COVID-19 highlights the need for universal adoption of standards of medical care for physicians in nursing homes in Europe

• Published in: European geriatric medicine 2020-08, Vol.11 (4), p.645-650
• Main Authors: O’Neill, Desmond, Briggs, Robert, Holmerová, Iva, Samuelsson, Olafur, Gordon, Adam L., Martin, Finbarr C.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cause of Death; Coronavirus Infections - epidemiology; Coronavirus Infections - therapy; COVID-19; Delivery of Health Care - standards; Delphi Technique; Europe; Female; Geriatric Assessment - methods; Geriatrics/Gerontology; Health Services Needs and Demand; Homes for the Aged - organization & administration; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Nursing Homes - organization & administration; Pandemics; Patient Care Team - standards; Physicians - standards; Pneumonia, Viral - epidemiology; Pneumonia, Viral - therapy; Practice Patterns, Physicians' - standards; Special; Special Article; Survival Analysis
• ISSN: 1878-7649; 1878-7657; 1878-7657
• DOI: 10.1007/s41999-020-00347-6

Key summary points Aim The gravity of concerns arising for nursing home care from the COVID-19 pandemic mandates urgent review of medical standards for nursing homes. Findings Physicians providing medical care to nursing home residents should have a formal competence in geriatric medicine and old age psychiatry. Message The coordination of the broad range of complexities of care in nursing homes requires clearly specified clinical leadership commensurate with the range of services needed. The nursing home sector has seen a disproportionately high number of deaths as part of the COVID-19 pandemic. This reflects, in part, the frailty and vulnerability of older people living in care homes but has also, in part, been a consequence of the failure to include care homes in the systematic planning of a response to COVID, as well as a measure of neglect of standards and quality improvement in the sector. In response, the EUGMS published a set of medical standards of care developed in consultation with experts across its member national societies in 2015. The standards consisted of seven core principles of medical care for physicians working in nursing homes as a first step in developing a programme of clinical, academic and policy engagement in improving medical care for older people who are living and frequently also dying as residents in nursing homes. The gravity of the concerns arising for nursing home care from the COVID-19 pandemic, as well as emerging insights on care improvement in nursing homes indicate that an update of these medical standards is timely. This was performed by the writing group from the original 2015 guidelines and is intended as an interim measure pending a more formal review incorporating a systematic review of emerging literature and a Delphi process.