The Situation with Institutionalized Elderly in Bulgaria during COVID-19 Pandemic

BACKGROUND: At the beginning of the pandemic, health authorities warned that the most vulnerable group of the coronavirus infection are persons over the age of 65 and in particular institutionalized elderly, as their mortality rate is growing exponentially. Therefore, the protection of old people living in social institutions during the periods of COVID-19 waves is an essential priority. AIM: The study presents information from Bulgarian and foreign surveys and available data from regional, international social and health organizations, government institutions, and departments regarding the situation with institutionalized elderly in Bulgaria during COVID-19 pandemic. MATERIALS AND METHODS: A systematic review was used by searching the Web of Science, Science Direct, Scopus, and PubMed online databases of various legal and scientific sources for relevant and reliable information. RESULTS: Bulgarian old people inhabiting specialized social institutions are at a much higher risk of coronavirus infection and disease. A significant part of them has severe impairments and accompanying chronic conditions, which instantly make them potential, quick, and easy victims of the  pandemic. Residents of social homes are isolated from the outside world. They are forced to eat in the common dining room and to share the personal room with another accommodated individual. Compliance with social and physical distancing, as well as hygienic and anti-epidemic measures, turns out to be impossible. They communicate daily with staff who care for them and who are in constant contact with the external environment, which inevitably contributes to the spread of the virus in social institutions. CONCLUSION: The pandemic put institutionalized elderly, a very vulnerable population group, at health risk and affected their well-being. The presented results confirmed the need for urgent change of policies in the long-term care and nursing home sector not only in preparation for future pandemics but also for the overall improvement of the quality of care provided.