Palliative Care for Older Adults with Multimorbidity in the Time of COVID 19

Powell, Victoria

doi:10.1080/08959420.2020.1851436

Cited by 14 publications

(34 citation statements)

References 16 publications

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“…Access to COVID-related services Acute COVID services [5,11,12] Supplementary oxygen services [5] ICU services [13] Access to non-COVID related services Homecare [14][15][16] Tele health [17][18][19][20][21][22][23][24][25][26][27][28] Routine/Outpatient health care [16,21,24,27,[29][30][31] Oral healthcare [24] Mental healthcare [11,12,19,29,30,[32][33][34][35][36][37][38] Medications [20] Palliative care services [13,23,39] Chronic healthcare services [40,41] Other primary healthcare services [42] Literacy and education Digital literacy [19,22,…”

Section: Main Themes Sub-themes Referencesmentioning

confidence: 99%

Factors influencing access and utilization of health services among older people during the COVID − 19 pandemic: a scoping review

et al. 2021

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Background Access to healthcare and service utilization are both considered essential factors for improving the general health and wellbeing of older people, especially at the time of COVID-19 pandemic. The aim of the study is to explore factors affecting healthcare access and health service utilization for older people during the pandemic. Methods PubMed, Web of Science, Scopus and Embase were systematically searched for relevant articles. Access, utilization, health, elderly and COVID-19 were used as keywords in the search strategy. A total of 4308 articles were identified through the initial database search; 50 articles were included in the review as passing the eligibility criteria. The searches were conducted up to August 2021. Data extraction was performed, and evidence was descriptively illustrated. Thematic analysis was used to explore factors influencing the elderly’s access and utilization of healthcare services, using Max QDA10, a qualitative analysis software. Results Among articles included in the review (n = 50), a majority of the studies were from the United States (36%), followed by India (8%). According to the main healthcare services, a large number of articles (18%) were related to mental health services, followed by digital health services (16%). Factors were identified at an individual, provider and systems level. Seven main themes emerged from the thematic analysis, as determinants of elderly’s access and utilization of healthcare services during COVID-19 pandemic. These included: access to non-COVID related services, access to COVID-related services, literacy and education, accommodation challenges, perceived attitudes of aging, and policies and structures, and social determinants. Conclusion Mental health and digital health services were identified as major issues influencing or contributing to or influencing older people’s health during the COVID-19 pandemic. We also argue on the importance of a rounded view, as attention to a range of factors is vital for policy decisions towards sustainable care and equitable interventions for improving the health of older people.

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Section: Main Themes Sub-themes Referencesmentioning

confidence: 99%

Factors influencing access and utilization of health services among older people during the COVID − 19 pandemic: a scoping review

et al. 2021

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“…Palliative care is specialized, holistic, person-centered medical care that aims to manage the symptoms of serious illnesses and to improve the quality of life of patients, their families, and their caregivers [ 1 ]. It provides communication, care coordination, and emotional support to patients and their family members, in addition to symptom management [ 2 ]. Palliative care seeks to align patients’ goals with the potential added benefit of lowering healthcare costs [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Older adults with multi-morbidity have experienced the most severe forms of COVID-19 symptoms, including trouble breathing and death [ 12 ]. Palliative care could provide communication, care coordination, and emotional support to these patients and their family members, in addition to symptom management [ 2 ]. In order to further promote palliative care use, especially in the context of future pandemics, it is important to investigate the types of opinions and perceptions about palliative care that people exchanged in relation to the COVID-19 pandemic, including misconceptions.…”

Section: Introductionmentioning

confidence: 99%

Opinion and Sentiment Analysis of Palliative Care in the Era of COVID-19

Inoue

Hashemi

et al. 2023

Healthcare

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During the COVID-19 pandemic, the value of palliative care has become more evident than ever. The current study quantitatively investigated the perceptions of palliative care emerging from the pandemic experience by analyzing a total of 26,494 English Tweets collected between 1 January 2020 and 1 January 2022. Such an investigation was considered invaluable in the era of more people sharing and seeking healthcare information on social media, as well as the emerging roles of palliative care. Using a web scraping method, we reviewed 6000 randomly selected Tweets and identified four themes in the extracted Tweets: (1) Negative Impact of the Pandemic on Palliative Care; (2) Positive Impact of the Pandemic on Palliative Care; (3) Recognized Benefits of Palliative Care; (4) Myth of Palliative Care. Although a large volume of Tweets focused on the negative impact of COVID-19 on palliative care as expected, we found almost the same volume of Tweets that were focused on the positive impact of COVID-19 on palliative care. We also found a smaller volume of Tweets associated with myths about palliative care. Using these manually classified Tweets, we trained machine learning (ML) algorithms to automatically classify the remaining tweets. The automatic classification of Tweets was found to be effective in classifying the negative impact of the COVID-19.

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“…This pathway of polypharmacy and hospital frequentation is particularly harmful to older individuals, triggering frailty, dependence, comorbidity, and a greater risk of mortality [18]. In addition, these multimorbid patients frequently experience pain, fatigue, dyspnea, depress mood, and anxiety in this last stage of lifespan, requiring palliative care [19]. Medication together with palliative care specialists, who are skilled at the management of limiting symptoms such as pain, are of paramount importance; however, palliative caregivers are still scarce, and both factors together increase sanitary burden [19].…”

Section: Introductionmentioning

confidence: 99%

“…These multicomponent programs aim specifically to improve both physical and cognitive function, and might be of great interest due to this mixed nature [33,34]. Noteworthy, palliative older adults live all together with high rates of pain [19,23] and intolerance to exercise [35], hindering their exercise training.…”

Section: Introductionmentioning

confidence: 99%

Multicomponent Physical Exercise Training in Multimorbid and Palliative Oldest Adults

Blasco-Lafarga

Soler

Llorens

2021

IJERPH

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Exercise counteracts aging and pathology symptoms, but there is still scarce research on exercise programs for multimorbid and/or palliative old patients (MPO-Ps). In order to analyze whether the multicomponent physical–cognitive training is beneficial for this population, 17 MPO-Ps (81.59 ± 5.63 years) completed a >26 weeks home-based intervention (20–50 min/session, three sessions/week). Twenty-eight supervised and thirty-two autonomous sessions were gradually distributed along three phases: supervised training (ST), reduced supervision training (RST), and autonomous training (AT). Physical function (gait speed, hand grip and lower-limb strength, balance, and agility), mental status (MMSE), and autonomy in daily living (the Barthel Index) were assessed. Categorical analyses regarding the changes in the walking aids used in the test were added to improve the assessment of strength and agility along the intervention. Despite important study limitations, such as the small sample size and lack of a control group, and despite the MPO-Ps’ very low baseline fitness and initial exercise intolerance, they benefited from the dual-tasking approach, especially in autonomy, lower-limb strength, and balance. Agility improvements were shown only by categorical analyses. As expected, most benefits increased the supervision (ST phase). Gait speed and cognitive status maintained despite the total autonomy in training in the last phase. Further research with larger samples should confirm if multicomponent physical–cognitive exercise, individualized and tailored on daily-basis, together with technical assistance and medical supervision, benefits this MPO-Ps population, and if it can be prescribed to them with security, in spite some of them already being palliative patients.

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Palliative Care for Older Adults with Multimorbidity in the Time of COVID 19

Cited by 14 publications

References 16 publications

Factors influencing access and utilization of health services among older people during the COVID − 19 pandemic: a scoping review

Factors influencing access and utilization of health services among older people during the COVID − 19 pandemic: a scoping review

Opinion and Sentiment Analysis of Palliative Care in the Era of COVID-19

Multicomponent Physical Exercise Training in Multimorbid and Palliative Oldest Adults

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