A COVID-19 Support Platform for Long Term Care Facilities

Rolland, Yves; Benetos, A.; Villars, H.; Braun, Helga Samara Ferreira; Blain, Hubert

doi:10.1007/s12603-020-1364-x

Cited by 23 publications

(22 citation statements)

References 3 publications

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“…Such a prevalence of atypical symptoms in this study confirms the great variety of presentations of the infection in this age group, confirming studies that have reported COVID-19 diagnosis after admission for syncope and delirium [25], or fall in older adults [26]. Further, an anomalous clinical presentation of COVID-19 heightens the risk of misdiagnosis leading to inappropriate medical care without quarantine and can be particularly dangerous in terms of infectiousness when considering nursing homes [18,27].…”

Section: Discussionsupporting

confidence: 85%

Acute Care of Older Patients with COVID-19: Clinical Characteristics and Outcomes

et al. 2020

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(1) Background: COVID-19 has become a global pandemic and older patients present higher mortality rates. However, studies on the characteristics of this population set are limited. The objective of this study is to describe clinical characteristics and outcomes of older patients hospitalized with COVID-19. (2) Methods: This retrospective cohort study was conducted from March to May 2020 and took place in three acute geriatric wards in France. Older patients hospitalized for COVID-19 infections were included. We collected clinical, radiological, and laboratory outcomes. (3) Results: Ninety-four patients were hospitalized and included in the final analysis. Mean age was 85.5 years and 55% were female. Sixty-four (68%) patients were confirmed COVID-19 cases and 30 (32%) were probable. A majority of patients were dependent (77%), 45% were malnourished, and the mean number of comorbidities was high in accordance with the CIRS-G score (12.3 ± 25.6). The leading causes of hospitalization were fever (30%), dyspnea (28%), and geriatric syndromes (falls, delirium, malaise) (18%). Upon follow-up, 32% presented acute respiratory failure and 30% a geriatric complication. Frailty and geriatric characteristics were not correlated with mortality. Acute respiratory failure (p = 0.03) and lymphopenia (p = 0.02) were significantly associated with mortality. (4) Conclusions: Among older patients hospitalized with COVID-19, clinical presentations were frequently atypical and complications occurred frequently. Frailty and geriatric characteristics were not correlated with mortality.

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Section: Discussionsupporting

confidence: 85%

Acute Care of Older Patients with COVID-19: Clinical Characteristics and Outcomes

et al. 2020

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“… Report positive SARS-CoV-2 results to local authorities and maintain records of staff members and residents who have positive tests to facilitate the reporting of aggregate data to national databases [ 11 ]. Assess IPC practices with help from the proximity COVID-19 support platform for LTCFs or a hygiene platform in the proximity hospital while conducting facility-wide testing [ 47 ]. Isolation and COVID-19 precautions in residents tested positive for COVID-19 should last until they meet the end of isolation criteria, in accordance with national guidance.…”

Section: Second Interim Eugms Guidance To Prepare European Long-term mentioning

confidence: 99%

“…Assess IPC practices with help from the proximity COVID-19 support platform for LTCFs or a hygiene platform in the proximity hospital while conducting facility-wide testing [ 47 ].…”

Section: Second Interim Eugms Guidance To Prepare European Long-term mentioning

confidence: 99%

“…These measure should be set up in collaboration with (1) nurses who have gerontological training, especially in dementia and palliative care, (2) care attendants who have due training in the care of older people, (3) physicians with a formal competencies in geriatric medicine and old-age psychiatry, and (4) specialist gerontology services, including geriatricians, old-age psychiatry and clinical nurse specialists as well as (5) specialists in palliative care support. COVID-19 geriatric support platforms can serve to liaise with IPCFP, hospital geriatric units (public or private), clinical nurse specialists, specialists in palliative care and infectious diseases, IPCFP of other LTCFs in the region, and public health [ 47 ]. In a recent study, every 20 min (per resident day) increase in registered nurse staffing was associated with a 22% reduction in the number of confirmed COVID-19 cases (in facilities with at least one confirmed case) and with 26% fewer COVID-19 deaths (in facilities with at least one death due to this infection).…”

Section: Second Interim Eugms Guidance To Prepare European Long-term mentioning

confidence: 99%

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August 2020 Interim EuGMS guidance to prepare European Long-Term Care Facilities for COVID-19

et al. 2020

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Purpose The European Geriatric Medicine Society (EuGMS) is launching a second interim guidance whose aim is to prevent the entrance and spread of COVID-19 into long-term care facilities (LTCFs). Methods The EuGMS gathered experts to propose a guide of measures to prevent COVID-19 outbreaks in LTCFs. It is based on the specific features of SARS-CoV-2 transmission in LTCFs, residents’ needs, and on experiences conducted in the field. Results Asymptomatic COVID-19 residents and staff members contribute substantially to the dissemination of COVID-19 infection in LTCFs. An infection prevention and control focal point should be set up in every LTCF for (1) supervising infection prevention and control measures aimed at keeping COVID-19 out of LTCFs, (2) RT-PCR testing of residents, staff members, and visitors with COVID-19 symptoms, even atypical, and (3) isolating subjects either infected or in contact with infected subjects. When a first LCTF resident or staff member is infected, a facility-wide RT-PCR test–retest strategy should be implemented for detecting all SARS-CoV-2 carriers. Testing should continue until no new COVID-19 cases are identified. The isolation of residents should be limited as much as possible and associated with measures aiming at limiting its negative effects on their mental and somatic health status. Conclusions An early recognition of symptoms compatible with COVID-19 may help to diagnose COVID-19 residents and staff more promptly. Subsequently, an earlier testing for SARS-CoV-2 symptomatic and asymptomatic LTCF staff and residents will enable the implementation of appropriate infection prevention and control. The negative effects of social isolation in residents should be limited as much as possible.

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“…AWGS recommends telephone‐ or online‐based support interventions for homebound seniors to prevent functional declines, and anxiety and/or depressive mood; adequate psychosocial support and financial relief schemes should be rendered to the “invisible workforce” of family caregivers and foreign/domestic helpers to ensure appropriate day‐to‐day care for seniors in home settings. AWGS recommends COVID‐19‐specific strategies for long‐term care facilities, including support for staff members, infection prevention and control processes, e.g., PPE, physical distancing measures, environmental cleaning and disinfection, visitor policy and restriction of movement . Moreover, a COVID‐19 support platform to advise care via telemedicine, implement screening for COVID‐19 and provide support for staff is recommended. AWGS recommends specific attentions to be paid to common geriatric conditions (e.g., delirium and falls), functional rehabilitation and end‐of‐life care for frail older adults admitted to acute hospitals, as these patients may be looked after by non‐geriatricians AWGS recommends that ethical frameworks that are developed for outbreak response should not automatically disqualify older people from access to intensive care based on age cutoffs .…”

Section: Recommendationsmentioning

confidence: 99%

COVID‐19 and older people in Asia: Asian Working Group for Sarcopenia calls to action

Lim

Liang

Assantachai

et al. 2020

Geriatrics Gerontology Int

131

142

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Japan 11 Health Promotion Administration, Ministry of Health and Welfare, Taiwan Abstract: The coronavirus disease 2019 (COVID-19) pandemic has casted a huge impact on global public health and economy. In this challenging situation, older people are vulnerable to the infection and the secondary effects of the pandemic and need special attentions. To evaluate the impacts of COVID-19 on older people, it is important to balance the successful pandemic control and active management of secondary consequences. These considerations are especially salient in the Asian context, with its diversity among countries in terms of sociocultural heritage, healthcare setup and availability of resources. Thus, the Asian Working Group for Sarcopenia summarized the considerations of Asian countries focusing on responses and difficulties in each country, impacts of health inequity related to COVID-19 pandemic and proposed recommendations for older people which are germane to the Asian context. More innovative services should be developed to address the increasing demands for new approaches to deliver health care in the difficult times and to establish resilient health care systems for older people.

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A COVID-19 Support Platform for Long Term Care Facilities

Cited by 23 publications

References 3 publications

Acute Care of Older Patients with COVID-19: Clinical Characteristics and Outcomes

Acute Care of Older Patients with COVID-19: Clinical Characteristics and Outcomes

August 2020 Interim EuGMS guidance to prepare European Long-Term Care Facilities for COVID-19

COVID‐19 and older people in Asia: Asian Working Group for Sarcopenia calls to action

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