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Really enjoyable* lunchtime teaching today with the team, discussing Covid19 and older people (and problems they face)
These were our thoughts
*although as you will see what we discussed was not cheery
These were our thoughts
*although as you will see what we discussed was not cheery
1) Seeing people now at a far worse baseline when they are admitted
10months of;
social isolation from family/friends, pubs and social clubs closed etc,
loneliness,
low mood,
Inactivity,
Elective activity cancelled; chronic disease not managed, delays in new diagnoses
10months of;
social isolation from family/friends, pubs and social clubs closed etc,
loneliness,
low mood,
Inactivity,
Elective activity cancelled; chronic disease not managed, delays in new diagnoses
2)When they come to hospital very difficult to get collateral, not seen family,
plus how do you get a true picture of someones exercise tolerance, functional status when they have been housebound for 10months
plus how do you get a true picture of someones exercise tolerance, functional status when they have been housebound for 10months
3)Covid presenting with #delirium, or develop delirium in hospital exacerbated by
No visitors,
Multiple ward moves,
Staff in PPE = lack of familiar faces, can’t see or hear us
Steroids = psychosis, delirium, insomnia
Poor sleep = regular night obs/BMs, oxygen mask/CPAP on
No visitors,
Multiple ward moves,
Staff in PPE = lack of familiar faces, can’t see or hear us
Steroids = psychosis, delirium, insomnia
Poor sleep = regular night obs/BMs, oxygen mask/CPAP on
4)Lower threshold for sedation due to risk of having person with delirium and Covid walking around and spreading Covid about
Sedation = falls, pressure sores, aspiration, deconditioning, worsening confusion
Sedation = falls, pressure sores, aspiration, deconditioning, worsening confusion
5)Then if they recover
Sarcopenic = from illness, steroid myopathy
Non resolving delirium +\\- dementia
Long length of stay as no community beds, ICB/rehab, care homes reluctant to take due to Covid status
Sarcopenic = from illness, steroid myopathy
Non resolving delirium +\\- dementia
Long length of stay as no community beds, ICB/rehab, care homes reluctant to take due to Covid status
Obviously not every older person has this experience, but discussion highlighted so many thinks that could be done better
