Ethical and logistical considerations of caring for older adults on inpatient psychiatry during the COVID-19 pandemic
Open accessAbstract
The coronavirus disease 2019 (COVID-19) pandemic has brought challenges to delivery of care for older adults on inpatient psychiatry. We describe two cases: patient A, a 62-year-old woman who initially refused screening for potential COVID-19, bringing up questions about threshold for capacity when public health is at risk and questions about whether screening for infection should be different in older adults. The other case, patient B, is that of an 83-year-old man who was on the unit when patient A tested positive, and brought up concerns for risk of dissemination in the context of wandering, spitting behaviors, and inability to adhere to room isolation or masking measures. We review measures taken to decrease risk of transmission and improve screening for infection in older adults.
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Emergence and worsening of neuropsychiatric symptoms were described in two patients with dementia due to AD after enforcement of social isolation measures.
“Emergence and worsening of neuropsychiatric symptoms were described in two patients with dementia due to AD after enforcement of social isolation measures.”
From The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia: A review (2020) · cites this paper as [25]
An 83-year-old man with dementia due to AD was hospitalised due to severe agitation that worsened after he was isolated to his room because suspected to have COVID-19, with little or no relief from interventions.
“An 83-year-old man was hospitalised due to severe agitation that worsened after he was isolated to his room because suspected to have COVID-19, with little or no relief gained from either pharmacological or non-pharmacological interventions (25).”
From The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia: A review (2020) · cites this paper as [25]
Behavioural disturbances observed in some patients either hospitalised or resident in nursing homes during COVID-19 appeared particularly severe and challenging to manage.
“However, behavioural disturbances observed in some patients either hospitalised (25) or resident in nursing homes (27) appeared to be particularly severe and challenging to manage.”
From The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia: A review (2020) · cites this paper as [25]
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- Authors
- Fahed, M., Barron, G. C., & Steffens, D. C.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- Fahed, Mario
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 28
- Issue
- 8
- Pages
- 829-834
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC7198992
- OpenAlex
- W3021808580
- Cited by
- 21
- References
- 11
- Citations by year
- 2025: 2 · 2022: 5 · 2021: 8 · 2020: 6
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- COVID-19 pandemic, older adults, psychiatric inpatient care, psychiatric hospitalization, infection screening, transmission prevention, informed consent, decision-making capacity, wandering behavior, isolation measures, masking, ethical considerations
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Aged, 80 and over, Female, Patient Care, Humans, Inpatients, Male, Mental Health Services, Middle Aged, Pneumonia, Viral, Coronavirus Infections, Pandemics
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