Challenges of Singapore’s First Acute Geriatric Isolation Facility During the COVID-19 Pandemic

Created on 31st January 2022

Conference: The European Conference on Aging & Gerontology (EGen2022)
Title: Challenges of Singapore’s First Acute Geriatric Isolation Facility During the COVID-19 Pandemic
Stream: Frailty
Presentation Type: Virtual Poster Presentation
Authors:
Bernard Kok Chong Yap, Department of Geriatric Medicine, Changi General Hospital, Singapore
Wrenzie Del Valle Espeleta, Department of Geriatric Medicine, Changi General Hospital, Singapore
Savithri Sinnatamby, Department of Nursing, Changi General Hospital, Singapore
Jansen Meng Kwang Koh, Department of Respiratory and Critical Care Medicine, Singapore
Lip Hoe Koh, Department of Geriatric Medicine, Changi General Hospital, Singapore
Kiat Sern Goh, Department of Geriatric Medicine, Changi General Hospital, singapore

Abstract:

Aims: The COVID-19 pandemic has seen hospitals isolating suspect cases. Geriatric populations are at risk of severe COVID-19 disease and present with geriatric syndromes requiring holistic interdisciplinary care. However, isolation of older people poses challenges to care delivery. This study shares the experience of Singapore’s first acute geriatric isolation facility geriatric PARI (Pneumonia-Acute Respiratory Infection) ward and describes the geriatric-related outcomes and pitfalls.

Methods: Retrospective cross-sectional study performed in 7 negative pressure isolation rooms in an acute care public hospital in Singapore. 100 patients admitted consecutively to the geriatric PARI ward were included. Patient demographics, presenting symptoms and geriatric-related adverse outcomes associated with hospitalisation were collected and analysed.

Results: Patients’ mean age was 86.4 years (standard deviation [SD]: 6.8) with significant comorbidities being hypertension (81%), hyperlipidaemia (74%) and renal disease (70%). 51% of patients had dementia and 24% had behaviour and psychological symptoms of dementia (BPSD). 27% of patients presented atypically with delirium and 15% presented with a fall. Delirium was associated with restraint use (OR: 3.88; p-value 0.01). Falls rate was 1.64 per 1000 occupied bed. 1 patient screened positive for COVID-19.

Conclusions: The geriatric PARI ward is essential for curbing nosocomial transmission of COVID-19. This is important in the older people with comorbidities who are more likely to develop morbidity and mortality. Our study reveals challenges in delivering person-centred care to the older patients in isolation rooms, especially in the management of delirium and falls prevention. Innovative strategies should be developed to minimise isolation-related adverse outcome.