HDJ gériatriques et COVID-19. Quelle gestion ? Quelles difficultés ? Quels enseignements ?

The COVID-19 pandemic has led to an unprecedented health crisis. In the subsequent response, geriatric day-hospitals paid a heavy price in the organizational restructuring of the hospital environment, with almost instantaneous closures enforced by the authorities. A survey was therefore conducted under the aegis of the APHJPA among day-hospitals to learn the lessons from the management of this crisis and to reflect on the role of these structures in context of this nature. Fifty day-hospitals throughout the country answered. Most of the professionals were immediately redeployed to classic hospitalization services, whether or not the population area was heavily impacted by COVID-19. Some of them then provided assistance to nursing homes or patients confined to their homes and their families. Although they accepted the closures during the acute period of the crisis, the lack of clarity about the reopening of their units despite the precautionary measures envisaged was not well received, often with the feeling that the authorities and sometimes the management of their establishments were not well acquainted with their role in the care of the elderly. The lockdown and discontinuation of care led to decompensations, especially among patients with neurodegenerative pathologies. Situated at the interface between the community and hospital health sectors, day-hospitals play a major role in the care of the elderly. This survey highlights the ability of professionals to adapt and commit themselves, demonstrating the relevance of day-hospitals in the field of chronic diseases (diagnosis, follow-up, rehabilitation) and also in prevention, identification and follow-up of frailty factors in elderly patients.