Qualitative Evaluation of a Pilot Physician Training Program in Long-Term Care Facilities in Switzerland

Increasing demand for long-term care facilities (LTCFs) and increasingly complex medical needs of LTCF residents necessitate recruiting new physician graduates and developing programs which provide them with experience and specific skills in geriatric and palliative medicine. We developed an educational program for physicians in training, which combines 1 year of immersion at 20% full-time equivalent with (1) theoretical teaching, (2) clinical exposure under the supervision of a senior LTCF physician, and (3) structured case presentations and debriefing with experienced geriatricians. This article presents a preliminary qualitative evaluation of this program from the perspectives of the trainees, supervising physicians, and public health stakeholders. The program was well accepted by all parties and showed positive effects on trainees' interest in long-term care medicine. Suggestions for improving future programs and their implementation are provided.

[COVID-19 infection in the elderly in French-speaking Switzerland: an inventory of beliefs, convictions and certainties]

Most patients hospitalized for COVID-19 are aged over 70 years old, and half of those who die are over 83 years old. Older patients do not always present with typical symptoms (fever, cough and dyspnoea) but sometimes are and remain asymptomatic (contact screening), or have aspecific presentations (altered general condition, falls, delirium, unusual fatigue). Rectal swab, which minimizes exposition risk, appears useful in long-term care patients with diarrhea. Older age is associated with worse prognosis, but the analysis should be refined by means of prognostic indexes that account for the heterogeneous health, functional, and cognitive status of the elderly population. Gathering elderly patients' wishes and assessing their remaining life expectancy allows to anticipate care decisions according to the level of tension in the health system.

[Management of infectious diarrhea in nursing homes]

Infectious diarrheas are of great concern in nursing homes and can engender outbreaks. Their importance in terms of morbidity, mortality and health economics justify the implementation of prevention and control measures. Although past studies emphasize the importance of infectious diarrheas occurring during hospitalization, data on nursing homes epidemiology remain scarce. This article is founded on recent data of the literature, on recommendations for the management of infectious diarrheas and for prevention and control of outbreaks in nursing homes.

[Depression in the elderly]

Often under diagnosed and inappropriately treated, depression in the elderly is a major public health problem. Semiology is often atypical with especially frequent physical and hypochondriac complaints. Concomitant somatic affections, social and surrounding particularities of elderly persons make the diagnosis of depression particularity difficult to make. lts treatment calls for a careful pharmacological care and adaptation of the psychotherapeutic manageme