Psychogeriatric care in times of COVID. Lessons learned and proposals for similar situations

Abstract

Introduction. The objective is to describe the problems related to outpatient psychogeriatric care in the context of the SARS-CoV-2 pandemic, as well as the proposed and implemented solutions for optimizing care for elderly people with mental disorders during the pandemic, that can also be applied in emerging similar situations in the future.

Methods. Data on healthcare provision and clinical problems in psychogeriatric practice over the course of one year of the COVID-19 pandemic were collected as the basis for proposals for action by a consensus of psychiatrists expert in psychogeriatrics. Setting: Outpatient psychogeriatric care services in the Madrid region, Spain.

Results. Eight topics relating to difficulties in the provision of psychogeriatric care were identified (access to services, treatment adherence, referrals and contact, continuity of care, isolation, nursing homes and laboratory tests) and agreement was reached on 14 possible solutions. In addition, 7 clinical problems of particular relevance were identified (bereavement, sleep, psychopharmacological treatments, physical, cognitivebehavioural and social deterioration, and violence) and 17 possible solutions proposed.

Conclusions. The SARS-CoV-2 pandemic poses a high risk to life for the geriatric population. Measures such as lockdowns and limiting contacts, exert a direct risk to mental health and an indirect risk due to greater difficulties in accessing psychogeriatric care. It is necessary to detect these situations and implement changes in how care is provided to this highly vulnerable population. We propose a series of possible solutions to the problematic situations detected that may be helpful in a variety of psychogeriatric care contexts.