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[养老院中的新冠疫情:从关于其他灾难或危机情况的文献中能学到什么?]

[COVID-19 outbreak in nursing homes: what can be learned from the literature about other disasters or crisis situations?].

作者信息

Boekel Leonieke van, Stoop Annerieke, Luijkx Katrien G

机构信息

Departement Tranzo, Tilburg University, Tilburg, The Netherlands.

出版信息

Tijdschr Gerontol Geriatr. 2020 Apr 23;51(3). doi: 10.36613/tgg.1875-6832/2020.03.01.

Abstract

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.

摘要

老年人的长期护理受到新冠疫情的严重影响。本快速综述的目的是了解我们可以从全球以往的危机或灾难中学到什么,以便在新冠疫情爆发期间优化长期护理机构中老年人的护理。我们检索了五个电子数据库以识别潜在相关文章。本研究共纳入23篇文章。基于这些文章,养老院似乎能从尽可能做好应对准备中受益。例如,通过制定适当的规程、明确任务分工以及组织内的协作。此外,养老院与其他医疗组织、全科医生、非正式照护者和地方当局密切合作是有帮助的。建议养老院关注员工的能力和就业能力,并尽可能为员工提供支持或减轻其负担。关于老年人护理,重要的是工作人员要尽快在为居民提供护理方面找到新的日常安排。发现了一些关于如何与患有痴呆症的人沟通的实用技巧。此外,痴呆症患者的行为在危机期间可能会发生变化。我们为工作人员找到了应对行为变化的技巧。新冠疫情爆发后,对工作人员、居民和非正式照护者的后续护理对于及时发现心理社会问题至关重要。在其他灾难的情况下,讨论了一方面是急性安全和风险降低(例如通过关闭住宿护理设施和隔离居民),另一方面是对居民和工作人员的心理社会影响之间的权衡。此外,养老院组织也关注如何为感染新冠的老年人提供良好的(姑息)护理并维持其生活质量。在所纳入的文章中,老年人、非正式照护者和工作人员的视角常常缺失。尤其是老年人、非正式照护者和养老院工作人员在当前情况下对老年人护理的经历,对于制定关于在新冠危机之前、期间和之后如何行动的经验教训很重要。这甚至在危机时期也可能进一步加强以人为主的护理。因此,我们建议在未来的研究中研究这些经历。

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