This document discusses emphasizing care for the elderly during the COVID-19 pandemic. It notes that elderly individuals are at higher risk from COVID-19 due to increased age and prevalence of comorbidities. It outlines principles of care at the individual, family, community, healthcare organization, and government levels. This includes maintaining hygiene, isolation, ensuring access to resources, and prioritizing the safety and well-being of elderly individuals. The role of nurses is also discussed as being courageous, opportunistic, and focused on prevention, early diagnosis, and rehabilitation during the pandemic.

1. Emphasizing Elderly Care
Practices With Covid 19
Prof Dr Jeyadeepa R
Principal
IQ City Institute of Nursing Sciences
Durgapur, West Bengal

2. Objectives
• At the end of the session participants
– Review the concept of aging and covid 19
– Describe the principles in emphasizing care
– Explain emphasizing care at various levels
– Identify nurses role in geriatric covid care

4. Introduction
• World’s population tripled from 1950 -
2020
• 8% of the total population is above 60 as
per 2011 census.
• As per 2016 report
– 16 crore senior citizen
• 60 – 69 yrs : 8.8 crore
• 70 – 79 yrs : 6.4 crore
• Destitutes : 0.18 crore

6. Who are at risk
• Chronic respiratory disease
• Chronic heart disease
• Chronic kidney disease
• Chronic liver disease
• Chronic neuro conditions
• Diabetes, Hypertension and
• Cancer

7. • Co morbidities increase the risk
• ACE inhibitors and Angiotensin II
receptor blockers are widely used for
hypertension, diabetes and CKD.
• Through ACE II receptor the virus
enter the host cells.
• Dysfunctional immunity
• Less T cells
• Reduced B cell activity

10. Three principles
Do not carry in
Do not carry out
Do not spread

11. Care emphasize at
• Individual level
• Family level
• Community level
• Health care Organization level
• Government – Central and State
• NGOs

12. Individual level
• Stay at home. Voluntary isolation
• Avoid visitors and gatherings
• If staying alone depend on healthy neighbours
• Stretch within the house
• Maintain hygiene
• Home cooked fresh hot meal
• Compliance to prescribed medicines
• Connect with family and friends
• Seek medical help when fall sick

13. Individual level - contn
• Be away from those who are sick
• Do not self medicate
• Use telemedicine service to minimize
hospital visit

14. Family level
• Maintain hygiene
• Assist elders to maintain hygiene
• Clean surfaces and commonly used
things like walker, wheel chair, bed pan
etc
• Ensure proper food and rest
• Monitor health

15. Community level
• Avoid loneliness
• Socialization by maintaining social
distance
• Provision for essentials at door step

16. Health care organization
Care
Home
Day care
OPD/Wards
ICU

17. Health Care Organization level
• Separate geriatric ward
• Routine IPC policies and procedures
• Adequate resources
• Train care givers
• Reminder posters
• Audit IPC procedure and give feed back
• Develop response manual
• Individual equipments for each patients
& proper disinfection

18. Health Care Organization level - contn
• Safe facility environment (plumbing,
ventilation, food preparation etc)
• Immunization for workers
• Advanced care planning
– Specialist care
– Virtual care modalities

19. Health Care Organization level - contn
• Provision for post hospitalization care
– Home care
– Rehabilitative care
• Triage and early recognition
• Testing protocol
• Rationale use of PPE
• Source control
– Screening
– Physical set up

20. Resource Allocation
• Avoid age as a criteria to exclude anyone from
care
• Assess co morbidities and consider disparate
impact of social determinants of health
• Primary focus to be on short term outcomes
• Avoid criteria like life years saved and long term
predicted life expectancy
• Forming triage committee
• Develop institutional resource allocation
committee.

21. Government level
• Increase financial and health security
for elders (especially destitute and
migrants)
• Increase social support
• Supply of adequate beds
• Supply of Critical care equipment
• Training of personnel
• Legal enforcement
• Relief measures through existing plans

22. Data from National Health Profile
• Beds available in India : 7,13,986
0.55 beds/1000 Population
Beds for elders 5.18/1000 Pop
West Bengal : 2.25/1000 pop
Tamil Nadu : 1.1/1000 pop

23. NGO level
• Arrange care givers for those who are
in need
• Help to meet basic needs (food and
medicines)
• Help destitute and migrants

24. Need of the hour
• Use of social and technological
innovations
• Ensuring safety and health of the
elders in all settings
• Comprehensive care to the needy
• Family and social support
• Hope for the best
• Acceptance

27. BCG
Vaccination
trial

28. Alternative
Medicine

29. Dignity
enabled care

30. Interdisciplinary
research

31. Plasma Banks

32. Refocus
Relationship
Relevance

33. The Golden Rule
Prevention is better
than cure

34. Primary
• Health promotion
• Disease prevention
Secondary
• Early diagnosis
• Treatment
Tertiary
• Recovery
• Rehabilitation

35. Nurses are
• C- Courage in Crisis
• O – Opportunity in adversity
• V- Volunteer, Vigilant & Willingness to
serve
• I – Implies values & Image building
• D – Dynamic Role

36. Reference
• Clara Bonand et al., Corona Virus: The Geriatric Agency of 2020. Joint
Document of the Section on Geriatric Cardiology of the Spanish
Society of Cardiology and the Spanish Society of Geriatrics and
Gerontology, Rev.Esp.Cardiol 2020 73(7) Pp 569 – 576
• Ting Guo et al., Clinical Charecteristics of Elderly patients with Covid 19
in Huhan Province China: A multicenter retrospective study.
Gerontology May 2020.
• Ministry of Social Justice and Empowerment, GOI D.O.No
Secy/SJE/SD/2020/214513 dtd 13/4/2020
• MOHFW- Health Advisory for elderly population of India during Covid
19
• Zainab Shahid et al;, Covid 19 and older adults: What we know. Journal
of American Geriatric Society Apr, May and June 2020
• WHO, Guidance on Covid 19 for the care of older people and people
living in long term care facilities and home care, 23rd Marc 2020
• Mane Abhay B, Elderly care in India, Journal of Gerontology and
Geriatric Research, 2016 5(5)

37. Reference
• MOHFW GOI, Guidelines on clinical management of Covid 19 17th Mar
2020
• Kai Liu et al., Clinical features of Covid 19 in elderly patients: A
comparison with young and middle aged patients. Journal of infection 80
(2020) 14 – 18
• Dibyasree Ganguly et al., India’s Covid 19 episode: Resilence, Responce,
Impact and lessons, MPRA paper no 99691
• Policy brief: The impact of Covid 19 on older persons, United Nations
report May 2020