Subject(s)
Communicable Disease Control/organization & administration , Continuity of Patient Care , Coronavirus Infections , Health Services Accessibility , Health Services for the Aged , Pandemics , Pneumonia, Viral , Aged , COVID-19 , Continuity of Patient Care/organization & administration , Continuity of Patient Care/standards , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Health Services Accessibility/standards , Health Services Accessibility/statistics & numerical data , Health Services Needs and Demand , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Hospital Bed Capacity , Hospitalization/statistics & numerical data , Humans , Italy/epidemiology , Mortality , Organizational Innovation , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapySubject(s)
Aging , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Mental Health Services , Pandemics , Pneumonia, Viral , Aged , Aging/physiology , Aging/psychology , Betacoronavirus , COVID-19 , China/epidemiology , Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Geriatric Psychiatry/methods , Geriatric Psychiatry/trends , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Humans , Mental Health/trends , Mental Health Services/organization & administration , Mental Health Services/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , SARS-CoV-2 , Social Isolation/psychology , Vulnerable Populations/psychologyABSTRACT
COVID-19 has exacted a disproportionate toll on the health of persons living in nursing homes. Healthcare providers and other decision-makers in those settings must refer to multiple evolving sources of guidance to coordinate care delivery in such a way as to minimize the introduction and spread of the causal virus, SARS-CoV-2. It is essential that guidance be presented in an accessible and usable format to facilitate its translation into evidence-based best practice. In this article, we propose the Haddon matrix as a tool well-suited to this task. The Haddon matrix is a conceptual model that organizes influencing factors into pre-event, event, and post-event phases, and into host, agent, and environment domains akin to the components of the epidemiologic triad. The Haddon matrix has previously been applied to topics relevant to the care of older persons, such as fall prevention, as well as to pandemic planning and response. Presented here is a novel application of the Haddon matrix to pandemic response in nursing homes, with practical applications for nursing home decision-makers in their efforts to prevent and contain COVID-19.
Subject(s)
COVID-19 , Civil Defense/organization & administration , Evidence-Based Practice , Homes for the Aged/organization & administration , Infection Control , Models, Organizational , Nursing Homes/organization & administration , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Disease Transmission, Infectious/prevention & control , Evidence-Based Practice/methods , Evidence-Based Practice/trends , Health Services for the Aged/organization & administration , Health Services for the Aged/standards , Health Services for the Aged/trends , Humans , Infection Control/methods , Infection Control/organization & administration , Infection Control/standards , Organizational Innovation , SARS-CoV-2 , United StatesSubject(s)
Aging , Communicable Disease Control , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Mental Health Services , Pandemics , Pneumonia, Viral , Aged , Aging/physiology , Aging/psychology , Betacoronavirus , COVID-19 , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Geriatric Psychiatry/methods , Geriatric Psychiatry/trends , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Humans , Mental Health/trends , Mental Health Services/organization & administration , Mental Health Services/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , SARS-CoV-2 , Social Isolation/psychology , Taiwan/epidemiology , Vulnerable Populations/psychologySubject(s)
Aging , Communicable Disease Control , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Mental Health Services , Pandemics , Pneumonia, Viral , Aged , Aging/physiology , Aging/psychology , Betacoronavirus , COVID-19 , Caribbean Region/epidemiology , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Geriatric Psychiatry/methods , Geriatric Psychiatry/trends , Health Services Needs and Demand , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Humans , Mental Health/trends , Mental Health Services/organization & administration , Mental Health Services/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , SARS-CoV-2 , Social Isolation/psychologySubject(s)
COVID-19 , Emotional Intelligence , Geriatrics/education , Independent Living/psychology , Social Isolation/psychology , Students, Medical/psychology , Aged , COVID-19/prevention & control , COVID-19/psychology , Curriculum/trends , Health Services for the Aged/trends , Humans , Physical Distancing , Psychosocial Intervention/methods , SARS-CoV-2 , Social SupportSubject(s)
Coronavirus Infections , Geriatric Nursing , Homes for the Aged , Nurse-Patient Relations , Nursing Homes , Pandemics , Patient Care , Pneumonia, Viral , Quarantine , Aged, 80 and over , Attitude of Health Personnel , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/nursing , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Dementia/nursing , Dementia/psychology , Geriatric Nursing/ethics , Geriatric Nursing/methods , Geriatric Nursing/trends , Health Services for the Aged/standards , Health Services for the Aged/trends , Humans , Needs Assessment , Pandemics/prevention & control , Patient Care/ethics , Patient Care/methods , Patient Care/psychology , Personal Protective Equipment/supply & distribution , Pneumonia, Viral/epidemiology , Pneumonia, Viral/nursing , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Practice Patterns, Nurses'/trends , Qualitative Research , Quarantine/methods , Quarantine/psychology , SARS-CoV-2 , Sweden/epidemiologySubject(s)
Aging , Cognition Disorders/therapy , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Pandemics , Pneumonia, Viral , Telemedicine/organization & administration , Aged , Aging/physiology , Aging/psychology , Betacoronavirus , COVID-19 , Communicable Disease Control/methods , Continuity of Patient Care/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Geriatric Psychiatry/methods , Geriatric Psychiatry/standards , Geriatric Psychiatry/trends , Health Services for the Aged/supply & distribution , Health Services for the Aged/trends , Humans , Internet Access , Mental Health/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Quality of Health Care , SARS-CoV-2 , Vulnerable PopulationsABSTRACT
The SARS-CoV-2 pandemic has led to a dramatic crisis of Health Care Systems worldwide, and older people have been among the most disadvantaged. Specific recommendations and reports have been released both at International and National level, regarding the diagnosis and management of COVID-19 in the elderly. However, little has been proposed for an appropriate response to older, frail and multimorbid patients in different settings of care (acute care units, long term care facilities, nursing homes and primary care) and for the management of geriatric syndromes (i.e. delirium, sarcopenia, falls). We presume that the current pandemic of will leads to substantial changes in health care systems, and we suggest some key guide principles that could inspire the provision of healthcare services to older people and their families. These principles are primarily directed to physicians and nurses working in the geriatric field but could also be useful for other specialists.
Subject(s)
Coronavirus Infections , Health Services for the Aged , Pandemics , Patient Care Management/methods , Pneumonia, Viral , Quality Improvement/organization & administration , Aged , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Health Services for the Aged/organization & administration , Health Services for the Aged/standards , Health Services for the Aged/trends , Humans , Multiple Chronic Conditions/epidemiology , Multiple Chronic Conditions/therapy , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , SARS-CoV-2Subject(s)
Aging , Communicable Disease Control , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Mental Health Services , Pandemics , Pneumonia, Viral , Aged , Aging/physiology , Aging/psychology , Betacoronavirus , COVID-19 , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Geriatric Psychiatry/methods , Geriatric Psychiatry/trends , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Humans , India/epidemiology , Mental Health/trends , Mental Health Services/organization & administration , Mental Health Services/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , SARS-CoV-2 , Vulnerable Populations/psychologySubject(s)
Aging/psychology , COVID-19 , Health Services for the Aged/trends , Meditation/psychology , Stress, Psychological , Yoga/psychology , Aged , Ageism/prevention & control , COVID-19/epidemiology , COVID-19/psychology , Health Services Needs and Demand , Humans , Mental Health , Mind-Body Therapies/methods , SARS-CoV-2 , Stress, Psychological/etiology , Stress, Psychological/prevention & controlSubject(s)
Aging , Communicable Disease Control , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Mental Health Services , Pandemics , Pneumonia, Viral , Aged , Aging/physiology , Aging/psychology , Ambulatory Care Facilities/statistics & numerical data , Betacoronavirus , Brazil/epidemiology , COVID-19 , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Geriatric Psychiatry/methods , Geriatric Psychiatry/trends , Health Services Needs and Demand , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Humans , Mental Health/trends , Mental Health Services/organization & administration , Mental Health Services/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Professional Practice Gaps , SARS-CoV-2 , Tertiary Healthcare/methods , Tertiary Healthcare/trendsSubject(s)
Aging , Communicable Disease Control , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Homes for the Aged , Mental Health Services , Nursing Homes , Pandemics , Pneumonia, Viral , Aged , Aging/physiology , Aging/psychology , Betacoronavirus , COVID-19 , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Geriatric Psychiatry/methods , Geriatric Psychiatry/trends , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Humans , Mental Health/trends , Mental Health Services/organization & administration , Mental Health Services/trends , Needs Assessment , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , SARS-CoV-2 , Social Isolation/psychology , Telemedicine/methods , Turkey/epidemiology , Vulnerable Populations/psychologySubject(s)
Aging , Communicable Disease Control/methods , Coronavirus Infections , Geriatric Psychiatry/methods , Health Services for the Aged , Mental Health , Pandemics , Pneumonia, Viral , Aged , Aging/physiology , Aging/psychology , Betacoronavirus/pathogenicity , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Humans , Organizational Innovation , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Risk Factors , SARS-CoV-2Subject(s)
Aging , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Influenza, Human , Pandemics , Pneumonia, Viral , Telemedicine , Vaccination/methods , Aged , Aging/physiology , Aging/psychology , Betacoronavirus , Brazil/epidemiology , COVID-19 , Communicable Disease Control/methods , Continuity of Patient Care/trends , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Geriatric Psychiatry/methods , Geriatric Psychiatry/standards , Geriatric Psychiatry/trends , Health Services for the Aged/supply & distribution , Health Services for the Aged/trends , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Mental Health/trends , Norway/epidemiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Portugal/epidemiology , SARS-CoV-2 , Telemedicine/methods , Telemedicine/organization & administrationSubject(s)
Aging , Communicable Disease Control , Coronavirus Infections , Geriatric Psychiatry , Health Services for the Aged , Mental Health Services , Pandemics , Pneumonia, Viral , Aged , Aging/physiology , Aging/psychology , Australia/epidemiology , Betacoronavirus , COVID-19 , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Coronavirus Infections/transmission , Disease Transmission, Infectious/prevention & control , Geriatric Psychiatry/methods , Geriatric Psychiatry/trends , Health Services Needs and Demand , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Humans , Mental Health/trends , Mental Health Services/organization & administration , Mental Health Services/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Pneumonia, Viral/transmission , SARS-CoV-2 , Social Isolation/psychologyABSTRACT
The ongoing coronavirus disease 2019 (COVID-19) pandemic has affected millions of people in over 180 territories, causing a significant impact on healthcare systems globally. Older adults, as well as people living with cancer, appear to be particularly vulnerable to COVID-19 related morbidity and mortality, which means that older adults with cancer are an especially high-risk population. This has led to significant changes in the way geriatric oncologists provide care to older patients, including the implementation of novel methods for clinical visits, interruptions or delays in procedures, and modification of therapeutic strategies, both in the curative and palliative settings. In this manuscript, we provide a global overview of the perspectives of geriatric oncology providers from countries across Europe, America, and Asia, regarding the adaptive strategies utilized to continue providing high quality care for older patients with cancer during the COVID-19 pandemic. Through these perspectives, we attempt to show that, although each country and setting has specific issues, we all face similar challenges when providing care for our older patients with cancer during these difficult times.
Subject(s)
Coronavirus Infections , Health Services for the Aged , Infection Control/methods , Medical Oncology , Neoplasms , Pandemics , Pneumonia, Viral , Aged , COVID-19 , Change Management , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Global Health/statistics & numerical data , Health Services for the Aged/organization & administration , Health Services for the Aged/trends , Humans , Medical Oncology/methods , Medical Oncology/trends , Neoplasms/epidemiology , Neoplasms/therapy , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Quality of Health Care , Risk FactorsABSTRACT
New York City is currently experiencing an outbreak of COVID-19, a highly contagious and potentially deadly virus, which is particularly dangerous for older adults. This pandemic has led to public health policies including social distancing and stay-at-home orders. We explore here the impact of this unique crisis on victims of elder mistreatment and people at risk of victimization. The COVID-19 outbreak has also had a profound impact on the organizations from many sectors that typically respond to protect and serve victims of elder mistreatment. We examine this impact and describe creative solutions developed by these organizations and initial lessons learned in New York City to help inform other communities facing this pandemic and provide guidance for future crises.
Subject(s)
Coronavirus Infections , Crime Victims/psychology , Health Services for the Aged , Pandemics , Pneumonia, Viral , Public Policy , Social Isolation/psychology , Aged , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , COVID-19 , Chronic Disease/epidemiology , Communicable Disease Control/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/physiopathology , Coronavirus Infections/psychology , Elder Abuse/economics , Elder Abuse/legislation & jurisprudence , Elder Abuse/prevention & control , Elder Abuse/psychology , Female , Health Services for the Aged/standards , Health Services for the Aged/trends , Humans , Male , Mortality , New York City/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Pneumonia, Viral/physiopathology , Pneumonia, Viral/psychology , Public Policy/legislation & jurisprudence , Public Policy/trends , Risk Assessment , SARS-CoV-2ABSTRACT
Older people are particularly affected by the COVID-19 outbreak because of their vulnerability as well as the complexity of health organisations, particularly in the often-compartmentalised interactions between community, hospital and nursing home actors. In this endemic situation, with massive flows of patients requiring holistic management including specific and intensive care, the appropriate assessment of each patient's level of care and the organisation of specific networks is essential. To that end, we propose here a territorial organisation of health care, favouring communication between all actors. This organisation of care is based on three key points: To use the basis of territorial organisation of health by facilitating the link between hospital settings and geriatric sectors at the regional level.To connect private, medico-social and hospital actors through a dedicated centralised unit for evaluation, geriatric coordination of care and decision support. A geriatrician coordinates this multidisciplinary unit. It includes an emergency room doctor, a supervisor from the medical regulation centre (Centre 15), an infectious disease physician, a medical hygienist and a palliative care specialist.To organise an ad hoc follow-up channel, including the necessary resources for the different levels of care required, according to the resources of the territorial network, and the creation of a specific COVID geriatric palliative care service. This organisation meets the urgent health needs of all stakeholders, facilitating its deployment and allows the sustainable implementation of a coordinated geriatric management dynamic between the stakeholders on the territory.