Emily West1, Kirsten Moore1, Nuriye Kupeli1, Elizabeth L Sampson1,2, Pushpa Nair3, Narin Aker3, Nathan Davies1,3. 1. Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK. 2. Barnet, Enfield and Haringey Mental Health Liaison Service, North Middlesex University Hospital NHS Trust, London, UK. 3. Centre for ageing population Studies, Research Department of Primary Care and Population Health, University College London, London, UK.
Abstract
INTRODUCTION: The coronavirus pandemic (COVID-19) has affected the functioning and capacity of healthcare systems worldwide. COVID-19 has also disproportionately affected older adults. In the context of COVID-19, decision-making surrounding place of care (PoC) and place of death (PoD) in older adults involves significant new challenges. AIMS: To explore key factors that influence PoC and PoD decisions in older adults. A secondary aim was to investigate key factors that influence the process and outcome of these decisions in older adults. To apply findings from current evidence to the context of COVID-19. METHODS: Rapid review of reviews, undertaken using WHO guidance for rapid reviews for the production of actionable evidence. Data extracted was synthesised using narrative synthesis, with thematic analysis and tabulation. RESULTS: 10 papers were included for full data extraction. These papers were published between 2005 and 2020. Papers included discussed actual PoD, as well as preferred. Results were divided into papers that explored the process of decision-making, and those that explored decision-making outcomes. CONCLUSIONS: The process and outcomes of decision-making for older people are affected by many factors-all of which have the potential to influence both patients and caregivers experience of illness and dying. Within the context of COVID-19, such decisions may have to be made rapidly and be reflexive to changing needs of systems and of families and patients.
INTRODUCTION: The coronavirus pandemic (COVID-19) has affected the functioning and capacity of healthcare systems worldwide. COVID-19 has also disproportionately affected older adults. In the context of COVID-19, decision-making surrounding place of care (PoC) and place of death (PoD) in older adults involves significant new challenges. AIMS: To explore key factors that influence PoC and PoD decisions in older adults. A secondary aim was to investigate key factors that influence the process and outcome of these decisions in older adults. To apply findings from current evidence to the context of COVID-19. METHODS: Rapid review of reviews, undertaken using WHO guidance for rapid reviews for the production of actionable evidence. Data extracted was synthesised using narrative synthesis, with thematic analysis and tabulation. RESULTS: 10 papers were included for full data extraction. These papers were published between 2005 and 2020. Papers included discussed actual PoD, as well as preferred. Results were divided into papers that explored the process of decision-making, and those that explored decision-making outcomes. CONCLUSIONS: The process and outcomes of decision-making for older people are affected by many factors-all of which have the potential to influence both patients and caregivers experience of illness and dying. Within the context of COVID-19, such decisions may have to be made rapidly and be reflexive to changing needs of systems and of families and patients.
Authors: Emily West; Pushpa Nair; Yolanda Barrado-Martin; Kate R Walters; Nuriye Kupeli; Elizabeth L Sampson; Nathan Davies Journal: BMJ Open Date: 2021-05-18 Impact factor: 2.692
Authors: Kathy Y Liu; Robert Howard; Sube Banerjee; Adelina Comas-Herrera; Joanne Goddard; Martin Knapp; Gill Livingston; Jill Manthorpe; John T O'Brien; Ross W Paterson; Louise Robinson; Martin Rossor; James B Rowe; David J Sharp; Andrew Sommerlad; Aida Suárez-González; Alistair Burns Journal: Int J Geriatr Psychiatry Date: 2021-05-27 Impact factor: 3.850