COVID-19: Pros and cons of different caring techniques of elderly patients.

Sir,

COVID-19 epidemics forces governments to take strict health and prevention attempts to minimize the effect of this disease. One of these attempts is related to establishing social distancing, especially for elders in community.[12]

Although caring of elders, isolating and disconnecting them from others are considerably effective in decreasing the rate of infection and mortality, this point should be considered that elders might expose them in epidemics of the disease to social isolation, depression, anxiety, and mental problems and health system will be faced to complicated and novel challenges.

Home care for the elderly during COVID-19 pandemic is associated with some advantages and disadvantages.[2] Although we all care for the elderly and wish to serve them to the best of our ability, choosing between long-term care facilities and at-home care services is usually challenging and calls for some certain considerations. Let's look at the bright side of the matter:

When it comes to care methods, you can opt for ones that both you and your loved ones deem favorable. This allows you to meet their essential needs and demands more independently

Allowing for having good time with the elderly loved ones and meeting their daily needs at the same time is one of the distinctive aspects of home care method

Familiar contexts and people can spare the elderly the need to adapt themselves to environmental changes and the need to learn to communicate with different caregivers

Opting for home care does name mean that you are deprived of social service supports, in case there is any need for them.

Home care is also associated with some disadvantages:

Home care may be really challenging in cases where relatives or other potential caregivers such as family members are away

Aside from the physical care, a variety of areas and factors need to be taken into account in the home care scenario: housekeeping, shopping, assistance in grooming or bathing, and taking care of their finances

Convenient home care for the elderly calls for modification of some domestic arrangements and activities

Taking care of elderlies at home and managing household activities, at the same time, can increase the risk of virus contraction and infection of other members of household

Personal protective equipment (PPE) that need to be worn by caregivers are usually expensive or hard-to-access even for healthcare workers

It is really worrisome and stressful to make sure that all safety protocols including PPE wearing, regular hand washing, sterilization of surfaces, as well as adequate observation of isolation and quarantine principles by the elderly throughout the day are completely followed

The pandemic makes it impossible for the elderly to follow their routine programs. Under such circumstances, the elderly may find it difficult to adapt to the new conditions, and this may pose some problems especially when you cannot be with them 24 h per day

Social healthcare services may be more difficult to access during the pandemic mainly because the healthcare bodies are required to adhere to social distancing and safety protocols or be already dealing with some challenges such as staff shortages at the same time.

Obstacles to effective remote patient monitoring (RPM) usage:[3]

Not accessible for everyone. RPM requires good broadband connectivity, which is hard to achieve for small healthcare institutions and rural hospitals. On the other hand, it is important to take into account that not everyone owns a smartphone, and elderly people often face difficulties in using modern gadgets, such as mobile phones

Patients’ and doctors’ skepticism. RPM, as reported in NEJM Catalyst Insights Council survey, is the least helpful instrument for patient engagement. Trying to backup this argument, researchers explain that not everyone is able to use wearables for this purpose

Reliability uncertainties. Wearable technologies used to track physical activity have been found to be associated with variable accuracy with error margins up to 25%. This also holds true for RPM data. According to the JAMA Dermatology, for instance, smartphone apps used to detect melanoma are associated with 30% failure rate.

In summary, elders are faced to the biggest challenge caused by COVID-19 regarding physical, mental, and social aspects, and in case of infection, a heavy burden will be imposed to health and treatment care system. Consideration of caring and protecting elders by the policymakers of health system is necessary. Preventive attempts should not cause mental disorders in elders and make a new disease instead of resolving problem of COVID-19 disease, considering that psychiatric advices and regulating orders of the quarantine based on these advices can be a solution. We hope to decrease corona disease complications in elders through this way.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.