Zeitschrift für Gerontologie und Geriatrie
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The SARS-CoV‑2 virus and the associated disease COVID-19 pose major challenges to healthcare systems worldwide. Especially the vulnerable group of people in need of long-term care is at risk of suffering a severe course of the disease or of dying from the infection. ⋯ This calls for higher nursing remuneration, better staffing levels and greater appreciation of the nursing profession. In order to protect the vulnerable group of people in need of nursing care from a SARS-CoV‑2 infection, long-term care must be given a stronger focus in health policy measures during the pandemic.
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The current corona crisis affects older patients as well as the geriatric infrastructure in all sectors. This article provides an overview about the current state of knowledge on COVID-19 with special consideration of geriatric aspects and the consequences for the geriatric care system.
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Due to the demographic development the need for palliative care in the outpatient setting will increase and challenge general practitioners and community nurses. ⋯ Symptom burden in the outpatient setting was similar to that of patients being cared for in hospitals. Healthcare personnel in general palliative care should be adequately qualified. The quality of communication via telephone calls should be critically examined in further studies.
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There is a lack of research into how hospital staff and institutional stakeholders (i. e. institutional representatives from public health authorities, hospital hygiene, and the departments of microbiology, palliative care, and geriatrics) engage with patients who are carriers of multidrug-resistant organisms and receiving end-of-life care. Knowledge of their experiences, workload, and needs should be considered in dealing with hospitalized carriers of multidrug-resistant organisms as well as staff education. ⋯ Staff members and institutional stakeholders perceived similar barriers to practice caused by multidrug-resistant organisms and similar needs for continuing education. The staff members' preferred management approach might originate from an uncertainty about the multidrug-resistant organism infection risk. Experiences and visions of both groups should be included in a specific recommendation for end-of-life care to ensure behavioral confidence.
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The Hospice and Palliative Care Act (2015) promotes advance care planning (ACP) for patients in nursing homes, but chronically ill patients living at home can also benefit from ACP. ⋯ The ACP discussions should to be aligned to patients' preferences in terms of communication and content. It is important to accept a rejection of dealing with ACP or conducting an advance directive. The patients' view needs to be integrated into future research.