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1.
Eur Geriatr Med ; 13(3): 719-724, 2022 06.
Article in English | MEDLINE | ID: covidwho-1653868

ABSTRACT

The COVID-19 pandemic has severely affected older adults and brought about unprecedented challenges to geriatricians. We aimed to evaluate the experiences of early career geriatricians (residents or consultants with up to 10 years of experience) throughout Europe using an online survey. We obtained 721 responses. Most of the respondents were females (77.8%) and residents in geriatric medicine (54.6%). The majority (91.4%) were directly involved in the care of patients with COVID-19. The respondents reported moderate levels of anxiety and feelings of being overloaded with work. The anxiety levels were higher in women than in men. Most of the respondents experienced a feeling of a strong restriction on their private lives and a change in their work routine. The residents also reported a moderate disruption in their training and research activities. In conclusion, early career geriatricians experienced a major impact of COVID-19 on their professional and private lives.


Subject(s)
COVID-19 , Geriatrics , Aged , COVID-19/epidemiology , Female , Geriatricians/education , Humans , Male , Pandemics , SARS-CoV-2
2.
Australas J Ageing ; 41(2): 301-308, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1570311

ABSTRACT

OBJECTIVE: To investigate geriatricians' views about issues facing geriatric medicine, and the preparedness of the health-care system during the COVID-19 pandemic. METHODS: An online survey of heads of geriatric medicine departments in hospitals in Australia and New Zealand undertaken in May 2020. RESULTS: The majority of hospitals had admitted one or more patients with suspected COVID-19. Most geriatricians believed their hospital was 'adequately' or 'well prepared' for the pandemic. Inpatient capacity increased to manage acute, post-acute and rehabilitative care of older patients with COVID-19. Non-inpatient services for older people were reduced and telehealth-instituted widely. Increases in work hours, on-call and staffing levels were reported. Geriatricians voiced major concerns about the preparedness of residential aged care facilities to manage the pandemic. CONCLUSIONS: The COVID-19 pandemic impacted on geriatricians and the provision of geriatric medicine services. Many issues that subsequently affected older people were predicted in advance.


Subject(s)
COVID-19 , Geriatrics , Aged , COVID-19/epidemiology , COVID-19/therapy , Geriatricians , Humans , New Zealand/epidemiology , Pandemics
3.
Ageing Res Rev ; 69: 101373, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1242880

ABSTRACT

The coronavirus disease 19 (COVID-19) is relevant in older people. Attention was given to the nursing homes in which frailer people are usually admitted. In this review, we discuss the approaches for daily problems found in nursing home as geriatricians and potentially new research directions. We start with the problem of the older people affected by dementia and Behavioral and Psychological Symptoms of Dementia for which also the execution of a simple diagnostic test (such as nasopharyngeal swab) could be problematic. Another important problem is the management of wandering patients for which the re-organization of the spaces and vaccination could be the solutions. The relationship with families is another important problem, also from a medico-legal point of view, that can be faced using video conferencing tools. Moreover, we discussed the importance of stratifying prognosis in older nursing home residents for the best management and therapeutically approach, including palliative care, also using telemedicine and the inclusion of prognostic tools in daily clinical practice. Finally, we approached the therapeutical issues in older people that suggests the necessity of future research for finding older-friendly medications.


Subject(s)
COVID-19 , Dementia , Aged , Dementia/therapy , Geriatricians , Humans , Nursing Homes , SARS-CoV-2
4.
J Am Geriatr Soc ; 69(5): 1166, 2021 05.
Article in English | MEDLINE | ID: covidwho-1232317
5.
Clin Interv Aging ; 16: 731-738, 2021.
Article in English | MEDLINE | ID: covidwho-1218451

ABSTRACT

The COVID-19 pandemic has disproportionately impacted frail older adults, especially residents of long-term care (LTC) facilities. This has appropriately led to prioritization of frail older adults and LTC residents, and those who care for them, in the vaccination effort against COVID-19. Older adults have distinct immunological, clinical, and practical complexity, which can be understood through a lens of frailty. Even so, frailty has not been considered in studies of COVID-19 vaccines to date, leading to concerns that the vaccines have not been optimally tailored for and evaluated in this population even as vaccination programs are being implemented. This is an example of how vaccines are often not tested in Phase 1/2/3 clinical trials in the people most in need of protection. We argue that geriatricians, as frailty specialists, have much to contribute to the development, testing and implementation of COVID-19 vaccines in older adults. We discuss roles for geriatricians in ten stages of the vaccine development process, covering vaccine design, trial design, trial recruitment, establishment and interpretation of illness definitions, safety monitoring, consideration of relevant health measures such as frailty and function, analysis methods to account for frailty and differential vulnerability, contributions in regulatory and advisory roles, post-marketing surveillance, and program implementation and public health messaging. In presenting key recommendations pertinent to each stage, we hope to contribute to a dialogue on how to push the field of vaccinology to embrace the complexity of frailty. Making vaccines that can benefit frail older adults will benefit everyone in the fight against COVID-19.


Subject(s)
Biomedical Research/organization & administration , COVID-19/epidemiology , Frailty/epidemiology , Geriatricians/organization & administration , Physician's Role , Aged , COVID-19/prevention & control , COVID-19 Vaccines , Frail Elderly/statistics & numerical data , Humans , Male , Pandemics , Public Health , SARS-CoV-2
6.
Rev Esp Geriatr Gerontol ; 56(3): 157-165, 2021.
Article in Spanish | MEDLINE | ID: covidwho-1108647

ABSTRACT

Older people living in nursing homes fulfil the criteria to be considered as geriatric patients, but they often do not have met their health care needs. Current deficits appeared as a result of COVID-19 pandemic. The need to improve the coordination between hospitals and nursing homes emerged, and in Madrid it materialized with the implantation of Liaison Geriatrics teams or units at public hospitals. The Sociedad Española de Geriatría y Gerontología has defined the role of the geriatricians in the COVID-19 pandemic and they have given guidelines about prevention, early detection, isolation and sectorization, training, care homes classification, patient referral coordination, and the role of the different care settings, among others. These units and teams also must undertake other care activities that have a shortfall currently, like nursing homes-hospital coordination, geriatricians visits to the homes, telemedicine sessions, geriatric assessment in emergency rooms, and primary care and public health services coordination. This paper describes the concept of Liaison Geriatrics and its implementation at the Autonomous Community of Madrid hospitals as a result of COVID-19 pandemic. Activity data from a unit at a hospital with a huge number of nursing homes in its catchment area are reported. The objective is to understand the need of this activity in order to avoid the current fragmentation of care between hospitals and nursing homes. This activity should be consolidated in the future.


Subject(s)
COVID-19/epidemiology , Geriatrics/organization & administration , Homes for the Aged/organization & administration , Nursing Homes/organization & administration , Pandemics , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/prevention & control , Emergency Service, Hospital/legislation & jurisprudence , Emergency Service, Hospital/organization & administration , Geriatric Assessment , Geriatricians/organization & administration , Geriatricians/supply & distribution , Health Services Administration , Homes for the Aged/classification , Hospitals, Public/organization & administration , Humans , Nursing Homes/classification , Pandemics/prevention & control , Patient Isolation , Primary Health Care/organization & administration , Public Health Administration , Referral and Consultation/organization & administration , SARS-CoV-2/immunology , Seroepidemiologic Studies , Spain/epidemiology , Telemedicine/organization & administration
9.
Clin Interv Aging ; 15: 1067-1069, 2020.
Article in English | MEDLINE | ID: covidwho-682350

ABSTRACT

The pandemic of the Covid-19 virus has become the main issue all over the world. In its current form, the disease is more severe in geriatric cases and individuals with chronic disease, even causing death. In older adults and atypical presentations, testing strategies for Covid-19, potential drug interactions of experimental Covid-19 therapies, and ageism are important issues in the course of the disease. Therefore, health-care professionals should be aware of these, and screening policies for Covid-19 should also include atypical presentations with or without classical symptoms of the illness in older adults. Furthermore, evaluation of individuals > 65 years of age from a geriatrician's perspective is very important, because Covid-19 is severe and fatal in seniors.


Subject(s)
Coronavirus Infections/epidemiology , Geriatricians/standards , Health Personnel/standards , Pneumonia, Viral/epidemiology , Aged , Ageism , Betacoronavirus , COVID-19 , Chronic Disease , Coronavirus Infections/prevention & control , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , SARS-CoV-2
10.
J Am Med Dir Assoc ; 21(7): 939-942, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-361511

ABSTRACT

The COVID-19 pandemic is devastating post-acute and long-term care (PA/LTC). As geriatricians practicing in PA/LTC and a regional academic medical center, we created this program for collaboration between academic medical centers and regional PA/LTC facilities. The mission of the Geriatric Engagement and Resource Integration in Post-Acute and Long-Term Care Facilities (GERI-PaL) program is to support optimal care of residents in PA/LTC facilities during the COVID-19 pandemic. There are 5 main components of our program: (1) Project ECHO; (2) nursing liaisons; (3) infection advisory consultation; (4) telemedicine consultation; and (5) resident social contact remote connections. Implementation of this program has had positive response from our local PA/LTC facilities. A key component of our program is our interprofessional team, which includes physicians and nursing, emergency response, and public health experts. With diverse professional backgrounds, our team members have created a new model for academic medical centers to collaborate with local PA/LTC facilities.


Subject(s)
Academic Medical Centers/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Skilled Nursing Facilities/organization & administration , Aged , COVID-19 , Female , Geriatricians/organization & administration , Geriatrics/organization & administration , Humans , Interdisciplinary Communication , Long-Term Care/organization & administration , Male , Nursing Homes/organization & administration , Outcome Assessment, Health Care , Pandemics , Patient Care Team/organization & administration , Program Evaluation , Remote Consultation/organization & administration , Risk Assessment , Telemedicine/organization & administration , United States
11.
J Am Med Dir Assoc ; 21(7): 937-938, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-108863

ABSTRACT

On February 20, 2020, a man living in the north of Italy was admitted to the emergency room with an atypical pneumonia that later proved to be COVID-19. This was the trigger of one of the most serious clusters of COVID-19 in the world, outside of China. Despite aggressive restraint and inhibition efforts, COVID-19 continues to increase, and the total number of infected patients in Italy is growing daily. After 6 weeks, the total number of patients reached 128,948 cases (April 5, 2020), with the higher case-fatality rate (15,887 deaths) dominated by old and very old patients. This sudden health emergency severely challenged the Italian Health System, in particular acute care hospitals and intensive care units. In 1 hospital, geriatric observation units were created, the experience of which can be extremely useful for European countries, the United States, and all countries that in the coming days will face a similar situation.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Disease Outbreaks/statistics & numerical data , Geriatric Assessment/methods , Geriatricians/statistics & numerical data , Infection Control/organization & administration , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Aged , Aged, 80 and over , COVID-19 , Disease Outbreaks/prevention & control , Emergency Service, Hospital/organization & administration , Female , Health Services for the Aged/organization & administration , Hospitalization/statistics & numerical data , Hospitals, Teaching , Humans , Intensive Care Units/organization & administration , Italy/epidemiology , Male , Outcome Assessment, Health Care , Pandemics , Physician's Role , Precision Medicine/methods , Risk Assessment
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