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Patient record sheets have been in use for a long time in the treatment of patients

The 70th press conference on the current situation regarding COVID-19, held for the last time in Cankarjev dom, was attended by the coordinator for the provision of healthcare services in social protection institutions for the Gorenjska region and the Director of the University Clinic of Pulmonary and Allergic Diseases Golnik, Aleš Rozman, and the government spokesperson, Jelko Kacin.

Director of the Golnik clinic Aleš Rozman

Director of the Golnik clinic Aleš Rozman | Author Anže Malovrh, STA

In the opinion of Aleš Rozman, the voice of coordinators for residential care homes has not gained its rightful place in public debate, although their role in the fight against COVID-19 was crucial in preventing the coronavirus from invading care homes and, where it did, ensuring that the infection did not spread to other residents.  Residential care homes adapted to the situation despite the fact that they were not prepared for it in terms of personnel, premises or equipment.

After the first cases of infection occurred in the Metlika care home, an expert coordination group began to be formed spontaneously at the national level and was officially approved by the Ministry. Director of the Golnik clinic Aleš Rozman stressed that it consisted of regional coordinators and other experts in individual fields. The group drew up instructions and organised assistance for residential care homes.

Primary, secondary and tertiary healthcare representatives, a nursing care representative and others were also involved in the coordination. The group held meetings with directors and the management of care homes. Mr Rozman said that, for the first time in his many years of experience as Director of the Golnik clinic, he saw residential care homes, primary healthcare, nursing care and hospitals all unite with one goal: how to help and prevent the epidemic and deaths among the elderly population in care homes.

In order to make it easier for doctors on duty to decide on the urgency of treatment of sick residents in emergency situations or in the event of a rapid deterioration of their condition, the group proposed triage to be carried out by a group consisting of a residential care home doctor, an internal medicine specialist from the nearby hospital and an expert in palliative care. "An 85-year-old person may be fully functional and able to take care of themselves, but then they catch a virus and, in a matter of a few days, they become bedridden and helpless," Mr Rozman described specific cases in care homes, adding that they just wanted to avoid assessing such an individual solely on the basis of their acute condition, thereby risking unnecessarily underestimating it and concluding that the patient's chronic disease has reached the end stage.

The group recorded the assessment of residents in special forms proposed by the national palliative care coordinator. Such assessments were made in advance and contained the assessment of whether the transfer of a particular resident to hospital was reasonable. If such decision were to be made, the doctor would consult the patient and/or their family members, said Mr Rozman.

In residential care homes, treatment was provided as best as possible: patients who needed oxygen were taken care of. Therapies and visits by doctors were provided. In this regard, Director Rozman stressed that patients were not automatically transported to hospital and that, in such cases, all circumstances pertaining to the patient should be considered.  He illustrated his point with the case of a resident for whom oxygen therapy would be too strenuous since it requires the patient to be physically strong.