As we all know, Italy was the first European country to be significantly affected by the spread of COVID-19 and while we can read all the numbers, what we imagine with difficulty are the tragedies that are taking place near us.
Right now all of Italy is in quarantine; no one can leave except for non-extendable needs. The sound of urban traffic in our cities has given way to an unreal silence broken only by the sounds of ambulances that transport patients to the nearest hospitals.
Undoubtedly, the curve of COVID-19 infections shows how the north of our peninsula – the most industrial part – is the area most affected by the epidemic. Perhaps because there has been more contact with China or perhaps just because of a strange game of fate.
Healthcare in these regions has always been praised, especially by politicians, for medical excellence and for the ability to deal with emergencies. But emergencies of this magnitude were not foreseen and frankly, we were not ready.
We don’t know much about this virus yet, but one thing is certain: it is attacking the most fragile sections of our society; the segment of the population that, more than any other, needs protection and care. Among these people there are also those who have dementia and who take care of them amidst many difficulties in normal conditions.
In these conditions of isolation, the management of daily life for the person with dementia becomes even more complex, and maintaining (even if revised or simplified) daily habits becomes the fundamental imperative for those who care for a loved one with dementia. So go ahead with arranging at home a little corner for the daily prayers that could replace going to mass, delivering the newspaper at home and planning a routine that reproduces as much as possible what was done before. Going out for people with dementia is an important tool that helps reduce anxiety in certain moments; therefore, ensuring a short walk using the condominium courtyard, the entrance hall or the stairs can be equally useful moments.
Family members and carers in this delicate moment, no longer having time available for themselves, must be supported, encouraged and helped. Their stories on “Pronto Alzheimer”, our national helpline, speak of loneliness, moments of crisis, daily load and daily unpredictability of reactions and behaviour of the person with dementia. Sometimes even just a phone call guarantees them the opportunity to receive advice, comfort and support that the inability to access services and social assistance activities has denied them.
We have also shared nationally with the media, family caregivers, operators and on our Facebook page, a handbook of practical advice dedicated to the caregivers to help them better face the period at home with their loved ones. It is a small support that intends to offer some ideas to spend the day, focusing on both manual and motor activities necessary to ensure psycho-physical well-being and, as mentioned above, as a useful strategy to defuse irritability and agitation in the person with dementia.
Health professionals – especially in the north but increasingly more in the south, – currently in a situation of scarcity of beds, assisted ventilation equipment and personal protective equipment, face a truly dramatic moment and often cannot hospitalize those who need it: both young and old due to lack of ICU beds. Our local and national governments are working hard to recover resources abroad that are lacking but unfortunately, these are scarce everywhere and the implementation of new hospital structures requires time that we do not have.
This leaves many vulnerable people, typically elderly with various pathologies – facing an infection at home that would require specialized hospital treatment.
But the testimonies speak of a tireless Italy that does not stop, of many local services that have organized themselves with the delivery of groceries, meals at home, small associations that reactivate helplines, towns that gather around the most fragile people delivering medicines, young engineers who started to convert snorkeling masks into respirators for people undergoing oxygen treatments and answered appeals by many local administrations on social media to donate these masks. There are many online platforms that highlight the numerous initiatives including the many videos that professionals and experts record from their home to provide indications, advice and suggestions.
Other unexpected initiatives start from those who help people with dementia day after day and put themselves at the service of the community. The Alzheimer Center in Gazzaniga, near Bergamo, is being transformed into a sub-acute medicine ward to manage COVID patients. It is a rehabilitation center for people with dementia who work within the Recage project for the management of BPSDs (behavioural and psychological symptoms of dementia). The center welcomed, with a great spirit of solidarity, a number of people with COVID-19 (both young and elderly without dementia) in order to lighten the Bergamo Hospital from the immense workload.
Thanks to the whole workforce and their skills – not just medical, but also human derived from taking care of people with dementia – even patients with coronavirus can be taken care of in the best way. This will make us reflect, when this nightmare has passed, on the importance of the human aspect in the care of a person suffering from a disease of which we still know too little, be it Dementia or COVID-19.