Geriatric care model for older patients with COVID-19 at a community treatment facility in Hong Kong

Abstract

Background. During the fifth wave of the COVID-19 pandemic in Hong Kong, a geriatric team was established to provide interdisciplinary intervention and discharge planning for older patients in a community treatment facility (CTF) at the AsiaWorld-Expo. This study examined clinical outcomes among these older patients and identified key determinants of these outcomes.Methods. Medical records of patients aged ≥60 years who were admitted to the CTF for management of COVID-19 by a geriatric team between 24 March 2022 and 4 May 2022 were retrospectively reviewed. Baseline characteristics, geriatric syndrome statuses, laboratory results, treatments, and clinical outcomes were collected. Risk factors for transfer to an acute care hospital, 28-day mortality, and 28-day readmission were examined.Results. Among 257 patients admitted to the CTF, 29.6% had geriatric syndromes; poor oral feeding was most common. The proportion of patients with frailty increased by 14.4% upon discharge. The 28-day mortality rate was 12.5%; risk factors were dexamethasone use and transfer to an acute care hospital. The 28-day readmission rate was 33.9%; risk factors were higher Charlson Comorbidity Index, dementia, and moderate to severe hyponatraemia.Conclusions. Geriatric syndromes (particularly poor oral feeding) were common in older patients with COVID-19 who were associated with significant post-hospitalisation mortality, readmission, and worsened frailty with functional decline. These findings highlight the importance of a geriatric care model in the management of older patients with COVID-19.

Fresh news as meaningful? A multi‐site ethnographic analysis of meaningful activities at four day centres in Denmark and Norway

“…Therefore, it has been claimed that close friendships and social interaction with others outside the family and previous network are important for older persons' social needs and meaningfulness (Ashida & Heaney, 2008). In that respect, it has been reported that day care centres can fulfil social needs and offer a sense of social connectedness and belonging that counteracts loneliness (Carlsson et al, 2020; Hickerson et al, 2008; Miller, 2016; Orellana et al, 2020c; Walker et al, 2004) and that staff‐facilitated activities can enhance meaningfulness and well‐being of the elderly people (Seddigh et al, 2020; enhancing well‐being and quality of life (Fields et al, 2014; García‐Martín et al, 2004; Kwok et al, 2013; Miller, 2016; Orellana et al, 2020c; Pitkala et al, 2009; Svidén et al, 2004; Tollén et al, 2007). Nevertheless, it is still a mystery as to what attendees find meaningful in attending organised activities and especially what the staff experiences as meaningful and purposeful about the activities offered.…”