Impact of covid-19 on elderly living long term residences
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Abstract
The institutionalization of the elderly in Long-Term Care Facilities (LTCF), due to the population and family changes in aging western societies, has always raised questions about the quality of life and safety of the elderly. Several LTCF models have been theorized, conceptualized and put into practice. However, it was precisely in these institutions where the COVID-19 pandemic has the most devastating impact. This study aims to present the epidemiological and scientific evidence about the impact of COVID-19 on institutionalized elderly, and to envisage the necessary changes that should be introduced in the LTFC models. We conducted a literature review in the Web of Knowledge database using the keywords: “COVID-19” and “Long Term Care Facility”, considering the publications from the beginning of the pandemic until the moment of the review. 176 citations were obtained. We included articles on: (1) incidence and mortality due to COVID-19 infection in institutionalized elderly (2) characteristics of residential structures which increase the risk of COVID-19 infection (3) architectural and organizational factors that mitigate the impact of the COVID-19 pandemic. Thus 23 were selected whose full text was analyzed: 12 are empirical studies; 8 are Reports and 3 are Guidelines. The serious impact of the COVID-19 pandemic is explicit in the reported figures. The factors that increase the risk of COVID-19 cases and worsens the outbreaks in ERPIs are: (1) related to residential structures; (2) related to the health status of the elderly; (3) human and material resources management; (4) training of health professionals; (5) demographics and health resources; (6) social risk. Strategies to mitigate the impact of outbreaks are identified in line with risk factors. Long-Term Care elderly institutions, such as ERPIs, have revealed their unequivocal exposure to the effect of the COVID-19 pandemic, so there is an urgent need to rethink this institutional model.
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