Abstract
ABSTRACTThe coronavirus disease 2019 (COVID-19) pandemic suspended face-to-face assistance offered by community spaces, such as day centers (DCs). People with dementia (PwD) and their families were faced with the risks posed by social detachment and suspension of treatments.Objective:This study aimed to present a virtual day center (VDC) program offered as a preventive strategy to reduce the damage caused by social isolation and interruption of treatment imposed by the pandemic.Methods:The experience report, describing the feasibility of a VDC program, offered to 26 PwD and their caregivers, during the first year of the pandemic. The VDC held individual and group meetings with PwD and their families and psychoeducational support groups for caregivers.Results:The attendance rate in group activities was 80%, and that in the caregiver group was 68%, showing a good virtual interaction. Throughout the year, three PwD interrupted the service due to difficulties of the caregivers to reconcile the schedules of the activities with their professional commitments and the absence of a support network, three others died, and two were institutionalized. PwD remained physically, socially, and cognitively active through daily virtual activities. Guidance and support for caregivers contributed to the organization of routines and adaptation to the isolation and maintenance of the bond. Family meetings made it possible to mediate conflicts and expand the support network.Conclusions:VDC is a promising modality to assist the needs and demands of PwD and their caregivers. VDC can contribute to the expansion of this intervention to individuals and families who do not have access to face-to-face treatment.
Highlights
IntroductionThe vulnerability of the elderly, such as hypertension, diabetes[1] has been correlated with increased morbidity in COVID-19,5 and people with dementia (PwD) have an increased risk of COVID-19.6 In addition, PwD would have a higher risk of contamination due to cognitive impairment, which would limit their ability to understand the pandemic and the need for biosafety procedures, such as washing hands, wearing masks, and maintaining social distance.[7] COVID-19 can worsen cognitive impairment and increase the incidence of psychological and behavioral changes, temporarily during the infectious process, or permanently if the duration of the infectious condition is very long.[1]
Most of the people with dementia (PwD) (80.76%) are at the age of 70–89 years and have a diagnosis of Alzheimer’s disease (AD; 80.8%)
According to the Clinical Dementia Rating (CDR),17 34.6% were in the mild stage with a mean MMSE18 score of 24.4, 38.5% were in the moderate stage with a mean Mini-Mental State Examination (MMSE) score of 19.1, and 26.9% were in the severe stage with a mean MMSE score of 8.5
Summary
The vulnerability of the elderly, such as hypertension, diabetes[1] has been correlated with increased morbidity in COVID-19,5 and people with dementia (PwD) have an increased risk of COVID-19.6 In addition, PwD would have a higher risk of contamination due to cognitive impairment, which would limit their ability to understand the pandemic and the need for biosafety procedures, such as washing hands, wearing masks, and maintaining social distance.[7] COVID-19 can worsen cognitive impairment and increase the incidence of psychological and behavioral changes, temporarily during the infectious process, or permanently if the duration of the infectious condition is very long.[1]. Social detachment can increase the feeling of loneliness, emotional isolation, and disconnection from existing relationships,[8,9,10,11,12] aggravating the situation of socioemotional isolation frequently reported by PwD caregivers.[1,2,13,14,15,16] Livingston et al.[8] suggested that social isolation is a risk factor for dementia, presenting a relative risk higher than the risk associated with alcohol abuse, physical inactivity, diabetes, and air pollution
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