ABSTRACT
Background COVID-19 has had a disproportionate impact on nursing home residents with significantly higher mortality rates compared to the general population. Less attention however has been paid to COVID- 19 induced morbidity in this cohort. Our study aims to examine how nursing home (NH) residents who survived a COVID-19 infection, have been affected in terms of their cognitive, mood and functional outcomes as compared to residents that did not contract the virus. Method We performed an observational retrospective cohort study of the records of 452 residents in NHs affected by COVID-19 in Ireland from February 2020 to February 2021. We extracted data from the scheduled monthly assessments of the Barthel Index (BI), the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) performed on residents of these NHs. We compared data from residents who had contracted COVID-19 (cases) to those that had not (controls);at 6, 3 and 1 month prior to a positive COVID-19 PCR test, to ensure comparability of control group, and again at 1, 3 and 6 months after the infection using a Students-T test for normally distributed data. Results We noted a significant deterioration in MMSE, BI and GDS scores in residents who had contracted COVID-19 as outlined in the table. While there was recovery in BI and GDS in the months following the index infection, the MMSE score in COVID-19 affected residents remained significantly adversely affected at 6 months. Conclusion Our study demonstrates the significant impact of COVID-19 infection on the physical, functional, cognitive and mental health of nursing home residents. The patient cohort displayed significant resilience in recovering from the physical and psychological consequences of the disease. The failure of cognitive function to improve over the period of observation may represent the development of 'Long COVID' in these patients. The development of this condition in nursing home residents has been poorly studied, is likely under reported and requires further exploration.
ABSTRACT
The role of care management within healthcare is evolving to help healthcare organizations respond to the demands of outcomes-based financial arrangements, the COVID-19 pandemic, and persistent inequitable health outcomes. Comprehensive care management plays a key role in enabling care that is responsive to the needs and desires of diverse patient populations, including older adults and people with complex care needs. While technology developments and other trends offer the promise of efficiency gains, when combined with financial pressures, they threaten to reduce the availability of relationship-based comprehensive care management, which is key to Age-Friendly Health Systems and the ability to age in community. Copyright 2020 American Society on Aging;all rights reserved.