The Importance of TeleHOMECARE in the Covid-19 Epidemic The corona virus is spreading rapidly around the world these days and many countries have been infected with this virus. Corona is actually a vast family of viruses that cause respiratory infections from a simple cold to the SARS-CoV2 epidemic that broke out in 2019. The Covid-19, the newest member of this family, known as Corona in Iran, is expanding rapidly . The spread of this disease has affected the health and medical CARE system and is rapidly moving health CARE to new ways of providing services. There is no doubt that the current global crisis of Covid-19, due to the high prevalence of the Corona virus disease and the limitations of face-to-face visits, is now more than ever applied to digital methods (Computers, Multimedia Computer Networks, Internet, Telephone. . . ) optimizing health CARE. TeleHOMECARE (THC) is now an effective way to provide medical CARE as well as distance education and is used in a variety of methods such as THC . THC is a subset of telemedicine. This includes providing health CARE to patients at HOME through the use of telecommunication technologies, which enable the interaction of audio, video and health-related data. THC includes a wide range of health CARE through education, emotional and social support, dissemination of information and self-CARE assistance and suggestions . The implementation of THC helps to better manage patients with chronic diseases such as heart disease, COPD, diabetes, etc. and reduces the number of people referring to primary health CARE services. THC increases access to health CARE, especially as the need for HOMECARE increases with age . In addition, THC can help build service networks between hospitals and primary CARE providers, giving patients better access to services. In addition to improving the management of chronic conditions and increasing access to health CARE, THC believes that it reduces health CARE costs . Chemical Veterans and CARE Challenges in the covid-19 Epidemic Chemical warfare victims are more at risk of contracting and dying from Covid-19 because under normal circumstances, they are struggling with pain and suffering from the diseases left from the eight-year war. This virus has made them even more short of breath. In particular, chemical warfare veterans suffer from acute problems due to respiratory and pulmonary problems with the smallest disease related to the respiratory system. This means paying attention and CARE to this group in the Covid-19 epidemic should be considered as a priority. The health and longevity of chemical warfare victims are under serious threat due to the following reasons: 1. Respiratory problems in different groups of chemical warfare victims. 2. Progressive nature of lesions caused by some chemical agents. 3. Side effect of drugs used in the treatment of long-term chemical lesions. 4. The effect of complications due to other injuries associated with complications related to chemical agents. 5. Complications due to aging or related anxiety to war casualties. 6. Occurrence of long-term factors caused by chemical agents of war. Among the mentioned cases, the highest frequency is related to respiratory complaints among chemical warfare victims who are at risk of respiratory attacks at any time, which leaves many worries for the family. These war wounded are prone to lung failure and respiratory problems due to lung infections, so that now, years after the imposed war, they are suffering from a high degree of martyrdom due to these complications. CAREful and adequate CARE of patients at HOME or in nursing HOMEs can help ease and improve them. Not being exposed to polluted air and using oxygen and humid air is effective in improving their quality of life...

Objective (s): The ELDERLY people consume much of the HOME health CARE. Therefore how to organize HOME CARE services and identify the services needed is important in order to manage and control resources. The purpose of this study was to describe HOME health services status in Tehran, Iran. Methods: A sample of ELDERLY people receiving HOME health CARE during April 2017 to September 2017 was studied. The data was collected using a checklist. Data was entered into SPSS V. 19 and analyzed by descriptive statistics. Results: In all 278 ELDERLY people were studied. Of these 59. 4% were female and 65. 2% were married and their mean age was 81 ± 2. 5 years. The results showed that the most frequent services that needed were nursing service (55. 4%), physician visit (17. 0%) physiotherapy (15. 0%). Medical services had a significant statistical relationship with the age and marital status of the ELDERLY but non-medical services (physiotherapy, nursing and laboratory) had a significant relationship with gender, age, marital status and education (p≤ 0. 05). Conclusion: The findings showed that ELDERLY people needed a variety of services. Also there were differences in the use of HOME health CARE among the ELDERLY by age, gender, and other demographic factors. Overall, it is necessary for health CARE providers to understand the growth of the ELDERLY population in the country and their needs in the coming years in order to plan appropriate programs and actions.

Background & Aims With the growing number of chronic diseases and the aged population, the need for more HOME CARE centers has increased. HOME CARE as a new approach can have many pros for the patients, families, and society. This study aims to investigate the challenges of HOME CARE service provision in Iran from the point of view of service providers and recipients and propose solutions to improve these services. Materials & Methods This is a qualitative study. Participants were 28 people, including 15 service providers (policymakers, HOME CARE center managers, professors from medical universities, and experts) and 13 service recipients, who were selected using a purposive sampling method until reaching data saturation. Data was collected using semi-structured face-to-face interviews. To analyze the data, Graneheim and Lundman’s content analysis method was used in MAXQDA 2020 software. Results Four themes (challenges) were extracted with 12 sub-themes: Challenges of families with the service center (manpower, difficulty in providing CARE services, and costs), challenges of the service center with the families (Therapeutic/communication process, security), challenges of the service center with hospitals (Referral method and previous hospital treatments, hospital violation), and existing challenges in the field of policymaking (culturalization, statute, insurance, violation of the law, and license provision). The solutions were proposed in three categories: the services center, treatment system/law, and culturalization. Conclusion The HOME CARE service provision in Iran is facing several challenges, including the challenges of families with the centers, challenges of the centers with families and hospitals, and challenges related to policymaking. These challenges can be solved by using the proposed solutions, which can improve HOME CARE service quality and planning.

BACKGROUND: Advanced stages of dementia interfere with ELDERLY self‑, CARE. Consequently, they need CAREgivers who take responsibility for their CARE in the long‑, term. Restrictions to the CAREgiver’, s access to information, resources, and organizational support have created problems in their CAREgiver role, which is why the World Health Organization (WHO) emphasizes caring for CAREgivers by providing evidence‑, based information and training programs. As there is no clinical practice guideline for HOME CARE in the Islamic Republic of Iran, this study aims to develop a HOME health CARE guideline for the ELDERLY with dementia. MATERIALS AND METHODS: The ADAPTE process provided by the Guidelines International Network was considered as the basis. In order to identify the CARE needs of Iranian patients with dementia, semi‑, structured interviews were added to this guideline. DISCUSSION: The identification and implementation of the perspectives of patients and CAREgivers during the process of guidelines adaptation increase the applicability of the guidelines. Improved quality of life for the patients in their place of residence is one of the expected consequences of this guideline’, s implementation. The developed guidelines will be used at HOME health CARE centers, and dementia and Alzheimer’, s associations in Iran.

Objectives ELDERLY people are at the highest risk for falling. In order to design and implement effective interventions and reduce the incidence of falling and its resulting injuries, the relative importance of each risk factor should be determined. This study aimed to determine how frequently different factors contribute to falls among the ELDERLY served by one HOME health agency in Tehran. Methods & Materials This study was a descriptive-analytic and cross-sectional study. A total of 400 ELDERLY were selected through random cluster sampling method from all 22 districts of Tehran City, Iran. The study data were collected through a researcher-made questionnaire of falling risk factors. The questionnaire consisted of two parts: first, demographic questions and second, questions related to falling in 7 dimensions (including 60 questions). The obtained data were analyzed in SPSS (V. 19) through descriptive and inferential statistics. Results In this study, female samples were 52. 5% of the participants (n=400) and the ELDERLY mean± SD age was 78± 8 years. The total frequency of falling among the ELDERLY was 28% (112 out of 400). Among the ELDERLY who had fallen (n= 112), 64 (57. 1%) of them were female and their Mean± SD age was 80± 7. 5 years. About 82% of them fell down inside their HOMEs, with these separate frequencies: bathroom (19. 6%), toilet (18%), bedroom (18%), and hall (16%). Parts of the body which were more frequently affected by falls in forms of injuries, bone fractures, dislocations, etc., were the pelvis (26. 8%), arms (22. 3%) and legs (19. 6%). Around 43. 8% of the falling among the ELDERLY had led to hospitalization, 44. 9%, between 1 and 5 days, 36. 7% between 6 and 10 days, and 18. 4% between 11 and 15 days. The relationship between falls and the medical, lifestyle, or environmental risk factors was non-significant. Conclusion A high percentage of affected ELDERLY were hospitalized after the incident, and among them a high percentage stayed in the hospital for a long time imposing considerable costs to the health system. Moreover, sensory and neuromuscular risk factors were the most frequent causes of falls which could be prevented by rehabilitation measures. Results showed that people who are afraid of falling have a higher risk of falling which requires adequate and special attention to this psychological risk factor.

Objectives: Cognitive impairments and negative attitudes toward self, world, and future in the ELDERLY are common problems that cause loss of efficiency, quality of life, and increased mortality among them. This study compared the cognitive triad (negative attitude toward the self, world, and future) between the ELDERLY who residing at HOMEs and nursing CARE facilities.Methods & Materials: This study method is causal-comparative and 40 ELDERLY people (20 HOME residents and 20 living in nursing) were selected for the study. Cognitive triad inventory (CTI) was performed on the ELDERLY. The data were analyzed using multivariate analysis of variance (MANOVA).Results: The mean age of the participants was 16±68 years. Results showed that there were significant differences between the ELDERLY people in nursing HOMEs and HOME, with regard to their attitude toward themselves (F=229.87, P<0.001), attitude toward the world (F=138.41, P<0.001), and attitudes towards the future (F=151.62, P<0.001).Conclusion: Cognitive impairment in the ELDERLY residents of nursing HOMEs compared to the ELDERLY living at HOMEs was significantly greater, i.e. the attitude of ELDERLY people living in their HOME is better than the ELDERLY living in nursing HOMEs. Practical results of this study can be applied in future studies. Furthermore, cognitive rehabilitation can be considered as a treatment for the ELDERLY negative attitudes.

Although modem health CARE technology has had a positive impact on the improvement and cure of many patients, it has led to a considerable increase in health CARE costs, specially in hospital services. Therefore, health CARE researchers have been always interested in alternative strategies, including HOME CARE. This article intends to present the defamation and scope of HOME CARE; then, it analyses major strengths and weaknesses of this strategy of health CARE deliver.