Coronavirus: measures for the protection, care and treatment of the elderly
COVID-19, the disease caused by the novel SARS-CoV-2 coronavirus, is mild for most people. However, there are also difficult courses. Senior citizens belong to the risk groups. Now concrete measures for the protection, care and treatment of older people have been presented.
The number of COVID-19 diseases caused by the novel coronavirus is increasing rapidly. As the Robert Koch Institute (RKI) explains, the risk of a serious illness from 50 to 60 years increases steadily with age. According to the experts, older people in particular can become more seriously ill after an infection due to the less well-reacting immune system. It is therefore important to protect this risk group particularly well from the virus.
Cushion the progress of the infection wave
The German Geriatric Society (DGG) has now presented specific measures for the protection, care and treatment of older people.
"We all have legitimate concerns as to how long-term care for our geriatric patients will continue," said DGG President Professor Hans Jürgen Heppner, chief physician at the Geriatric Clinic at Helios Klinikum Schwelm, in a press release.
"We are now dependent on the support of each individual and the consistent implementation of sensible measures to cushion the progress of the wave of infections."
What affected people can do themselves
The DGG has put together tips on how to deal with general practitioner visits to nursing homes, the completion of a pneumococcal vaccination or care in family care.
Specific measures to protect and care for the elderly:
General measures for the elderly and the elderly:
- Keep a distance of at least 1.5 meters from other people
- Hygiene: Wash hands regularly for at least 20 to 30 seconds
- Avoid events
- Complete vaccinations
- Prepare the emergency list
Measures for specialist staff
Measures for outpatient care of geriatric patients:
- Keep practice contacts to a minimum
- Discuss suspected cases of diagnosis and, if necessary, therapy closely with the local health authorities
- Limit admissions to emergency departments and hospitals to urgent emergencies
Measures for inpatient care of geriatric patients:
- Day care facilities should limit their admissions to the bare minimum
- Take a daily risk history
- No recordings of registrations with signs of infection / cold
- Geriatric day clinics should stop operating for the next few weeks
- If possible, outpatient rehabilitation measures should only be carried out as individual therapies or in the home, and should be limited to the minimum necessary
Measures for inpatient care of geriatric patients:
- Detailed medical history to identify potential infection contacts
- Implementation of the visit ban
- No elective or plan and movable recordings
- Watch for early signs of respiratory infections
- Implement pandemic plans according to your own hospital planning
Measures to care for geriatric residents in care facilities:
- Temporarily suspend regular home visits by the family doctor
- Education of employees and residents about the risks and protective measures
- Pay attention to visit bans and minimum distance
- The same principles apply to residents of old people's or nursing homes as to prevention or outbreak management of other respiratory diseases - as they are deposited with the RKI.
When older people are cared for at home
Measures to care for geriatric people in family care:
- In the case of older family members or those with pre-existing illnesses, all of the above-mentioned rules should be observed to avoid infection.
- For older or chronically ill family members who need support, the rules for avoiding infection must of course also be maintained.
- It is primarily the family members with the lowest risk of infection who should be looked after, and not just those who have symptoms of respiratory disease themselves - even if they are the ones who have always looked after them.
Suspend regular visits: measures for primary care visits to nursing homes
According to the DGG, precautions must be taken, but these must not end in isolation for this vulnerable group. An important measure is that regular visits to home and house visits are suspended until further notice.
It is a good decision not to make regular visits to nursing homes without a specific reason for treatment. This can prevent further spread of infection. This recommendation is designed for the next two to four weeks.
But these are also arbitrary numbers that can be changed again. The DGG assumes that these decisions will be relaxed and partially withdrawn as soon as an initial relaxation in the spread of the virus can be seen.
However, this assessment must not lead to the fact that necessary measures are not taken.
In any case, it should first be clarified by telephone and external medical history with the nursing facility whether a medical home visit to this nursing home is really necessary for the patient - or whether initial therapy measures are initiated without the doctor's appearance on site can be.
Contact with the local health department is essential so that further measures can be discussed together. An unreflected briefing in the emergency room does not solve the problem in any way.
Lack of protective equipment: hygiene and logistics are required
In this context, the problem of insufficient personal protective equipment crops up again and again. This is known - no facility was and is prepared for it.
However, this problem can neither be solved by the medical societies nor by the local outpatient providers. Hygiene and logistics are required here: According to the DGG, the reprocessing of previously used disposable material must certainly be discussed in these times.
Risk of severe courses
It is crucial to know that the increased risk of severe courses primarily relates to the elderly and people with previous illnesses. The RKI and the federal government name the following risk groups:
- older people (with a steadily increasing risk of severe course from about 50 to 60 years) and
- People with certain previous illnesses are also more likely to have a severe course. This includes people
- with diseases of the heart (e.g. coronary heart disease),
- with diseases of the lungs (e.g. asthma, chronic bronchitis),
- with chronic liver disease,
- with diabetes mellitus (diabetes),
- with cancer as well
- with a weakened immune system (for example, due to a disease that is associated with an immune deficiency or due to the use of drugs that weaken the immune system, including cortisone).
This list is reminiscent of the defined risk groups for influenza or pneumococcal diseases. The DGG points out that completing the pneumococcal vaccinations is very useful. However, there are currently only a few stocks of vaccines left.
Caring relatives: Avoid risk contacts in any case
The case of patients who are cared for by their families in their home environment is the same as everywhere in the general population: risk contacts must be avoided in any case, caring relatives must currently - even without reasonable suspicion - get out of their social life in the environment withdraw as far as possible so as not to unnecessarily endanger your relatives at risk.
Alternatives to direct contact: video switching, live chats, visits to the window on the ground floor.
Another key challenge is the care of residents in long-term care facilities. The measures for infection prevention have meanwhile been tightened enormously and now extend to the ban on visits.
This certainly makes sense, but family and friend contacts do not have to be foregone. There are enough opportunities to create alternative contacts. This includes regular video connections, live chats, social media or a visit to the window on the ground floor of a care facility. (ad)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- German Geriatric Society (DGG): PM: COVID-19 and Seniors: Geriatricians present measures to protect and care for the elderly, (accessed: March 21, 2020), German Society for Geriatrics (DGG)
- Robert Koch Institute (RKI): Information and support for people at higher risk for a severe COVID-19 disease course, (access: March 21, 2020), Robert Koch Institute (RKI)
- Federal Government: Covid-19: These are the risk groups, (accessed: March 21, 2020), Federal Government