COVID-19 causes more harm to seniors than just death

COVID-19 causes more harm to seniors than just death
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As a geriatric medicine physician specializing in care for older adults, I am witnessing the COVID-19 pandemic cause more problems for older adults than just sickness and death. 

The implications of widespread social distancing and cancellation of routine home-based medical care will be profound and potentially devastating for elders. 

It’s getting harder for seniors to get care at home at a time when they need it most. The COVID-19 pandemic is majorly disrupting critical home care services. Home health agencies hesitate to continue skilled nursing or therapy services for homebound seniors at the risk of potentially infecting them. 

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An estimated 12 million Americans utilize in-home services each year to help them function on a daily basis. Some report that lab services serving the homebound population may suspend services. If that is the case, a patient may need to travel to a lab or clinic, instead of a phlebotomist coming into the home to draw blood. 

Blood tests to monitor blood thinners or kidney function for people on high-risk medications may not be routinely available until this crisis subsides. Many elderly patients no longer have home health services available to help set up medications or assist with a bath. Some patients have been relying on family to step up; others have no choice but to wait for these critical services to resume.

Additionally, nursing facility care is reportedly harder to find. Hospitals are filling up beyond capacity, which makes it critical for non-urgent patients to be discharged to make space. However, when a senior is hospitalized, they can become weaker during the process and are often recommended to go to a short-term rehab or skilled nursing facility to regain their function and strength before going home. 

But nursing facilities and rehabs are reportedly becoming more strict with who they accept, and are very reluctant to take any patients who have been infected with the virus or have any similar symptoms. Some hospitals report having a hard time getting patients into these critical facilities – so much so, that states are now mandating facilities start accepting patients immediately to unburden the hospitals. 

This will likely have a cascade of bad outcomes, including patients who are even weaker when they are ready to leave the hospital. The recovery process will be even more prolonged and arduous. 

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In defense of these long-term care facilities, due to the spike in cases and deaths especially in Washington, they are trying to protect their current residents and patients by not allowing patients from hospitals where people are testing positive for COVID-19. But there needs to be a balance to serve the most people in the most effective way possible while causing the least amount of harm. 

Social isolation increases loneliness. This eternal struggle for seniors is worsening. My sister, who’s a volunteer to deliver food and other necessities to seniors in her community, has had to stop doing so at the risk of unknowingly passing along the virus. What will happen to these seniors who not only rely on volunteer programs like this but also will miss the human connection?

While continuing to social distance for the sake of all — and especially for seniors — is the right move, the tragic consequence, unfortunately, is social isolation.

Some digital ways to ease isolation underscore the importance of staying in touch with elderly loved ones. They need a familiar voice more now than ever. 

Older people are not alone in their anxiety about future uncertainties. Geriatricians are doing everything they can, at every level, to ensure minimal harm comes to their geriatric patients who are the elders and pillars of their communities. 

While older adults have the highest mortality rates from COVID-19, this global pandemic affects everyone. Vigilance, preparation and empathy can serve as tools during and after the crisis. 

Alexander Sasha Rackman, M.D. is a geriatric medicine physician and assistant professor of medicine at Rush University Medical Center in Chicago. Follow him on Twitter: @RackmanMD.