Q&A: How to care for the elderly without putting them at risk of coronavirus - STAT

While the coronavirus outbreak poses health risks for everyone, officials have made clear that the elderly are particularly vulnerable.

In Kirkland, Wash., a nursing home that saw one of the first confirmed U.S. clusters of Covid-19 has already confirmed the death of 19 residents. Now other nursing homes and long-term care facilities are putting strict restrictions in place to limit residents’ risk of exposure to infection. Elderly living at home are also being encouraged to limit social contacts.

The measures are precautionary, but will put strain on families and friends who not only are eager to preserve contact with their loved ones, but are also increasingly worried about their well-being.

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Experts stress there are ways to stay in touch with and care for the elderly without putting them at risk of exposure to Covid-19. STAT spoke with Charlotte Yeh, chief medical officer at AARP, to learn more. This transcript has been lightly edited for clarity.

How do you recommend elderly populations protect themselves against Covid-19?

Apart from following the general guidelines on regularly washing hands, avoiding crowds, and practicing social distancing, it is very important that the elderly think twice about having friends and family members visit them, especially if anyone in the family might be sick. Caregivers should practice extra precaution themselves and the family should have a backup plan to care for their loved one in case the caregiver gets sick. … Planning also helps reduce panic and anxiety, so communicate a care plan among family members. There should also be enough supplies [food and medication] in the house that can last for at least two weeks, or maybe more. In many cases, you can mail order the medication and use grocery delivery services, as ways to further protect the older adults in the family.

If the elderly have an annual checkup coming up, should they be concerned about going to the hospital?

It can vary by location and community based on how widespread cases of coronavirus are. In case one is concerned, they should call their physician and say, “I’m scheduled for an annual checkup. I’m otherwise feeling well and do not have any particular concerns. Is this something we can reschedule or postpone for later?” It is also helpful because, again, if there’s an outbreak in your particular community, health care workers are also very busy taking care of those who are ill. If you can handle anything on your own through conversation or through telehealth, it will be good for you and also for the health care worker.

How would you advise the elderly regarding travel?

Well, everyone is going to have their own risk tolerance, but if you’re of old age and have serious underlying health conditions, you should think twice about travel, particularly by airplane. I do not recommend cruise ships at this point, or traveling to go to events where there will be large crowds. This would be a time where people should take an abundance of precaution about travel.

Should people consider taking their elderly out of long-term care facilities?

The guidance is continuing to change day by day, as we learn more about how the virus is behaving in the community. In this case, I would urge the individuals to contact the care facility and find out about the precautions they have in place. There are infection control procedures that every nursing home has to follow, and [you can tell the care facility] that you want to be notified what they are. In certain states, where there is higher concentration of outbreaks, there is guidance from the state department of public health, which may vary by locality. Most importantly, if [the elderly] are already in the long-term care facility, you just want to verify that these facilities are following proper precautions. You have to balance the care that your elderly can get in a facility versus if you took them home, you might be able to provide that care. Keep a close eye on what is happening in your particular community, your particular state, and follow the department of health guidance.

How can people stay connected with their elderly family members during a time of restrictions on visits?

Social connections are so important and this is a time where long-term facilities may be restricting visitors due to the risk of infection. But there are other ways of staying in touch. This is a time where we may go back to the old-fashioned ways of communication. This means making telephone calls more frequently. Don’t forget, there’s video conferencing available to use and sharing of photographs through social media, so you can stay in touch and not feel isolated or disconnected. There are captioned telephones for those who have documented hearing impairment. This is a free service that is covered by the FCC. [Older adults] can ask people to talk more slowly, especially if you have a captioned telephone, so you can capture the entire conversation and read it at the same time as hearing it. Just because you can’t visit your loved ones doesn’t mean you can’t stay connected. There are delivery services for things like flowers and groceries, just to say I’m thinking of you. Don’t forget about mail. These days we forget that a handwritten card, a letter sent to your loved one, might give us a result. The nice part about it is that you can read it over and over again to remind yourself that people care about you.

How can the elderly stay active inside their home and keep themselves entertained?

Even if you are at home, you can walk in the hallways, and walk around your room. It is really important to not just sit or lie down all day. We need to move and get the blood flowing and it is good for overall health. Even small housework is a form of exercise. Secondly, maybe this is a good time to catch up on old movies. In fact, you could have your family watch the same movie on the same day and afterwards catch up and talk about the movie. This might also be a good time to do things that you always wanted to do but never had the time. How about learning a new language [online], and sending notes to your family? Maybe write a note to your grandchild.

What are some steps to take if someone is worried that they have been potentially exposed to Covid-19?

The important thing to know is that, if you are not sick but fear that you have been exposed to someone with the infection, you don’t have to go to a hospital to seek help. You can call or use telehealth to contact your physician. Ask them what [symptoms] to watch out for, and when should you consider being tested. Clearly, if you have a fever, a cough, shortness of breath, there is a risk that you do have coronavirus and that might be a circumstance where it is recommended that you get tested. For people who have insurance coverage, there is typically a nurse helpline, in addition to contacting a doctor and telehealth option.

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