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Eur J Public Health ; 30(Supplement_4): iv22-iv27, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32894300


The present study explores the situation of migrant carers in long-term care (LTC) in European Union Member States and the disruptions caused by the COVID-19 pandemic from a public health perspective. The aim is to bring LTC migrant carers into health workforce research and highlight a need for trans-sectoral and European heath workforce governance. We apply an exploratory approach based on secondary sources, document analysis and expert information. A framework comprising four major dimensions was developed for data collection and analysis: LTC system, LTC health labour market, LTC labour migration policies and specific LTC migrant carer policies during the COVID-19 crisis March to May 2020. Material from Austria, Italy, Germany, Poland and Romania was included in the study. Results suggest that undersupply of carers coupled with cash benefits and a culture of family responsibility may result in high inflows of migrant carers, who are channelled in low-level positions or the informal care sector. COVID-19 made the fragile labour market arrangements of migrant carers visible, which may create new health risks for both the individual carer and the population. Two important policy recommendations are emerging: to include LTC migrant carers more systematically in public health and health workforce research and to develop European health workforce governance which connects health system needs, health labour markets and the individual migrant carers.

Cuidadores/psicologia , Emigração e Imigração , Pessoal Profissional Estrangeiro , Mão de Obra em Saúde , Assistência de Longa Duração , Política Pública , Betacoronavirus , Infecções por Coronavirus , Europa (Continente) , União Europeia , Governo , Serviços de Saúde para Idosos/organização & administração , Humanos , Assistência de Longa Duração/organização & administração , Pandemias , Pneumonia Viral , Saúde Pública
Emerg Med J ; 37(11): 714-716, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32972913


We describe the expansion and adaptation of a frailty response team to assess older people in their usual place of residence. The team had commenced a weekend service to a limited area in February 2020. As a consequence of demand related to the COVID-19 pandemic, we expanded it and adapted the model of care to provide a 7-day service to our entire catchment area. Five hundred and ninety two patient reviews have been completed in the first 105 days of operation with 43 patients transferred to hospital for further investigation or management following assessment.

Infecções por Coronavirus/epidemiologia , Serviços Médicos de Emergência/organização & administração , Idoso Fragilizado , Avaliação Geriátrica , Serviços de Saúde para Idosos/organização & administração , Serviços Hospitalares de Assistência Domiciliar/organização & administração , Pneumonia Viral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Feminino , Humanos , Irlanda/epidemiologia , Masculino , Pandemias
J Am Med Dir Assoc ; 21(7): 937-938, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32674823


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.

Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Surtos de Doenças/estatística & dados numéricos , Avaliação Geriátrica/métodos , Geriatras/estatística & dados numéricos , Controle de Infecções/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Idoso , Idoso de 80 Anos ou mais , Surtos de Doenças/prevenção & controle , Serviço Hospitalar de Emergência/organização & administração , Feminino , Serviços de Saúde para Idosos/organização & administração , Hospitalização/estatística & dados numéricos , Hospitais de Ensino , Humanos , Unidades de Terapia Intensiva/organização & administração , Itália/epidemiologia , Masculino , Avaliação de Resultados em Cuidados de Saúde , Pandemias , Papel do Médico , Medicina de Precisão/métodos , Medição de Risco
Age Ageing ; 49(4): 516-522, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32725209


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.

Infecções por Coronavirus , Avaliação Geriátrica/métodos , Serviços de Saúde para Idosos , Pandemias , Administração dos Cuidados ao Paciente , Pneumonia Viral , Programas Médicos Regionais/organização & administração , Idoso , Betacoronavirus/isolamento & purificação , Redes Comunitárias/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , França/epidemiologia , Alocação de Recursos para a Atenção à Saúde/tendências , Serviços de Saúde para Idosos/ética , Serviços de Saúde para Idosos/organização & administração , Serviços de Saúde para Idosos/tendências , Humanos , Inovação Organizacional , Cuidados Paliativos/métodos , Pandemias/prevenção & controle , Administração dos Cuidados ao Paciente/ética , Administração dos Cuidados ao Paciente/organização & administração , Administração dos Cuidados ao Paciente/tendências , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Web Semântica , Participação dos Interessados
Aging Clin Exp Res ; 32(9): 1883-1888, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32654005


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.

Infecções por Coronavirus , Serviços de Saúde para Idosos , Pandemias , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral , Melhoria de Qualidade/organização & administração , Idoso , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Serviços de Saúde para Idosos/organização & administração , Serviços de Saúde para Idosos/normas , Serviços de Saúde para Idosos/tendências , Humanos , Múltiplas Afecções Crônicas/epidemiologia , Múltiplas Afecções Crônicas/terapia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia
Rev. salud pública ; 22(3): e184617, May-June 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1115881


RESUMEN Latinoamérica, al igual que el resto del mundo, se está enfrentando actualmente a las consecuencias del envejecimiento poblacional, entre las que se incluye el aumento en la incidencia de neoplasias malignas en adultos mayores, con un subsecuente incremento en la uso de servicios de salud oncológicos. La oncología geriátrica es una disciplina de reciente creación que suma principios geriátricos a los avances oncológicos para ofrecer un tratamiento individualizado a los adultos mayores con cáncer. Este abordaje multidisciplinario actualmente es recomendado en el cuidado oncológico rutinario en adultos mayores. En Latinoamérica existen varias iniciativas asistenciales de enseñanza e investigación en oncología geriátrica; sin embargo, el número de centros especializados y la disponibilidad de personal capacitado en el área es limitada en comparación con los recursos disponibles en países de ingresos altos. En este trabajo se describen recomendaciones internacionales para la implementación de los principios de la oncología geriátrica en la práctica clínica habitual, los centros y recursos con los que se cuenta en Latinoamérica y los retos a futuro para mejorar la atención multidisciplinaria de los adultos mayores con cáncer en la región.(AU)

ABSTRACT Latin America, like the rest of the world, is currently facing the consequences of population aging. Among these consequences is a rise in incidence in malignant neoplasms among older adults, with an anticipated increase in oncologic health service requirements in this population. Geriatric oncology is a recently created discipline which integrates geriatric principles into oncology care to offer older adults with cancer individualized treatments. This multidisciplinary approach is now recommended as part of routine oncology care by international associations. Although several geriatric oncology clinical, educational and research initiatives exist in Latin America, the number and availability of specialized facilities and personnel is limited in comparison to those in high-income regions. In this manuscript, we review international recommendations for the implementation of geriatric oncology principles into routine clinical practice, describe resources available for geriatric oncology in Latin America, and provide recommendations to improve multidisciplinary care for older adults with cancer in the region.(AU)

Humanos , Pessoa de Meia-Idade , Idoso , Institutos de Câncer/organização & administração , Envelhecimento , Serviços de Saúde para Idosos/organização & administração , Neoplasias/epidemiologia , Incidência , América Latina/epidemiologia