A.Martin1,N.Boyle2,J.Cooke3,S.P.Kennelly4,R.Martin5,M.Mulroy6,M.O’Connor7,S.O'Keeffe8,D.O’Neill4OnbehalfoftheIrishSocietyofPhysiciansinGeriatricMedicine.1.BeaumontHospital,Dublin.2.St.Vincent’sUniversityHospital,Dublin.3.UniversityHospitalWaterford.4.TallaghtUniversityHospital,Dublin.5.ConnollyHospital,Dublin.6.OurLadyofLourdesHospital,Drogheda.7.CorkUniversityHospital.8.GalwayUniversityHospital.AbstractResidents in nursing home care have borne a disproprtionate morbidity and mortality in the COVID-19 pandemic in comparison to the general population. Although the high rate of infection, morbidity and mortality in older people living in nursing homes may be attributable to increased levels of frailty and comorbidity in residents, the physical infrastructure and governance structures within nursing homes is also likely to be highly significant. The authors present, on behalf of Irish Society of Physicians in Geriatric Medicine, a position paper on changes that should be implemented to enhance the safety and quality of care for nursing home residents in Ireland. IntroductionResidentsinnursinghomesrepresentagroupwithhighlevelsofdisabilityandco-morbiditywhichrenderthemparticularlyvulnerabletoexternalandinternalstressors1,asexemplifiedbythehighdeathrateinIrishnursinghomesduringtheCOVID-19pandemic.Atthelastcensusin2016were22,762peopleover65yearsofage(3.7%)listedasresidentinnursinghomesinIreland2.Althoughthiswasadecreaseintheproportionoftheolderpopulationinresidentialcarefrom2011itreflectsanactualincreaseof9.4%inpeoplelivinginnursinghomesinthiscountry.Asoursocietyagesitwillbeincreasinglyimportanttoprovidehighqualitycareforthisvulnerablegroup.TheIrishSocietyofPhysiciansinGeriatricMedicine(ISPGM)haspromotedthedevelopmentofimprovedstandardsofcareinresidentialcareforseveraldecadesandwasthefirstIrishprofessionalgrouptoformulateimprovedstandardsofcarein2001,publishedintheIrishMedicalJournal3.

摘要

Residents in nursing home care have borne a disproprtionate morbidity and mortality in the COVID19 pandemic in comparison to the general population. Although the high rate of infection, morbidity and mortality in older people living in nursing homes may be attributable to increased levels of frailty and comorbidity in residents, the physical infrastructure and governance structures within nursing homes is also likely to be highly significant. The authors present, on behalf of Irish Society of Physicians in Geriatric Medicine, a position paper on changes that should be implemented to enhance the safety and quality of care for nursing home residents in Ireland.