Learning Together During a Pandemic Lockdown: Connecting Older Mentors with Nursing Students

Abstract Nursing education tends to focus on complex clinical issues affecting older adults who are acutely ill or in long-term care. This creates challenges for educators wanting to expose students to a greater range of experience, including realities of healthy aging. Opportunities to do things differently were presented when an established undergraduate nursing course on complex aging care underwent significant adjustment in the early months of the COVID-19 pandemic. As the course was condensed and moved online and clinical sites closed, invitations were extended to community-dwelling older people who wanted to “help teach nursing students about aging”. The response was overwhelming; over nine days, 118 people (ages 65-94) volunteered to be mentors. Through weekly online/ phone conversations, each person guided their assigned student to learn about diverse experiences of aging. Post-survey results showed the impact of these conversations. Over 90% of mentors felt they had contributed in a meaningful way to student learning and would do it again and recommend it to others. 85% of students felt it was a meaningful experience, offering comments like: “I am more mindful of my assumptions now” and “I learned to approach interactions with older adults as a collaboration; we have so much to give each other”. These results provide a needed counterpoint to the predominant COVID discourse of older people as “isolated, helpless, and needy”. Students came to understand that older people were also “engaged, active, and contributing” and identified how this had changed their view of aging. Implications for nursing education are explored.


LONELINESS AMONG RURAL AND UNDERSERVED OLDER ADULTS DURING THE COVID-19 PANDEMIC
Lindsay Wilkinson, 1 Julie Masters, 2 Christopher Kelly, 1 Miechelle McKelvey, 3 Ladan Ghazi Saidi, 3 and Toni Hill, 4 1.University of Nebraska Omaha, Omaha, Nebraska, United States, 2. University of Nebraska Omaha, Lincoln, Nebraska, United States, 3. University of Nebraska Kearney,Kearney,Nebraska,United States,4.University of Nebraska -Kearney, Kearney, Nebraska, United States During the COVID-19 pandemic, older adults are among the most vulnerable populations to the medical complications of COVID-19; however, they are also deeply affected by the unintended consequences of social distancing and sheltering in place.Social distancing effectively mitigates the spread of COVID-19, but this practice can also lead to social isolation and loneliness.Drawing on a sample of adults age 60 or older receiving Meals on Wheels/Grab and Go Meals in the state of Nebraska, this study investigates loneliness among rural and underserved older adults during the COVID-19 pandemic.Surveys were distributed to 3725 meal recipients across Nebraska's eight Area Agencies on Aging in July 2020 (response rate = 50%), and a stratified random subsample was selected for preliminary analysis (N = 240).Logistic regression models were used to estimate the effects of COVID-19 and its associated safety precautions on loneliness.The findings reveal that 1 in 10 older adults have not left their home in over a month, and 38 percent feel lonelier due to the impact of COVID-19.Older adults who engaged in more community activities before the pandemic, reported leaving their home less, and experienced a longer absence of social interaction since the pandemic all had significantly increased odds of feeling lonelier in the COVID-19 era.Longer duration of sheltering in place was marginally associated with increased loneliness.The findings from this study show the consequences of social distancing on rural and underserved older adults, which calls for coordinated intervention.

LONELINESS DURING COVID-19: DOES LIVING SITUATION OR ABILITY TO ACCESS INFORMATION ABOUT SOCIAL ACTIVITIES MATTER?
Patti Parker, 1 Verena Menec, 2 and Nancy Newall, 3 1.University of Alberta,Edmonton,Alberta,Canada,2. University of Manitoba,Winnipeg,Manitoba,Canada,3. Brandon University,Brandon,Manitoba,Canada Social isolation is deleterious for both mental and physical health (Coyle & Dugan, 2012;Hawkley et al., 2006).Conversely, social participation has mental and physical health benefits (Novek et al., 2013).In light of the current Covid-19 pandemic requiring social distancing, the present study examined whether living situation and ability to access information about social activities are associated with older adults' loneliness during the pandemic.Specifically, we surveyed ninety-one adults aged 60 years or older in May and June of 2020, at a time when social distancing measures were still in place.We tested whether their living situation and having access to information about social activities was associated with loneliness.OLS regression analyses revealed living alone was associated with higher loneliness (b = .43,p = .050);and having access to information about social activities was associated with lower loneliness (b = -.18,p = .027)amidst the pandemic.The analyses controlled for participants' age, gender, and education.Our findings highlight that during Covid-19, older adults' living situation and access to information about social activities matter and may impact their social behavior.Thus, at this difficult time, it is recommended organizations that offer social activities find creative ways to reach those living alone who will benefit most from having access to such activities.

LONG-TERM CARE REGISTERED DIETITIANS' INITIAL RESPONSE TO THE COVID-19 PANDEMIC Julie Beitel, and Allison Cammer, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
At the outset of the global pandemic, long-term care (LTC) homes in Canada were captured in media reports as the centre of Canada's COVID-19 epidemic.An estimated 80% of all COVID-19 deaths in Canada were associated with LTC outbreaks as of May 25, 2020.Infection control measures have swiftly changed the environment in many LTC homes for residents, workers, loved ones, and other supports.Registered Dietitians (RDs) are among the many care professionals working in LTC affected by these changes.The aim of this qualitative study was to examine the roles of RDs in supporting LTC residents during the initial phases of the pandemic.RDs faced remote practice, redeployment to address pandemic priorities, or cohorting to a sole practice site, yet were responsible for resident nutritional health.In-depth, web-based, semi-structured interviews with thirteen RDs working in LTC in a prairie province of Canada were used to explore the changes to work, challenges faced, impact on residents, and innovations in practice.The findings from this study capture nutrition and wellness-related implications of the COVID-19 pandemic within LTC homes.Examining the initial response of LTC RDs to the COVID-19 pandemic can help in planning for opportunities to support or enhance delivery of nutrition care in LTC homes, both in the context of the ongoing pandemic as well as future practice.

MATERIAL HARDSHIP, MENTAL HEALTH, AND PARENTING STRESS AMONG GRANDPARENT KINSHIP PROVIDERS IN COVID-19
Yanfeng Xu, 1 Qi Wu, 2 Sue Levkoff, 1 and Merav Jedwab, 3 1.University of South Carolina,Columbia,South Carolina,United States,2. Arizona State University,Phoenix,Arizona,United States,3. Hadassah Academic College,Jerusalem Israel,Israel The COVID 19 pandemic has exposed the vulnerability of many families, including grandparent kinship families, to deal with a health/economic crisis.The fear of COVID-19 plus stay-at-home orders have increased individuals' psychological distress.Moreover, school closures and homeschooling further increased parenting stress among caregivers.This study examined the relationship between material hardship and parenting stress among grandparent kinship providers and assessed grandparents' mental health as a potential mediator to this relationship during the COVID-19 pandemic in the United States.Grandparent kinship providers (N=362) that took primary care of their grandchildren participated in a cross-sectional survey via Qualtrics Panels in June 2020 in the United States.Descriptive and bivariate analyses, binary logistic regression, and mediation analyses were conducted using STATA 15.0.Experiencing material hardship (OR = 1.67, p < 0.001) was significantly associated with higher odds of parenting stress among grandparent kinship providers, and grandparents' mental health (indirect effect = 0.11, 95% CI [0.01, 0.25]) partially mediated this association.Addressing material and mental health needs among grandparent kinship providers is critical to decreasing their parenting stress.

MENTAL HEALTH IMPACT OF THE CONFINEMENT MEASURES DURING THE COVID-19 PANDEMIC
Claire Pauly, 1 Valerie Schröder, 2 Laure Pauly, 3 Rejko Krüger, 4 and Anja Leist, 1 1.University of Luxembourg, Esch-sur-Alzette, Luxembourg, 2. Luxembourg Centre for Systems Biomedicine,Belvaux,Luxembourg,3. Clinical and Experimental Neuroscience,Luxembourg Centre for Systems Biomedicine,University of Luxembourg,Luxembourg,Luxembourg,4. Luxembourg Institute of Health,Strassen,Luxembourg Background.Mid-March 2020, with exponentially increasing COVID-19 infections, Luxembourg closed schools and businesses, and declared a crisis (état de crise) to implement confinement measures, including orders to not leave the home unless to fulfill essential needs.The psychological consequences of these policy responses to the pandemic on older people, considered a high-risk group, were unknown at the time.The aim of this study was to use the nationally representative CON-VINCE study that assessed mental health at the height of the confinement measures mid-April 2020, to assess the psychological impact of quarantine on older adults.Method.A total of 451 participants aged 60+ years (55.0%male) filled in the CES-D, the GAD-7 and the 3-item loneliness scale that measured depressive symptoms, level of anxiety, and feelings of social isolation.Results.Mean age was 67.7 years (SD 5.5), average number of school years were 13.1 (SD 3.6).The participants were mainly of Luxembourgish nationality (87.8%), and a majority (69.8%) was married.Clinically relevant depression scores were present in 13.1%, generalized anxiety in 1.8%, and self-perceived isolation in 16.9% of participants.Number of depressive symptoms was associated with perceived isolation (p<0.001) and current exercise levels (p=0.02).Discussion.The rate of older adults with clinically relevant impaired mental health was similar to pre-pandemic levels in Luxembourg, suggesting that negative mental health consequences of the confinement measures were largely absent.Possible explanations are that confinement was considered a universal experience, and that the healthcare system remained functional, unlike in other countries at the time.