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Cien Saude Colet ; 26(1): 159-168, 2021 Jan.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-33533836


The objective of this study is to analyze the residential care crisis in Spain in the context of the COVID-19 pandemic and its impact on high mortality and abandonment of the user population. The direct, indirect and structural causes are analyzed. Specifically, precarious employment in residences over the past decade was analyzed as one of the main explanatory causes of the structural crisis of nursing homes. The theoretical focus of analysis is the comprehensive and person-centered care (CPCC) model based on the autonomy of people and the centrality of their rights. The methodology combines a quantitative analysis of employment and a qualitative analysis of documents and debates. The study concludes by proposing a comprehensive reform of long-term care that includes both a change in residential care in the form of small cohabitation units and reinforcement of care in the home and the community as a growing preference for the elderly population. An optimal combination of residential and home care is the basic proposal of this work.

/epidemiologia , Instituição de Longa Permanência para Idosos , Casas de Saúde , Pandemias , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Emprego , Feminino , Serviços de Saúde para Idosos/organização & administração , Instituição de Longa Permanência para Idosos/legislação & jurisprudência , Instituição de Longa Permanência para Idosos/organização & administração , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Masculino , Casas de Saúde/legislação & jurisprudência , Casas de Saúde/organização & administração , Casas de Saúde/estatística & dados numéricos , Assistência Centrada no Paciente , Pesquisa Qualitativa , Distribuição por Sexo , Espanha/epidemiologia
S Afr Fam Pract (2004) ; 63(1): e1-e5, 2021 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-33567833


The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on elderly patients, and thus, adequate treatment plans are essential. This qualitative report provides recommendations for the supportive care and treatment of residents in long-term care facilities (LTCF) with COVID-19. A treatment protocol was developed in response to an outbreak of COVID-19 in an LTCF based in Johannesburg and was implemented over a 3-month period.

/terapia , Instituição de Longa Permanência para Idosos/organização & administração , Controle de Infecções/organização & administração , Assistência de Longa Duração/organização & administração , Casas de Saúde/organização & administração , Administração dos Cuidados ao Paciente/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Idoso Fragilizado , Implementação de Plano de Saúde , Humanos , Controle de Infecções/métodos , Assistência de Longa Duração/métodos , Masculino , África do Sul
J Am Med Dir Assoc ; 22(2): 253-255.e1, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33406385


Long-term care facilities (LTCFs), retirement homes (RHs), and other congregate care settings in Canada and worldwide have experienced significant COVID-19 outbreaks. As a health system response, our acute care hospital in Toronto, Ontario, Canada, developed and mobilized an onsite Infection Prevention and Control (IPAC) SWAT team (IPAC-SWAT) to regional settings on outbreak and implemented a strategy of support through education, training, and engagement. Between April 28, 2020, and June 30, 2020, IPAC-SWAT assessed 7 LTCFs and 10 RHs for IPAC preparedness and actively managed 10 of 13 COVID-19 outbreaks (LTCF n=5; RH n=5). IPAC-SWAT strategies were multi-interventional and intended to mitigate further viral transmission or prevent outbreaks. Dedicated training of local "IPAC champions" was facilitated at 7 sites (LTCF = 5; RH = 2) using a "train-the-trainer" approach to promote local knowledge, autonomy, and site-led audits and feedback.

/epidemiologia , Instituição de Longa Permanência para Idosos/organização & administração , Controle de Infecções/organização & administração , Assistência de Longa Duração/organização & administração , Inovação Organizacional , Pneumonia Viral/virologia , Idoso , Feminino , Humanos , Masculino , Ontário/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
PLoS One ; 15(12): e0243726, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33320911


Extending previous studies on job crafting, the aim of the present study is to analyze the effect of job crafting on quality of care in residential homes for elderly people in two European countries (Spain and Sweden). We hypothesize that cognitive crafting could be a consequence of behavioral crafting and that it will mediate the relationship between behavioral crafting and the perception of quality of care. A correlational design was used, with two-waves approximately 12 months apart (n = 226). Our results indicate that behavioral job crafting at T1 had an effect on cognitive job crafting at T2, relational job crafting at T1 increases quality of care at T2, and the mediation effect of cognitive job crafting. These results indicate that we must differentiate between the two forms of crafting (behavioral and cognitive), not as indicators of the same latent construct, but as aggregates. Additionally, we point out two main implications for managerial practice. First, as relational job crafting has a direct effect on quality of care, it is important to assure an organizational culture oriented towards employees. Secondly, due to the mediation effect of cognitive job crafting, managers should facilitate meaningful work environments. To do so, jobs should be re-designed, increasing skills variety, identity and significance.

Pessoal de Saúde/organização & administração , Instituição de Longa Permanência para Idosos/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Engajamento no Trabalho , Local de Trabalho/organização & administração , Idoso , Cognição , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Satisfação no Emprego , Masculino , Papel Profissional/psicologia , Espanha , Inquéritos e Questionários/estatística & dados numéricos , Suécia , Local de Trabalho/psicologia , Local de Trabalho/estatística & dados numéricos
Tijdschr Gerontol Geriatr ; 51(3)2020 Apr 23.
Artigo em Holandês | MEDLINE | ID: mdl-32951401


Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study.Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems.The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

Infecções por Coronavirus/epidemiologia , Assistência à Saúde/métodos , Instituição de Longa Permanência para Idosos/organização & administração , Casas de Saúde/organização & administração , Pneumonia Viral/epidemiologia , Idoso , Betacoronavirus , Comunicação , Demência , Desastres , Humanos , Pandemias , Qualidade de Vida
Rev. Rol enferm ; 43(9): 579-599, sept. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-194389


El coronavirus SARS-CoV-2 causa COVID-19, una enfermedad cuyas manifestaciones clínicas varían desde una infección asintomática hasta cuadros clínicos graves, incluso con desenlace fatal. Este virus procede de China y en pocos meses se ha extendido por todo el planeta, lo que demuestra una alta capacidad de transmisión. Su transmisión es muy buena en entornos cerrados, poco ventilados, donde haya muchas personas, a poca distancia entre ellas y que no usen mascarillas. El estudio de las medidas preventivas frente a COVID-19 tiene una importancia capital en esta nueva enfermedad, que ha demostrado su agresividad y letalidad, sobre todo porque no se dispone de tratamientos efectivos específicos ni de vacunas comercializadas para su uso poblacional. Esto adquiere mayor importancia, si cabe, cuando se conoce, a través de diversos estudios, que la inmunidad poblacional es en todo el mundo baja o muy baja, a pesar de la agresividad del virus; también en España, como mostró un importante estudio longitudinal seroepidemiológico de base poblacional en el ámbito nacional. A pesar de la ausencia de tratamientos efectivos específicos y de vacunas comercializadas, la población debe convivir con el virus hasta que pueda ser vencido definitivamente. La sociedad no puede pararse indefinidamente y debe seguir adelante, aplicando las recomendaciones para prevenir la infección por el virus. En este contexto resulta clave poner en marcha el sistema educativo presencial y las residencias de mayores, dos actores imprescindibles en nuestra sociedad. Para su funcionamiento de la forma más segura posible, se requiere aplicar las medidas preventivas con efectividad y conocimiento. En este artículo se expone una aproximación a los factores de riesgo poblacional frente al virus y a las medidas preventivas de aplicación poblacional más significativas para reducir la transmisión del coronavirus SARS-CoV-2 basadas en la evidencia científica actual. Para ello se ha realizado una revisión de la bibliografía disponible en PubMed (inglés y castellano) sobre prevención de la infección por coronavirus SARS-CoV-2, sin limitación de rango temporal dado el reciente comienzo de la afectación humana conocida, y en instituciones y entidades de referencia. La ventilación con aire exterior, la higiene de manos frecuente (lavado o aplicación de gel hidroalcohólico), el distanciamiento social, evitar aglomeraciones, la limpieza y desinfección de objetos y superficies y el uso de mascarillas son las medidas preventivas de aplicación general que pueden considerarse de más impacto. No hay que olvidar otras como, por ejemplo, no fumar

Coronavirus SARS-CoV-2 causes COVID-19, a disease whose clinical manifestations can vary from an asymptomatic infection to a severe medical condition (including death). This virus comes from China and, in a few months, it has spread throughout the planet, proving to have a high transmission rate. A transmission which is excellent in closed, poorly ventilated environments, where there are many people with a short distance between them. Studying useful preventive measures against COVID-19 has a great importance in fighting this new disease, which has proved its high aggressiveness and lethality, especially since no specific treatments or vaccines are available on the market at the present. This becomes even more important when it is known that population immunity is low or very low over the world, including Spain, despite the aggressiveness of the virus, as an important population-based seroepidemiological longitudinal study showed at the national level. Despite the absence of specific effective treatments and marketed vaccines, the population must live with the virus until it can be definitively defeated. Society cannot stop indefinitely and must move forward, applying the recommendations to prevent the infection with the virus to the entire population. In this context, implementing these measures in an in-person education system and in the residences of the elderly (two essential actors in our society) is a key to fight the pandemic. To operate as safely as possible, preventive measures are required apply with effectiveness and knowledge. This article outlines an approximation of population risk factors against the virus and the most significant preventive measures of popular application to reduce the transmission of SARC-CoV-2 coronavirus based on current scientific evidence. To achieve this, a review of the available literature in PubMed (English and Spanish) on the prevention of coronarivus infection has been carried out, without limitation of temporal range given the recent beginning of known human involvement. Ventilation with outdoor air, frequent hands hygiene, social distancing, avoiding crowds, cleaning and disinfection of objects and surfaces and the use of masks are the preventive measures of general application that can be considered of the greatest impact. Do not forget others such as not smoking

Humanos , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Precauções Universais/métodos , Síndrome Respiratória Aguda Grave/prevenção & controle , Vírus da SARS/patogenicidade , Instituição de Longa Permanência para Idosos/organização & administração , Instituições Acadêmicas/organização & administração , Centros de Saúde
Cuad. bioét ; 31(102): 223-229, mayo-ago. 2020.
Artigo em Espanhol | IBECS | ID: ibc-194279


La llegada de la pandemia COVID-19 puso en evidencia el riesgo de una posible falta de atención de los ancianos de las residencias de mayores. Aportamos la experiencia de un equipo multidisciplinar con profesionales voluntarios de diferentes especialidades que realizó una labor de apoyo a los profesionales sanitarios de las residencias. Este equipo se implementó desde las gerencias de atención primaria y de atención especializada. La sistemática de trabajo se inspiraba en el de hospitalización a domicilio e incluía la atención directa de los pacientes más complejos y el asesoramiento en las medidas de prevención, aislamiento e higiene dentro de la residencia. De este modo fue posible que los ancianos de las residencias con sospecha o diagnóstico de COVID-19 recibieran una atención adecuada por parte de un equipo interdisciplinar, que se descargara parte de la presión de los profesionales de las residencias y que los familiares percibieran que no existía abandono terapéutico. El compromiso desde diversos niveles asistenciales en una labor coordinada ha conseguido evitar que una población vulnerable pudiera quedar desatendido durante la pandemia

With the arrival of the COVID-19 pandemic, the risk of a possible lack of care for the elderly in nursing homes became evident. We summarize the experience of a multidisciplinary team with volunteer professionals from different specialties who carried out support for healthcare professionals in nursing homes. This team was implemented from both Primary and Specialty Care managements. Its work paradigm was proposed by our home hospitalization team, which included direct care of the most complex patients and general counselling on isolation, hygiene and preventive measures within the nursing homes. Thanks to this support, the elderly population placed there, with suspected or diagnosed COVID-19, received adequate care from an interdisciplinary team, which led part of the pressure to be released from their professional workers, and many family members were aware that there was no neglect of the elderly. Commitment from various levels of care in a coordinated effort has prevented a vulnerable population from being left unattended during the pandemic

Humanos , Idoso , Instituição de Longa Permanência para Idosos/organização & administração , Direitos dos Idosos/legislação & jurisprudência , Pandemias/ética , Infecções por Coronavirus/epidemiologia , Recusa do Médico a Tratar/ética , Prioridades em Saúde/ética , Capacidade de Resposta ante Emergências/ética
Cuad. bioét ; 31(102): 231-243, mayo-ago. 2020.
Artigo em Espanhol | IBECS | ID: ibc-194280


La pandemia por Covid-19 ha afectado especialmente a los mayores que viven en residencias desde su aparición. Para frenar sus efectos devastadores las autoridades sanitarias pusieron en marcha numerosos protocolos y medidas que han podido vulnerar la debida ética asistencial. El asilamiento social de los ancianos de las residencias, el confinamiento en las habitaciones, el cribado en la derivación de los pacientes mayores a los hospitales, y a las unidades de cuidados intensivos han hecho tanto daño como beneficio. En el presente trabajo se plantean diversas líneas reflexivas en torno a la eticidad de cada una de las medidas adoptadas. También acerca del papel de los comités de ética en la vigilancia y supervisión de todos los procesos asistenciales en las residencias

The Covid-19 pandemic has particularly affected older people living in nursing homes since its onset. To curb its devastating effects, the health authorities have put in place numerous protocols and measures that have been able to violate the proper ethics of care. The social isolation of the elderly from the nursing homes, the confinement in the rooms, the screening in the referral of the elderly patients to the hospitals, and to intensives cares units have done both harm and benefit. In the present work, several reflexive lines are proposed around the ethicity of each of the measures adopted. Also about the role of ethics commit-tees in the monitoring and supervision of all care processes in residences

Humanos , Idoso , Instituição de Longa Permanência para Idosos/organização & administração , Direitos dos Idosos/legislação & jurisprudência , Pandemias/ética , Infecções por Coronavirus/epidemiologia , Temas Bioéticos , Recusa do Médico a Tratar/ética , Prioridades em Saúde/ética , Capacidade de Resposta ante Emergências/ética , Ageismo/ética
Rev. Rol enferm ; 43(7/8): 529-539, jul.-ago. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-192954


COVID-19 es una enfermedad provocada por coronavirus SARS-CoV-2, un virus detectado recientemente. Se originó en China y en pocos meses se ha extendido por todo el planeta, lo que demuestra una alta capacidad de transmisión. Su transmisión es muy buena en entornos cerrados, poco ventilados, donde haya muchas personas, a poca distancia entre ellas y que no usen mascarilla. Las personas mayores se muestran especialmente susceptibles a este virus y desarrollan muchas veces cuadros clínicos graves que han llevado a un desenlace fatal. En ello influyen factores de las propias personas, como un deterioro del sistema de defensa y la existencia de enfermedades previas, pero también factores del medio en el que estas personas se encuentran. Así, en los centros sociosanitarios la situación puede agravarse con factores del entorno como escasa ventilación, baja exposición solar, excesivo número de personas por unidad de superficie, dependencia y realización de numerosas actividades que implican un mayor contacto interpersonal, etc. En este artículo se hace una aproximación a los factores que inducen que las personas mayores sean especialmente vulnerables a COVID-19 y a las medidas que se pueden poner en marcha para paliar esta situación

COVID-19 is the disease produced by SARS-CoV-2 coronavirus, a recently detected pathogen. It originated in China and, in a few months, it has spread all over the planet. This proved a high rate of transmission, which is great in closed and weakly ventilated environments, especially if there is a high number of people, keeping a short distance between them, and without using mask. It has been proved that elders are especially vulnerable to this virus and can develop with a higher probability, far more severe clinical features with a fateful prognosis. However, it must be taken into account that the prognosis of a COVID-19 patient depends on many factors, including the patient himself, a weak immune system, and the existence of previous diseases. In addition, environment-dependent factors cannot be forgot. That's how in nursing homes, the situation can be worse if these environment-dependent factors come into action, such as a poor ventilation, a low sun exposure, an excessive number of people and the performance of many activities that could involve a high interpersonal contact. In this article, an approach is made to the factors that induce the elderly to be especially vulnerable to COVID-19, and to the measures that can be put in place to alleviate this situation

Humanos , Idoso , Infecções por Coronavirus/prevenção & controle , Cuidados de Enfermagem/métodos , Controle de Doenças Transmissíveis/métodos , Síndrome Respiratória Aguda Grave/prevenção & controle , Vírus da SARS/patogenicidade , Fatores Etários , Fatores de Risco , Infecções por Coronavirus/epidemiologia , Instituição de Longa Permanência para Idosos/organização & administração , Precauções Universais/métodos , Pandemias/estatística & dados numéricos
Int Psychogeriatr ; 32(10): 1239-1243, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32609082
J Am Med Dir Assoc ; 21(7): 900-904, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32674816


OBJECTIVES: To prevent and control COVID-19 infections, nursing homes across the world have taken very restrictive measures, including a ban for visitors. These restrictive measures have an enormous impact on residents' well-being and pose dilemmas for staff, although primary data are lacking. A Dutch guideline was developed to cautiously open nursing homes for visitors during the COVID-19 pandemic. This study reports the first findings on how the guideline was applied in the local context; the compliance to local protocols; and the impact on well-being of residents, their family caregivers, and staff. DESIGN: A mixed-methods cross-sectional study was conducted. SETTING AND PARTICIPANTS: In total, 26 nursing homes were permitted to enlarge their possibilities for allowing visitors in their facility. These nursing homes were proportionally representative of the Netherlands as they were selected by their local Area Health Authority for participation. At each nursing home, a contact person was selected for participation in the current study. METHODS: A mixed-methods cross-sectional study was conducted, consisting of questionnaire, telephone interviews, analyses of documentation (ie, local visiting protocols), and a WhatsApp group. RESULTS: Variation in local protocols was observed, for example, related to the use of personal protective equipment, location, and supervision of visits. In general, experiences were very positive. All nursing homes recognized the added value of real and personal contact between residents and their loved ones and indicated a positive impact on well-being. Compliance with local guidelines was sufficient to good. No new COVID-19 infections were reported during this time. CONCLUSIONS AND IMPLICATIONS: These results indicate the value of family visitation in nursing homes and positive impact of visits. Based on these results, the Dutch government has decided to allow all nursing homes in the Netherlands to cautiously open their homes using the guidelines. More research is needed on impact and long-term compliance.

Infecções por Coronavirus/prevenção & controle , Guias como Assunto , Controle de Infecções/organização & administração , Casas de Saúde/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Visitas a Pacientes/legislação & jurisprudência , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Avaliação Geriátrica , Fidelidade a Diretrizes , Instituição de Longa Permanência para Idosos/organização & administração , Humanos , Masculino , Países Baixos , Pandemias/estatística & dados numéricos , Segurança do Paciente , Pneumonia Viral/epidemiologia