Staying Safe and Healthy During Coronavirus Response: A Guide for Older Adults

Claire Pendergrast and Mary Helander
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Older adults are at greater risk for several reasons. Our immune function, or our bodies’ ability to fight off new infections like coronavirus, declines with age. In addition, people with chronic diseases have lower immune function, making it harder to ward off infections. Older adults are more likely to have chronic diseases than younger age groups. However, not all older adults experience the same level of risk from coronavirus. Those with more chronic conditions or those in the oldest age groups (in their 80s and 90s) are at greatest risk.2

Coronavirus is not a death sentence for any age group.  However, given the novelty of COVID-19 and the severity of health risks, preventing exposure is the best approach for protecting older adults. While younger adults should isolate, treat, and monitor symptoms and may not need emergency care unless life-threatening symptoms arise, older adults should contact their physician or a medical provider as soon as symptoms occur to ensure they have the care they need to recover.

Different considerations for older adults in institutional settings vs. those living in the community
There has been much media and policy attention focused on coronavirus risk for older adults in institutional settings (e.g., nursing homes and assisted living facilities). Older adults in nursing homes and other communal living settings are at high risk of exposure because common rooms present opportunities for the pathogen to spread quickly3 and because the virus can be introduced from the outside by facility staff and visitors.  To protect nursing home residents, many states have put restrictions on visitors. This is an important step to protect this vulnerable group.

However, only about 2 million of the U.S.’s 48 million older adults (age 65+) live in nursing homes or residential care facilities.4 The vast majority of older adults in the U.S. live in their own homes or with family members. For older adults in these community-based settings, public health officials recommend that older adults avoid leaving their homes to reduce their risk of exposure to coronavirus. Following this guidance may make it challenging for older adults to obtain food and medication, access healthcare for chronic conditions, and cope with changes in social connections. Social gatherings (e.g., churches, senior centers), and in-person visits from friends, family members volunteers, paid companions, and home health aides all increase risk of exposure to coronavirus. All of this translates to challenges in maintaining physical and social activities and increases the risk of social isolation for older adults.

What should older adults and their loved ones do to maintain safety and health during coronavirus response?
Reduce Risk of Exposure

  • Limit and avoid visits to households with multiple people.
  • Stay six feet away from others, particularly from those who are sick, as much as possible,
  • Avoid public transportation unless urgent and absolutely necessary.
  • If possible, older adults should avoid trips to the grocery store by having someone else shop for their groceries, or by helping them to order online.
  • Many grocery stores are designating specific times for older adults to shop in less crowded environments: check to see if this is an option at grocery stores near you.
  • If an older adult receives care from a home health aide, have a conversation about standard infection controls, personal protection equipment (PPE), and ensure that aides will not come into contact with older adults if they may be sick.
  • If friends, families or neighbors are delivering food or supplies, ensure they are practicing good hygiene to avoid inadvertently exposing older adults. One potential option is to leave groceries on a front porch or in an entry area to avoid in-person contact.
  • Consider cancelling non-essential doctor’s appointments or looking into telemedicine options to avoid leaving home and risking potential exposure.

Physical and mental health care

  • Make plans for meals and groceries. If older adults receive Meals on Wheels or eat at senior nutrition sites, check to see if those services are continuing.
  • Staying active is important for older adults’ physical health, but cancellations of fitness programming at gyms and senior centers may make this challenging. Discuss options for getting physical activity indoors or outdoors while taking into account social distancing and safety.
  • Make a plan for chronic healthcare needs, including plans for how to get prescription medications and hygiene supplies.
  • For older adults with caregivers or aides, be sure to plan who will provide care if their caregiver or aide gets sick.
  • Watching, reading, and listening to news, talk shows, etc. about the pandemic can exacerbate anxiety.  Government directions for “what to do” have changed a few times, making the overall situation confusing and concerning. Older adults may benefit from finding alternatives to constant news consumption.

Maintain social connection and communication

  • Consider strategies to maintain social connection. For older adults who are comfortable with technology, transition from in-person visits to FaceTime or Skype.
  • Frequent phone calls are a great way to keep in touch and provide social support.
  • Encourage grandchildren, nieces and nephews to get in touch with their older family members via email, Facebook, FaceTime, Skype, and phone calls.  These connections mean so much.
  • Many of our mainstream remedies for dealing with the challenges of social distancing are technology based, such as searching the internet and streaming videos. Using this technology is not necessarily easy for older adults due to poor vision, declining cognition, or lack of exposure to complex apps. This can create frustration and more stress in trying to use technology than the value that the tech brings. Older adults may need help getting their TVs connected and navigating these systems.
  • Friends and family can help older adults see the value of their hobbies and engaging with them. For example, if they knit or sew, encourage them to do community projects.  If they woodwork or do handiwork, help them to get materials so they can keep it up.
  • Plan hobbies and activities to stay active and mentally engaged while maintaining social distance. New hobbies might include writing a journal, writing their life story, or writing fiction.
  • Friends and family should work to find ways to communicate the risks of coronavirus and strategies to protect their health that older adults. This can be a frightening situation, and the changes needed to reduce risks can be challenging.  Be patient and compassionate in your conversations and planning. Be sure that information is coming from reliable sources like the CDC or a healthcare professional to avoid misinformation or unfounded rumors.

Make a plan for what will happen if an older adult gets sick
Experts recommend the following approach.5

  • First, call a healthcare professional. Stay at home to avoid infecting others unless you need immediate medical care.
  • Ask for help from friends, family, neighbors, community health workers, and others if you become sick. Identify someone who will be your emergency contact in advance, and reach out to them to keep them informed.
  • Call 9-1-1 and get medical attention immediately if you have difficulty breathing or shortness of breath, persistent pain or pressure in the chest.

References

  1.  U.S. Centers for Disease Control and Prevention. (2020). “Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020.” MMWR. Morbidity and Mortality Weekly Report 69.
  2. Ifran, U. and Belluz, J. (March 2020). Why Covid-19 is so dangerous for older adults. Vox.com Retrieved March 20, 2020 from https://www.vox.com/2020/3/12/21173783/coronavirus-death-age-covid-19-elderly-seniors
  3. Kluger, J. (March 2020). A Coronavirus Guide for Older Adults (And Their Family Advocates). Time. Retrieved March 20, 2020 from https://time.com/5794374/coronavirus-seniors/
  4. Federal Interagency Forum on Aging-Related Statistics. (2016). “Older Americans 2016: Key Indicators of Well-Being.” Retrieved March 22, 2020 from https://agingstats.gov/docs/LatestReport/Older-Americans-2016-Key-Indicators-of-WellBeing.pdf
  5. Alliance for Aging Research. (March 2020). Common questions and answers about Covid-19 for older adults and people with chronic health conditions. Retrieved March 20, 2020 from https://acl.gov/sites/default/files/common/AOA%20-%20Alliance%20for%20Aging%20Rsch%20-%20Natl%20Fdn%20for%20ID%20-%203-12-20.pdf

Acknowledgments
The authors thank Dr. Shannon Monnat and the Lerner Center staff.

About the Authors
Claire Pendergrast (cpenderg@syr.edu) is a PhD student in the Department of Sociology in the Maxwell School of Citizenship and Public Affairs at Syracuse University. Mary Helander (meheland@syr.edu) is a PhD student in the Department of Social Sciences in the Maxwell School and an MPH student in Falk College at Syracuse University.  Both authors are graduate research affiliates of the Lerner Center and the Center for Policy Research at Syracuse University.

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