The impact of COVID-19 in nursing homes in Madrid, Spain: a need for assessment

Koleva, Gergana; Rico, Manuel; López, Fernando J. García; Figuera, D; Padilla, Javier; García, Mónica C.

doi:10.1016/j.lanepe.2021.100261

Cited by 7 publications

(7 citation statements)

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“…In all these environments, technologies helped bridge distances and isolation, allowing contact with health professionals, caregivers, and teachers to be maintained. The results reported in the study coincide in highlighting the importance of technologies [ 47 , 48 , 49 , 50 ].…”

Section: Discussionsupporting

confidence: 79%

Care Recommendations for the Chronic Risk of COVID-19: Nursing Intervention for Behaviour Changes

Aguña

Batalla

Diego

et al. 2022

IJERPH

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The COVID-19 pandemic is a challenge for health systems. The absence of prior evidence makes it difficult to disseminate consensual care recommendations. However, lifestyle adaptation is key to controlling the pandemic. In light of this, nursing has its own model and language that allow these recommendations to be combined from global and person-centred perspectives. The purpose of the study is to design a population-oriented care recommendation guide for COVID-19. The methodology uses a group of experts who provide classified recommendations according to Gordon’s functional patterns, after which a technical team unifies them and returns them for validation through the content validity index (CVI). The experts send 1178 records representing 624 recommendations, which are unified into 258. In total, 246 recommendations (95.35%) are validated, 170 (65.89%) obtain high validation with CVI > 0.80, and 12 (4.65%) are not validated by CVI < 0.50. The mean CVI per pattern is 0.84 (0.70–0.93). These recommendations provide a general framework from a nursing care perspective. Each professional can use this guide to adapt the recommendations to each individual or community and thus measure the health impact. In the future, this guideline could be updated as more evidence becomes available.

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Section: Discussionsupporting

confidence: 79%

Care Recommendations for the Chronic Risk of COVID-19: Nursing Intervention for Behaviour Changes

Aguña

Batalla

Diego

et al. 2022

IJERPH

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“…[29] Figures from the Madrid government and the Ministry of Health reported at least 9,470 deaths among nursing home residents in March and April 2020. [30]…”

Section: Resultsmentioning

confidence: 99%

“…[29] Figures from the Madrid government and the Ministry of Health reported at least 9,470 deaths among nursing home residents in March and April 2020. [30] In the first wave of the pandemic Spanish armed forces were called up to help nursing homes.…”

Section: Resultsmentioning

confidence: 99%

Effects of COVID-19 in Care Homes - A Mixed Methods Review

Heneghan

Dietrich²,

Brassey

et al. 2022

Preprint

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IntroductionThe report provides an up-to-date review of the global effects of the COVID-19 pandemic in care homes. We used a mixed methods approach to assess care home mortality by country, how the deaths compared with previous periods, and how excess deaths may be explained. We retrieved national datasets for 25 countries on mortality, 17 cohort studies assessing deaths compared to a previous period, and 16 cohort studies reporting interventions or factors associated with excess mortality.The COVID-19 pandemic disproportionately impacted those living in care homes at the highest risk for severe outcomes. However, the pandemic only highlighted and exacerbated a long-running problem: underfunding, poor structural layout, undertraining, under-skilling, under-equipping, and finally, lack of humanity in dealing with the most vulnerable members of society.The 17 cohort studies point to excess mortality worsening during the pandemic. Despite involving vast numbers of care homes around the globe, the quality of the evidence is not good. For example, the majority of the studies infer the cause of extra deaths from the observation window (mainly the spring of 2020) rather than through detailed investigations. This is why we do not draw any clear conclusions about the specific causes of death, apart from noting their significantly high numbers. In addition, we did not review all policy actions since 2020 but note there has been a scarcity of studies since then - an indicator that interest in this problem has waned and likely not been addressed.Analysis of national datasets for 25 countries shows that care home deaths were, on average, 30% of the total COVID-19 deaths (range: 9-64%). The quality of the current evidence base is limited, short term, and lacks standardised methods to prevent robust countrywide comparisons. Residual excess deaths were also observed, with excess mortality being reported for both COVID-19 positive and negative patients.Several reported interventions or factors suggest the potential to mitigate the risk in care homes substantially. Interventions that could reduce mortality include improving the care home quality, increasing staffing levels, reducing the number of beds in the facility, employing staff confinement strategies with residents, and improving clinical care such as implementing daily examinations. Some care home solutions like US ‘Green House’ homes, which usually have fewer than 12 beds, may provide crucial insights into the care home problem compared with larger homes. Furthermore, care home residents faced barriers accessing emergency treatments during the pandemic waves. Finally, interventions targeting care homes should be subject to smaller trials given large effect sizes in some studies.Approximately one per cent of the global population resides in care homes, while care home residents account for nearly one-third of deaths attributed to COVID-19 in the 25 countries studied. Reducing this ratio requires analysing current care home infrastructures, funding models, and incentives for providing high-quality care. The scale of the problem in care homes requires robust evaluation and coordinated strategies to improve outcomes for those most vulnerable to COVID-19. Failure to address these systemic problems could mean global care home populations will be similarly affected by future crises and pandemics.

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“…This was essentially observed in responses provided by people who were already institutionalized. Added to this is the experience of living in nursing homes during the COVID-19 pandemic, which gave rise to a profound reflection regarding the need to review the current model to improve the age-friendliness and security of nursing homes and make them environments for active and healthy ageing [ 92 , 93 , 94 ].…”

Section: Discussionmentioning

confidence: 99%

Social Image of Old Age, Gendered Ageism and Inclusive Places: Older People in the Media

Sánchez-Román

Autric-Tamayo

Fernández-Mayoralas

et al. 2022

IJERPH

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Ageism promotes the exclusion of older people from society by generating a negative image that they also internalize. The aim of this article is to investigate older people’s social self-image, through statements broadcast on a national Spanish radio program aimed at this group. A qualitative analysis was conducted for a random sample from the sound archive for the Radio Nacional de España program Juntos Paso a Paso (Together, Step by Step) (2008–2021), using codes based on the pillars and determinants of active ageing and the three dimensions of ageism. Intercoder agreement was calculated. There were significant findings regarding ageism, gendered ageism and ageing in place, with differences according to size of municipal area. The program in question can be considered a viable secondary source for the research aim. Ageism is most commonly manifested through implicit opinions and invisibilization in family and social contexts. Care activities play a notably central role in responses related to gendered ageism. In relation to ageing in place, older people prefer their habitual environment when they have moderate care needs and accept moves to nursing homes when their needs increase.

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The impact of COVID-19 in nursing homes in Madrid, Spain: a need for assessment

Cited by 7 publications

References 1 publication

Care Recommendations for the Chronic Risk of COVID-19: Nursing Intervention for Behaviour Changes

Care Recommendations for the Chronic Risk of COVID-19: Nursing Intervention for Behaviour Changes

Effects of COVID-19 in Care Homes - A Mixed Methods Review

Social Image of Old Age, Gendered Ageism and Inclusive Places: Older People in the Media

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