencies that are tasked with advocating for marginalized populations, empowering clients, and addressing psychosocial problems of older adults, may be uniquely helpful in the re-entry process. Guided by ecological systems theory, this article presents the eco-map tool for social service professionals (e.g., social workers, probation officers) to use in tandem with eco-systems perspective. Using this tool in collaboration with older adult clients may assist with re-entry. Furthermore, social service providers can use this to navigate complex relationships within the community and society at large. Finally, the use of this tool may assist with facilitating comprehensive support and wrap-around services for older adults.

Depression and anxiety correlate differentially with dissatisfaction with healthcare services in older adults: The Yilan Study, Taiwan

Previous studies have seldom investigated the psychological factors that are associated with dissatisfaction with healthcare services. We therefore examined the associations of depression and anxiety with service dissatisfaction among older adults. A community-based health survey was conducted from 2012 to 2016. Residents aged ≥65 years were randomly recruited from Yilan City, Taiwan. Besides overall dissatisfaction, we assessed dissatisfaction with physicians' ability, physicians' attitude, and waiting time. The Hospital Anxiety and Depression Scale was used to detect depressive and anxiety symptoms with optimal cut-off points of 3 for the anxiety subscale and 6 for the depression subscales. Of the 3480 residents included in this study, the overall dissatisfaction rate was 7.9%. After controlling for covariates, depressive and anxiety symptoms were consistently correlated with the various dimensions of dissatisfaction. More specifically, depressive symptoms were associated with overall dissatisfaction and dissatisfaction with physicians' ability and attitude. Conversely, anxiety was uniquely associated with dissatisfaction with waiting time. Psychological symptoms were consistent correlates of dissatisfaction with healthcare services among older adults, although the specific symptoms had different associations with the various dimensions of dissatisfaction.

From volunteer work to informal care by stealth: a ‘new voluntarism’ in social democratic health and welfare services for older adults

AbstractIn the context of current and expected demographic changes, the issues of which services the welfare state should offer and, ultimately, the very function of the welfare state are currently debated in Norway. The political discourse on health and care services for older adults has morphed into an accepted reality in which the system must be altered, prompting policy makers and stakeholders to find new and novel solutions to problems associated with population ageing. In this paper, we discuss one such proposed solution: the transformation of health and care services for the older adult population through the increased involvement of volunteers. We ask how volunteer efforts are articulated and delineated through official accounts and discuss the implications of such an articulation and delineation. We seek answers to these questions through a critical discourse analysis of recent governmental white papers. We investigate, in other words, volunteer efforts as a political instrument. We argue that the official representation of how efforts in health and care services should be re-aligned take the form of a distinct discourse of ‘voluntarism’. Within this ‘voluntarism’, volunteer efforts have been altered from a third sector comprising charity and non-profit organisations that contribute within or as a supplement to the largely public-run welfare system to a limitless and extensive concept that is blurring the boundaries to informal care.

Aging tsunami coming: the main finding from China's seventh national population census.

China is undergoing great social changes, and its demographic makeup is shifting every year along with those changes. China released key indicators from the seventh national population census on 12 May 2021. The total population of China's mainland increased to 1.41178 billion in 2020 from 1.33972 billion in 2010 (sixth national population census) with an average annual growth rate of 0.53%. In the past 10years, the share of the population aged above 60 and 65years increased by 5.44% (from 13.26% in 2010 to 18.70% in 2020) and 4.6% (from 8.9 to 13.5%), respectively. The share of the population with a college education or above rose from 8.93% in 2010 to 15.47% in 2020, and the illiteracy rate dropped from 4.08% in 2010 to 2.67% in 2020. In the next decade, China is likely to face many changes, including the increasing proportion of older adults in the population, declining births, and economic transformation. In an effort to respond to the changed demographic landscape, the authorities should adopt new laws and strategies to improve government services for older adults and consider ways to support women and families and make childbearing more attractive to and feasible for women.

Graphic Novela: Mexican American Families' Use of Community Services for Older Adults.

Knowledge gaps exist about how to help Mexican American (MA) families seek assistance when their capacity to assist older family members is challenged. MA families may resist confronting unpleasant but real situations with the older adult, for example, the need to access long term support services (LTSS), because of cultural and structural barriers. The purpose was to describe stakeholders' reactions to a culturally focused graphic novela created in partnership with a community advisory council. Qualitative description with content analysis of a focus group's reactions to the graphic novela was used. Results included positive reactions as well as suggestions for improvement and dissemination. Graphic novelas can be an effective medium for modeling conversations about older adults' needing additional care, and demonstrating how to identify and access available LTSS or other services. Included is a description of the researchers' process of partnering with diverse stakeholders, which is essential for creating new solutions.

Guidance for hospital and community-based health services for older adults: The senior friendly care framework

To meet the needs of a population of older adults at risk of becoming frail in the context of known limitations to current practice, frameworks have emerged to guide health service development. Typically these frameworks have developed in the hospital sector despite the need for hospital/community sector co-development and adoption. In the present study one such framework – the Senior Friendly Hospital (SFH11SFH – Senior Friendly Hospital) Framework – is examined with an intersectoral lens.The study included a scoping review of literature addressing system-based approaches to improving healthcare of older people as well as a modified Delphi process to incorporate these findings into an expanded framework. Qualitative analysis of the data extracted from the scoping review resulted in the identification of “senior friendly” excerpts that were charted using an apriori matrix provided by the SFH Framework. Researchers conducted thematic analysis of the excerpts to avoid redundancy and wrote statements to optimize thematic clarity. In a modified Delphi process, the statements were subsequently rated for perceived importance, clarity and fit by an intersectoral panel of experts resulting in a refined Senior Friendly Care (sfCare22sfCare – Senior Friendly Care) Framework comprising 31 statements and 7 guiding principles to consider when implementing improvements in the care of older adults. Finally, a panel of stakeholders were consulted for feedback on the clarity of the framework's intent and its anticipated impact on care. The sfCare Framework is now available to guide hospital and community-based health service development for older adults.

Multilevel Governance and the Implementation of Inclusion Policy for Older Adults With Intellectual and Developmental Disabilities in Canada

AbstractThis study analyzes the influence of Canadian provincial governance structures on support services for older adults with intellectual and developmental disabilities. Following multilevel governance (MLG) literature, it compares Ontario's more centralized governance structure with Québec's more disentangled multi‐jurisdictional structure by how they promote social inclusion—a guiding policy priority for disability and aging services. Despite their divergent MLG structures, the findings show that when accounting for implementation effects, Ontario and Québec are producing strikingly similar social inclusion outcomes, owing to the similar motivations of frontline workers. Interviewees in both provinces prioritized needs related to health and medication use, to the detriment of social inclusion goals, reflecting the “siloization” of aging and disability support services. Respondents also stressed the impracticality of person‐centered care within current funding models, thus defending divergence from a central policy priority in both provinces. This points to the importance of accounting for the input of policy implementers, whose resistance to overarching policy priorities confound structural differences in the production of policy outcomes.

A SHARP Response: Developing COVID-19 Research Aims in Partnership with the Seniors Helping as Research Partners (SHARP) Group.

COVID-19 has disproportionally impacted older adults, and has highlighted many issues, including extreme deficiencies in Canadian long-term care homes and gaps in home and community care services for older adults. In recent years, there has been a push towards better patient and family engagement in health system research, and with the onset of the pandemic, engaging older adults in research and policy planning is more important than ever. In this article, we describe the Seniors Helping as Research Partners (SHARP) approach to engagement with older adults as an example of how partnerships that engage older adults in the development of research aims and processes can help to ensure that future research meets the needs of older adults. SHARP members highlighted a number of areas for future COVID-19 research such as improvements to long-term care, enhancing access to home and community care, and a focus on aging and social isolation.