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Hospital Elder Lifge Program

COVID-19 Resources

Delirium is a common presenting symptom of severe illness in older adults. Thus, with a suspected COVID-19, mental status should be assessed. Moreover, if delirium is present, suspicion should rise for the presence of COVID-19, as well as the potential for a more severe infection. Older adults are most vulnerable to severe infection with COVID-19 and mortality. Here, we provide you with some resources relevant to COVID-19 and delirium to assist you in the care of older adults.

Also available are the Toolkit Instructions, Verbal De-escalation Suggestions, and Orientation Card in Spanish; Toolkit Instructions, Verbal De-escalation, and Orientation Card in Portuguese.

Looking for ways to boost mobility in older adults who have been discharged home to aid in recovery? HELP Family Mobility Protocols adapted for the home are available.

What is delirium and what does it have to do with COVID-19?

Delirium is an acute confusional state that is common among hospitalized elders and is strongly associated with poor short-term and long-term outcomes. Delirium is preventable, and non-pharmacologic methods are effective for prevention and management. Pharmacologic management of delirium should be reserved for extreme cases of agitation.

Atypical Presentations of COVID-19 in Older Adults

Early reports are showing not only an increase in delirium attributable to COVID-19 infection, but also delirium or altered mental status as a presenting symptom of COVID-19. Some atypical presentations of COVID-19 include altered mental status and no typical symptoms such as shortness of breath, cough, or fever. While there is currently limited data on this atypical presentation, you can read more about it in Age & Ageing and Next Avenue.

The World Health Organization core case record form for COVID-19 includes "altered consciousness/confusion" as a presenting symptom of COVID-19. Click on the image below for more official guidance from the WHO.

Screening for Delirium

The Geriatric Emergency Department Collaborative and Regional Geriatric Program Toronto  

 

 

The following one-pager from the Geriatric Emergency Department Collaborative is specific to identifying, preventing, and treating delirium in the ED in regards to the COVID-19 pandemic:

Social Isolation in Older Adults

Advance Care Planning and Palliative Care

Considering advance care planning with older adults during COVID-19 is extremely important for patients, family members, and clinicians. For resources to help you facilitate those discussions:

When considering palliative care for an older adult with COVID-19:

COVID-19 Conversations

The National Academy of Medicine and American Public Health Association are hosting a webinar series called "COVID-19 Conversations" on the most relevant topics related to the global pandemic, featuring medical and public health experts. You can tune into the live webinars or watch recordings of previous webinars on their site.

Care of Older Adults in Post-Acute and Long-Term Care Communities:

Additional Resources: