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Case Reports
. 2021 Jun;33(6):1753-1756.
doi: 10.1007/s40520-021-01875-2. Epub 2021 May 18.

Telemedicine-assisted care of an older patient with COVID-19 and dementia: bridging the gap between hospital and home

Renata Marinello  1 , Enrico Brunetti  2   3 , Chiara Luppi  1 , Dario Bianca  1   4 , Vittoria Tibaldi  1 , Gianluca Isaia  1 , Mario Bo  1   4
Affiliations
Case Reports

Telemedicine-assisted care of an older patient with COVID-19 and dementia: bridging the gap between hospital and home

Renata Marinello et al. Aging Clin Exp Res. 2021 Jun.

Abstract

Hospital at Home (HaH) has been proposed as a solution to relieve pressure on hospital beds during the COVID-19 pandemic; however, caregivers' feelings of inadequacy and concerns on the need for tighter clinical monitoring might lead to unnecessary and potentially harmful hospital admissions in frail older patients with mild or atypical COVID-19. Here we report the case of a 91-year old woman with severe dementia and atypical COVID-19 that could be successfully managed by our HaH thanks to her highly motivated caregivers and the support of a telemedicine solution (TMS) to provide caregiver training and support as well as supplementary telemonitoring. Despite some well-known issues on TMS use, the hybrid in-person and tele-visit approach of TMS-assisted HaH could help to create a "secure" environment, empowering caregivers to manage frail older adults with COVID-19 at home, avoiding unnecessary admissions to closed wards and their negative physical, functional and psychological outcomes.

Keywords: COVID-19; Caregiver education; Hospital at home; SARS-CoV-2; Telemedicine.

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Conflict of interest statement

A.O.U. Città della Salute e della Scienza di Torino (Turin, Italy), Università degli Studi di Torino (Turin, Italy), and Tesi S.p.A. (Bra, Italy) were among the partners of a Syndicate Association (Associazione Temporanea di Scopo—ATS in Italian) for the sole purpose of bringing forward the CANP Project. In this context, Tesi S.p.A. provided the TMS, and any technical support needed. The funding source and Tesi S.p.A. had no role in the design, methods, subject recruitment, data analysis, interpretation of data, manuscript preparation, and decision to submit the present article for publication. All individual authors report no relevant personal conflicts of interest.

Figures

Fig. 1
Fig. 1
Aspect and use of the telemedicine system. A shows Hospital at Home nursing and medical personnel wearing personal protective equipment while providing hospital-level care, including fluid infusion, to the patient. On the background, the remote station, featuring an operator-controlled high-definition camera with built-in optical and digital zoom (arrowhead), a touchscreen monitor (asterisk) and speakerphone (arrow). B shows Hospital at Home personnel using the control station to monitor the patient’s condition communicating with caregivers through a high-fidelity monitor (asterisk), webcam (arrowhead), and speakerphone (arrow). Televisits are prompted by the control station and accepted by the remote station to ensure privacy. The control station allows to control multiple televisits simultaneously
See this image and copyright information in PMC

References

    1. Bo M, Brunetti E, Presta R, et al. To keep a COVID-19-free hospital ward: mission possible? Aging Clin Exp Res. 2020;32:1627–1628. doi: 10.1007/s40520-020-01640-x. - DOI - PMC - PubMed
    1. Marengoni A, Zucchelli A, Grande G, et al. The impact of delirium on outcomes for older adults hospitalised with COVID-19. Age Ageing. 2020;49(6):923–926. doi: 10.1093/ageing/afaa189. - DOI - PMC - PubMed
    1. Bielza R, Sanz J, Zambrana F, et al. Clinical characteristics, frailty, and mortality of residents with COVID-19 in nursing homes of a region of Madrid. J Am Med Dir Assoc. 2020;22:245–252.e2. doi: 10.1016/j.jamda.2020.12.003. - DOI - PMC - PubMed
    1. Shepperd S, Iliffe S, Doll HA et al (2016) Admission avoidance hospital at home. Cochrane Database Syst Rev 9:CD007491. 10.1002/14651858.CD007491.pub2 - PMC - PubMed
    1. Isaia G, Astengo MA, Tibaldi V, et al. Delirium in elderly home-treated patients: a prospective study with 6-month follow-up. Age (Dordr) 2009;31:109–117. doi: 10.1007/s11357-009-9086-3. - DOI - PMC - PubMed

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