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While it’s well-known that older adults are at higher risk for developing serious complications from COVID-19, it may be less clear what they think about the current pandemic. How are older adults obtaining their information about the virus? What matters most to them during these unsettling times? How are they adapting to consequent changes in the provision of health care?
One of the key ways to make care more age-friendly is to address what matters most to patients. With that in mind, IHI recently spoke with some members of the Age-Friendly Health Systems initiative Older Adult Advisory Group. While not necessarily representative, their comments offer importance perspectives on the current pandemic.
Most of the Age-Friendly advisors we spoke to said their health care systems had provided information about COVID-19. Some were also learning from family members, other institutions, and the media. Elissa Brown, 76, a retired clinical nurse who lives in Los Angeles, said her health system “keeps us updated on what’s going on.” MaeMargaret Evans, 75, who also lives in Los Angeles, said that her health system “has sent out several letters explaining coronavirus procedures.” Her apartment manager has also sent out three letters establishing health protocols for the building.
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Marian Hoy, 72, lives in Texas, and her daughter writes public health policies for the state legislature. When reports of the coronavirus first began to emerge, her daughter told her, “Mother, I want you to listen to me now. Don’t mess around with this virus. There’s not enough known. Don’t go out of the house. I’ll give you everything you need.”
Hoy also has received extra attention from her primary care provider during this time. Recently, a nurse called, and said, “‘We’re just checking in. How are you?’ That’s a very smart move in terms of dealing with me,” said Hoy. “When you get [to be] this age, that extra step of kindness and respect is appreciated.”
The nurse told Hoy that if she ever wanted to speak with her doctor, she could contact the office and they would arrange a video call. The doctor wanted to see her in June for her annual physical. “That’s how well they look after me,” Hoy said. “That’s a lot different than 25 years ago . . . [Now they try to] catch things before they get out of hand.”
Elissa Brown and her husband both had experiences going to a health care facility during the pandemic. “They had it set up so well,” she recalled. “One line in, one line out. Nursing and security all along. They take your temperature, triage you to where you are going.” Anyone who showed any signs of having the virus was quickly moved to a separate area. “It felt very safe,” Brown said.
This group of older adults and their spouses also had positive opinions about telehealth. Recently, Brown got a sliver in her right hand. She called her doctor’s office and received a call back within half an hour. “He was very nice, asked questions,” she recalled, and determined that Brown needed to come into the office. “I [scheduled an] appointment within another half hour and went to see them the next morning. It was so quick. I was amazed.” While she did ultimately need a face-to-face visit, the telehealth system felt more efficient to her.
Before the pandemic hit, Evans participated in a weight-loss program through her health care system. It has since transitioned to a teleconferencing platform. It’s led by a specialist in nutrition and psychology, and there are about 30 participants. “It’s very helpful,” Evans said. “It gives you a support system.”
“I think [telehealth] might be a thing of the future,” said Evans. She noted that she appreciates that using telehealth means not having to risk exposure to viruses that might be present at the health care facility.
Randel Smith, 78, lives in Maryland and agrees that telehealth, in appropriate situations, is a “good thing. You don’t have all that time lost in a waiting room. You don’t have that travel time lost.”
Although this group of older adults said that they were faring well, they recognized that it was a scary time for many of their peers. Brown pointed to the risk of increased loneliness during quarantine, exacerbating an existing problem that is widespread. “We have a number of friends who are widows or widowers,” she said. When she worked as a nurse, she recalled conducting a support group with older adults at the VA. She recalled that loneliness — more than mobility or any other issue — came up as the biggest obstacle to well-being.
Hoy points to another obstacle to well-being in the current environment: fear. “Fear is so damaging to getting well,” she said. To combat fear among her peers, she made a recording for her church. In it, she first sings the national anthem, then says, “I love this country, and we’re going to get through this [pandemic] like we have so many other difficulties in our history.” She goes on to thank first responders and medical professionals “who put their lives on the line just to keep us well” and scientists searching for a cure for COVID-19. She ends by saying, “I love you, my fellow Americans, as well as those who have come to this country seeking a better and safer life for themselves and their families. My very best to you. Stay safe and well.”
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