Improving the care of older patients during the COVID-19 pandemic

Bianchetti, Angelo; Bellelli, Giuseppe; Guerini, Fabio; Marengoni, Alessandra; Padovani, Alessandro; Rozzini, Renzo; Trabucchi, Marco

doi:10.1007/s40520-020-01641-w

Cited by 49 publications

(48 citation statements)

References 28 publications

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“…The high mortality rates observed among LTCF residents during the COVID-19 pandemic has triggered a debate about the overall organization and management of these facilities, about patient-staff ratios, about healthcare personnel's skills and, more in general, about resources allocated by the Italian healthcare system in this sector. Even if a unique model of LCTF organization and management cannot be implemented in all Italian Regions for administrative and political reasons, it is clear that it is necessary to allocate more resources for the care of frail patients, especially in LTCF ( 28 ). The “hospital-centered” health system in which the LCTF acts as a passive actor has proven to be totally unsuitable for the proper management of emergencies such as the COVID-19 pandemic ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Older People Living in Long-Term Care Facilities and Mortality Rates During the COVID-19 Pandemic in Italy: Preliminary Epidemiological Data and Lessons to Learn

Girolamo

Bellelli

Bianchetti³

et al. 2020

Front. Psychiatry

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Background: Long-Term Care Facilities (LTCF) in Italy have been particularly affected by the COVID-19 pandemic, especially in terms of mortality rates of older residents. However, it is still unclear the actual extent of this situation. The aim of this manuscript is to assess the extent of mortality rates of older adults in LTCF during the pandemic across different regions of Italy, compared to the previous years and to older general population not resident in LTCF. Methods: We extracted and analyzed data collected by three Italian institutions (i.e., Italian Statistician Institute ISTAT, Italian N.I.H, Milan Health Unit) about the number of deaths among older people living in the community and among LTCF residents during the pandemic and the previous years. We also compared the observed mortality rate among LTCF residents in each Italian Region with the corresponding expected number of deaths of the general older adult population to obtain an observed/expected ratio (O/E ratio). Results: During the pandemic, about 8.5% ( N = 6,797) of Italian older adults residents in LTCF died. Findings resulting from the O/E ratio suggest that LTCF residents (in particular in the Lombardy Region) show higher mortality rates when compared to expected values of mortality rates among the older general population living in the community. Furthermore, we found that the risk of death among LTCF residents increased about 4 times during the pandemic when compared to the previous years. Conclusions: Mortality rates in LTCF were high during the pandemic, especially in Lombardy. Possible causes of higher mortality rates in LTCF and suggestions for specific targeted interventions are discussed.

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Section: Discussionmentioning

confidence: 99%

Older People Living in Long-Term Care Facilities and Mortality Rates During the COVID-19 Pandemic in Italy: Preliminary Epidemiological Data and Lessons to Learn

Girolamo

Bellelli

Bianchetti³

et al. 2020

Front. Psychiatry

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“…On the other hand, the SARS-CoV-2 pandemic has enforced a rapid and unsettling transformation of the world healthcare systems. Detailed recommendations and reports have been published at international level particularly regarding the diagnosis and management of COVID-19 in the older adults [ 21 ]. However, little has been proposed for an appropriate response to older, frail, and multimorbid patients in different settings of care (long-term care, nursing homes, primary care, and hospitals) and for the management of geriatric syndromes (delirium, malnutrition, and falls) [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Age-Friendly Health Care: A Systematic Review

2021

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Background: Health care provided to older adults must take into account the characteristics of chronic diseases and the comorbidities resulting from ageing. However, health services are still too oriented towards acute situations. To overcome this problem, the World Health Organization (WHO) proposed a set of Age-Friendly Principles that seek to optimize the provision of health care for this population. This article aims to understand how such Principles are considered in the implementation of age-friendly health care worldwide. Methods: A systematic review was conducted to synthesize the literature on age-friendly health care in accordance with the PRISMA recommendations in the PubMed, Web of Science, and Scopus databases. Results: The research identified 34 articles, with only seven recognizing the WHO Principles and only four using the implementation toolkit. In addition, in the context of primary care, three studies recognize the WHO Principles, but only two use the toolkit. Conclusions: The WHO Principles are being implemented in health care, but in a smaller scale than desired, which reveals possible flaws in their dissemination and standardization. Thus, a greater scientific investment in age-friendly health care should be considered, which represents a greater operationalization of the Principles and an evaluation of their effectiveness and impacts.

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“…While the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is an unprecedented threat to all of us, older adults are especially at risk for serious complications from coronavirus disease 2019 (COVID-19) that necessitate hospitalization ( 1 , 2 ). Significant attention has rightfully been given to the respiratory and cardiovascular consequences of COVID-19.…”

Section: Introductionmentioning

confidence: 99%