On 29 May, the Chief Medical Officer of the Scottish Government published a rapid guidance document for NHS Scotland, aiming to provide advice on the presentation and management of COVID-19 in older persons in acute care.
The guidelines include descriptions of common symptoms of COVID-19 in older people, which do not always include fever, cough or influenza-like illness. Instead, they identify delirium, anorexia, vomiting, low-grade fever, fatigue and falls as more common symptoms in this age group. The document also recommends that all patients over 65 years should have a frailty assessment upon admission to hospital, to identify those who are most vulnerable and therefore require comprehensive geriatric assessment. A further recommendation is made to ensure communication is promoted between patients and family members using digital tools such as smartphones and tablets. Anticipatory care plans should be put in place, taking into account their current situation, previous health and what matters to the patient and their family.
Finally, the guidance document outlines how isolation for the purposes of infection control could be managed in acute care, with recommendations on what to do when discharging patients to home, nursing homes or other care settings. The guidelines can be downloaded here: https://www.sign.ac.uk/assets/sg_presentations_and_management_of-covid-19_in_older_people.pdf
