None listed
Conditions
Brief summary
Older adults take longer to recover from COVID-19 and other viruses and are at higher risk of experiencing ongoing symptoms. However, symptoms are often under-recognised and under-treated and we want to understand how we can better identify and support older adults in their recovery. In this study we will train staff and implement a model of care for recovery in frail older adults informed by frailty management guidelines, long COVID recovery guidelines, and the needs and preferences of consumers which we have captured in previous workshops. The model of care will be implemented in partnership with our partner aged care organisations in both residential and home-based settings with adaptations for each setting as required. We will evaluate the effectiveness of the model as well as evaluate implementation outcomes.
Interventions
Rehabilitation and recovery program designed for frail older people with post-viral illness symptoms and/or functional decline. The program is underpinned by frailty guidelines, rehabilitation guidelines for long COVID and our consultation with consumers regarding a preferred model of care. The intervention includes comprehensive assessment and care planning by an allied health professional, nurse or allied health student (1 consultation). The comprehensive assessment will include an assessment
Rehabilitation and recovery program designed for frail older people with post-viral illness symptoms and/or functional decline. The program is underpinned by frailty guidelines, rehabilitation guidelines for long COVID and our consultation with consumers regarding a preferred model of care. The intervention includes comprehensive assessment and care planning by an allied health professional, nurse or allied health student (1 consultation). The comprehensive assessment will include an assessment of the person's symptoms, frailty, level of function and goals for recovery. This will be followed by optional referral to other health professions as needed (counselling, specialist, dietitian, pharmacist). A short goal-orientated program will be offered twice weekly over 8 weeks by an allied health professional, nurse, allied health assistant or allied health student or careworker (16 consultations). This program will involve completion of appropriate prescribed exercises and activities designed to build strength, endurance and capacity while avoiding post exertional malaise. The person will also receive personalised education and support with fatigue management (using the principles of planning, pacing, and prioritising and applying these to the person's daily routines) by an allied health professional, nurse or allied health student (1 consultation) followed by final review whereby the person's function, symptoms and goal attainment are reviewed (1 consultation). Therefore the intervention will involve a total of 19 consultations plus referrals to other disciplines as required. Consultations are expected to last for a duration of approximately 30-60 minutes. The program will be delivered by a combination of allied health professionals/nurses/allied health students and allied health assistants/careworkers. The program will be offered to individuals either in person or online in individual consultations. For online programs, the participant will be emailed a meeting invitation to join via an online platform. (It will be offered in the person's residence (private home for community dwelling older people and residential care home for residents of aged care homes). Adherence and fidelity will be measured using interventionist records and a fidelity checklist.
Sponsors
Flinders University
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Older person receiving aged care services through partner organisations (residential or home-based care through Support at Home or Commonwealth Home Support). Frail, determined using the Clinical Frailty Scale with a score of 5-7. Recent history of viral illness (long COVID, Respiratory Syncytial Virus (RSV), influenza, gastroenteritis) identified through self-report, test, or clinical assessment. The World Health Organization’s COVID-19 case definitions of ‘suspected’, ‘probable’, or ‘confirmed’ infection will be used. Where applicable, testing would be via an antigen test which tests for COVID-19, RSV, and Influenza A&B (e.g., Covid-19/RSV/Influenza A&B Antigen Test). Persistent symptoms (physical or cognitive fatigue) and/or functional decline (has not recovered to usual level of independence in daily activities) at 4 weeks (and up to 12 weeks) post-illness onset identified through care provider records or older person self-report. Participants must have sufficient cognitive ability to be able to participate in the intervention (e.g. understand and follow simple instructions). This will be determined with a score of <10 using the PAS Subject Interview.
Exclusion criteria
Score of >10 using the PAS Subject interview tool. Disruptive behaviours untenable for supervised exercise (e.g., agitation which causes distress to self or others) as documented in care provider data.
Outcome results
None listed