Behavioral Interventions in Long-Term Care Facilities during the COVID-19 Pandemic: A Case Study

Carlos Dosil-Díaz,Romina Mouriz-Corbelle,David Facal

doi:10.3390/geriatrics7010001

Carlos Dosil-Díaz, Romina Mouriz-Corbelle + Show 1 more

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https://doi.org/10.3390/geriatrics7010001

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Journal: Geriatrics	Publication Date: Dec 21, 2021
Citations: 2	License type: CC BY 4.0

Affiliation: University of Santiago de Compostela

Abstract

During the COVID-19 pandemic, long-term care (LTC) centers have adopted a series of measures that have affected the physical and cognitive health of patients. The routines of the patients, as well as the interventions of professionals, have been altered. In the case presented here, our aim was to explain the effect that the strong confinement due to the spread of the first COVID-19 wave in Spain had on a 75-year-old resident in an LTC center, with cognitive and behavioral symptomatology compatible with a diagnosis of mixed dementia, as well as the measures that the center adopted to manage the lockdown situation in the best possible way, including personalized attention protocols and a video call program. Different nosological hypotheses are also raised using a semiological analysis, including the analysis of the initial and continuation diagnostic protocols, as well as the therapeutic options.

Highlights

In March 2020, long-term care (LTC) centers were dramatically affected in their operations by the COVID-19 pandemic
Persons with Behavioral and Psychological Symptoms of Dementia (BPSD) present higher risks of severe COVID-19 infection due to the relation between frailty and dementia, a higher risk of severe neuropsychiatric symptoms related to delirium and encephalopathy, higher difficulty participating in screening tests, lower ability to report symptoms of infections, and higher difficulty adhering to infection control measures due to their difficulties in comprehension and remembering, and they may place themselves at higher risk of infection because of their lower abilities to maintain social isolation, to stay in one place, or to wear face masks [11]
The numerous challenges of the management of BPSD in the context of the COVID-19 pandemic have stressed the relevance of multidisciplinary, teamwork-based, and comprehensive approaches [12,13]

Summary

Introduction

In March 2020, long-term care (LTC) centers were dramatically affected in their operations by the COVID-19 pandemic. In LTC centers, 60–80% of patients have some degree of cognitive impairment, 20–30% show severe phase dementia, and 65% have some behavioral disorder [3]. In this way, patients suffering from dementia, in addition to presenting an important alteration in cognitive functions, due to the progressive deterioration of some brain functions, show the Behavioral and Psychological Symptoms of Dementia (BPSD). One of the models used to address the management of behavior disorders is that of CohenMansfield [6] In this model, the needs of the person with dementia and professionals caring for them are considered, as well as clinical and environmental characteristics. The intervention, arises from a paradigm of personalized care, where the person is the center of the intervention, and the professional must adapt to the patient’s needs

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