Seniors were the first population in California advised to socially distance themselves and to enter preventative quarantine. That’s because they are vulnerable to contracting COVID-19 at a faster rate then less vulnerable populations.
“That's largely because our immune system sort of changes as we age, and it becomes harder to fight off diseases and infections,” said Kathryn G. Kietzman, a research scientist at the UCLA Center for Health Policy Research with an emphasis in elder health.
The last time a public health emergency was out of control, Kietzman says, was possibly the polio epidemic.
“I'm hard pressed to think of something that's quite the same as this,” said Kietzman. “I think it's the rapidly changing environment and dynamics around this virus that are very different.”
She says it’s so important to remain in contact with older people during this crisis. Making sure they are taking care of their bodies in terms of nutrition, hydration and exercise are important, says Lakelyn Hogan, a gerontologist and caregiver advocate with Home Instead Senior Care.
“Even if it's just limited to what they can do in their living room can go a long way because we can see negative health impacts on older adults in the form of poor mental health, anxiety and depression,” said Hogan.
Checking in and helping seniors with groceries, tech and medical needs all while following the state’s guidelines of social distancing are important to protect seniors, she adds.
Both Hogan and Kietzman agree that for bending the curve to be successful we have to act collectively.
“I tend to go to the saying this too shall pass,” said Kietzman. “It’s something that most or maybe all of us have not experienced in our lifetimes and we have to hold on to that to emotionally and mentally get through this trying time.”
As the coronavirus pandemic continues CapRadio listeners — seniors and those that care for them — are asking questions about how to move forward. We asked Kietzman and Hogan to address these questions and will continue to answer your inquiries as the crisis continues.
The Experts
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What Seniors Need To Know
Some states — like Georgia, New Jersey and New Mexico — have set up a hotline for seniors unable to obtain groceries. Is there one for seniors to call for advice?
KIETZMAN: “With California being such a large state, I would say that the best hotline would be the senior information line, which is available through the Area Agencies on Aging, which are available in every county across the state. There is a hotline number that seniors can call to get information about the resources available to them in their communities. I know the number; it's 1-800-510-2020. So that's an important first line for seniors who need information about what's available in their local communities. They'll connect you with the local area agency on aging, which should have the latest information about what's happening in the community.”
Are local grocery stores as well as large chains going to institute “senior” shopping hours?
KIETZMAN: “Yes. I was at my local Trader Joe's just two days ago and the cashier told me that they were opening the store for the first hour for seniors 65 plus, so that they could get in and get the items they need. As you know, there's been a lot of hoarding people going and emptying out shelves, unfortunately, and it's much more challenging for seniors typically, sometimes because of mobility issues. But also I think importantly this is going to be ideally at its most hygenic in terms of people not having to rummage through the shelves.”
What are the local resources for older people needing supplies like food or medicine? Do the new guidelines mean seniors shouldn't be getting groceries and meds?
KIETZMAN: “If your only recourse is to go and get the grocery yourself, then I don't think the government is telling you not to do that. But then you do it with all the precautions. And if you can identify the market that has those special hours, then you're reducing your risk of additional exposure. If you go to the market during the middle of the day there have been hundreds of people already there. If you're the first one through the door, it's a little bit of a safer time. So I think if something's essential, like medications, if you have to go to the pharmacy, if you can't have it delivered, I would start with trying to get things delivered or having somebody you know help you through the market, through the pharmacy, or through family member friend or caregiver, or neighbor. But if you have to go and get it yourself, then you do it and just use the precautions.”
Can an indoor cat serve to transmit coronavirus from a working person to a senior in the same house who are otherwise isolated?
KIETZMAN: “OK, this is important actually. And it's actually not known. There's no evidence, I looked this up, there's no evidence that pets can get sick from the virus right now, according to the World Health Organization. But it's important to know that dogs and cats can spread viral and bacterial illnesses to humans. So recommendations are to wash your hands really well after you touch your animal or clean up after it and make sure that your pets are up to date on their vaccines and flea and tick treatments and so forth.
“The CDC recommends that you don't let your dog or cat lick you in the mouth or on an open sound. I'm chuckling. But it's actually really important to avoid that, because they do transmit germs.”
“But this question is really important because a lot of people who live alone in particular, really rely on the social support that an animal provides. And pets with older adults, there have been a lot of studies on this really, incredibly important to combat the bad consequences of social isolation. So we want to make sure that older adults and their pets both are keeping healthy, and that when we're stockpiling for ourselves, it's also important to stockpile for the pet. Make sure that the pet has the food and maybe if they're on medication have all of that their needs also taken care of.”
How can people 65-and-up purchase pseudoephedrine, which has to be purchased in person with ID, when we are supposed to stay home? Thanks.
KIETZMAN: “At this point, stocking up on prescription medications is extremely important for older adults and anybody who relies on those for their health and well being. I think the industry is catching up, there are restrictions on how many pills people get at one time or what they can access and how they have access to it. But the industry is starting to waive some of the regulations or the rules. So, if somebody needs to stock up, you should talk to your doctor. Sometimes the doctor will increase a 30 day supply to a 90 day supply of pills for example. And you can also talk to your pharmacy or your prescription plan to say, you know, this is a medication that I normally need to get in person, how can you help me out here? Some pharmacies are now waiving delivery fees.”
I live in Truckee, I'm 66 years old. My son and his wife and son live here in Truckee but have their own home. Is it safe to visit them?
KIETZMAN: “The line of thinking is we should all interact with others and with physical places as if we have the virus because we may have it and we just don't know because we don't have symptoms. Older Adults are not excluded from that category.
“This is a decision that most everybody's facing right now, whether or not to visit or interact with older adult parents, relatives, neighbors, etc. What we have to be careful is to walk that line between people who are socially isolated and have real needs, making sure that those real needs are still met. And that's going to in many cases involve some human interaction. So I think that's where the social distancing comes in.
“I think that we need to be very thoughtful about when we go to visit family members of all ages, but especially older adults, or people who have existing health conditions that make them more vulnerable to this virus. But that said, I think if we practice social distancing within the home, if we stay six feet apart, if we wipe down surfaces with sanitary wipes or use gloves, there are ways to still engage with our loved ones and our family members.”
I am 63 with a chronic lung condition. If I die from this virus, what will happen to my body? Can I donate it to the science for this virus?
KIETZMAN: “I don't know the answer to that question. Certainly we can sign up and donate our bodies to science. We can do that. I don't know if there's a mechanism to specifically donate it for this virus.”
Should I continue to have my house cleaners come twice a month? I am over 65.
KIETZMAN: “We need to make decisions based on what's essential. If there's some essential tasks that are going to be important to the person's safety and hygiene in their home, maybe they want to still have that housekeeper come, but very reduced time and effort just to take care of items that are needed to maintain health and well being in the home. And importantly, that person needs to be informed about what they need to do to protect themselves and to protect the individual that they're providing the services to. So following all the same practices that are being released from CDC and Department of Public Health in California.”
I am a 68 year old nurse practitioner working part-time with very little paid time off. How do I isolate at home and survive financially?
KIETZMAN: “That's a tough one because there are so many layers there. So this person is an older adult themselves, and then they're part time, so they have financial concerns. I think that's a really important issue to address. In general with older adults in California, one in five are living in poverty so this becomes almost more of a double jeopardy situation where people are told to stay at home, but they may not be able to stay at home because they're worried about having to pay their rent.
“I'm not saying this individual has that financial problem necessarily, but because of the question, I think it's important to recognize the decisions that state policymakers, federal government are making right now. The state is also working on all fronts to shore up economic public programs that can support people so this person who's a nurse practitioner has a lot of different decisions to make. Number one is it safe for her to interact with patients and how will she do that? It sounds like the gist of the question is really about how can I do this? I don't have paid leave. So hopefully the state and federal efforts to address what many people are experiencing with a sudden disruption and work will help to stem some of that so that maybe she can stay home.”
Perhap trivial, but I wonder if the risk of a biweekly housekeeper outweighs any benefit. I am 70 and have an auto-immune blood disorder.
KIETZMAN: “I’m not a pathologist and I'm not really qualified to know the answer to that. I'm picturing the newspaper that I picked up this morning in a plastic bag. Certainly if it's in a plastic bag, and you could pick it up with the gloves, I suppose it might be okay. It's a tough question because we're learning that this virus might be spread from surfaces. I guess erring on the side of avoiding any potential transmission I would probably suggest if you can read the paper with gloves you should be okay. But if you're concerned then I would avoid it because it’s something that's not essential.”
Can I keep my hair appointment? I am healthy, however, 72 years old
KIETZMAN: “It's a personal decision. I think that it's not an essential thing. I know it's a very important thing for a lot of us. There's no six foot distancing if someone's doing your hair. I think it's something that if it's not essential, it should be avoided. I just keep reminding people let's just mentally take it two weeks at a time so we don't get overwhelmed and then we'll find alternatives and figure out creative ways to do our own hair for example.”
I am 77 yrs young. Is it OK for me to go out to walk by myself around McKinley Park?
KIETZMAN: “I believe the answer to that, from what I've heard from all the public health professionals, is yes. And actually it might be very important for our mental health assuming we're fit and we can still maintain our six feet of distance from others. I think it's probably going to be a very important antidote for many of us to engage in that kind of activity.”
I'm 60 and have one kidney in third stage disease, should I really be staying home as much as possible. Is handling money truly a concern?
KIETZMAN: “I would use gloves with the autoimmune disorder and with everything I would use gloves. I'm not a medical clinical professional. So, I'm just basing this on public health recommendations that I've been following as a public health researcher.”
Is it safe to go to a neighborhood restaurant if you are a senior?
KIETZMAN: “Well, we have a restriction now on restaurants only doing takeout. I know that the restaurants are instructed to handle things properly using the same precautions. But again, I think on the conservative side, if at all possible, better to eat food that you can prepare at home. Some older adults cannot do that preparation. So again, that might be where family or neighbors come into play if available using all of the protections.”
I have friends who don't drive. They take public transit or services like Uber and Lyft. How can they protect themselves and drivers?
KIETZMAN: “It's a little more of a fine line because you're going to be in an enclosed space, I suppose to really protect both the driver and the person, maybe you should wear a mask and use gloves.”
I’m over 65 and live alone. What is the difference to me and others if I am indoors, alone in my car or walking alone outdoors?
KIETZMAN: “The important message is that we need to collectively engage in these public health practices in order to level the curve and reduce the spread of this virus. I know that we are hearing projections that up to half of us could get this virus in California. But all of the measures that everybody is promoting the public health departments, the CDC, the World Health Organization, these are things that are known to reduce the exponential growth of this. So absolutely.”
When it comes to seniors, what warning signs can family and friends in loved ones that tell us isolation is having a negative impact on their mental health?
HOGAN: “You can look for physical symptoms like if they're complaining of extra aches and pains that are above and beyond kind of the normal day to day or headaches. Also, if you're noticing they're a little more anxious or paranoid, that can be a warning sign or if they're exhibiting low energy, maybe they're talking about how tired they are, maybe they're experiencing a little brain fog that can be assigned and then also sleep issues. We know that when we have a lot more downtime, it can be appealing to take naps throughout the day, but that could be impacting their sleep quality at night. So if your loved one is talking about waking up frequently during the night or hard, having a hard time getting to sleep, those could be just some signs that they're feeling a little isolated and lonely.”
How can friends and family engage with senior loved ones while avoiding contact or visiting?
HOGAN: “Every situation is different and it's really important when you're considering getting out and about to really take into consideration the well being of older adults. For a lot of people, it can be okay to take a walk in the neighborhood but it might not be good too. If the park is highly populated, it might not be good to stop at the park. It might just be better to continue to walk around the block. But again I think the best ways are for us to check in on our loved ones. If it is okay to visit, stop by for brief visits, but again, you know, follow the CDC recommendations of hand washing and limiting contact and disinfecting especially before and after visits.
“I think it's really important to connect even if your loved one is unable to leave the home or if you're unable to enter the home. I've seen lots of great social media stories of people going to the home and standing outside the window and talking to their loved one on the phone, just to have that face to face. Talking verbally can really brighten the older adult's day.”
Do you have any advice for seniors asking these questions, especially those that don't have family?
HOGAN: “I think it's very important to follow the recommendations of your local government and this CDC in terms of self isolation, but older adults do have needs for things like groceries and medications as well as the need for social isolation. There's a lot of community organizations that are creating hotlines or organizations that are offering to go get groceries for the older adults in their community. Looking for those opportunities can help an older adult to minimize the risk.
“Also, home care companies like Home Instead Senior Care We're still providing services. We're taking new clients, and we focus on that companionship and social interaction and can help meet the needs of older adults.”
If I want to visit my aunt or I want to make sure my great aunt or grandparents are doing OK, what are your recommendations?
HOGAN: “If you can't make an in person visit, you can always communicate over the phone. Making a phone call and having a conversation with your loved one can be a great way to connect and even better is a video call. You can even pull up old photos or if they've never been to your house, you can give them a kind of video tour of the home. If those mechanisms aren't available handwritten notes can go a long way as well.
When a senior lives in a home with younger people, what should be done to protect the senior from infection from other household members?
HOGAN: “As family members we have to practice social distancing. Still work with the assumption that other members of your household may be infected. That means not sharing cups and dishes or food and really keeping a line between you and others in your household.”
For those of us looking for in-home care for our elderly parents, what resources are out there, and will they be limited due to COVID-19?
KIETZMAN: “It's very tricky. Our whole health system is being tested and we're really under supply in terms of the workforce for older adults and people with disabilities in general. I'm afraid that this is going to be a very difficult time if people are looking to get homecare that they didn't already have. It might even be challenging for some who already have homecare because people who are medical professionals are getting pulled in all different directions. They also have their own social isolation orders to follow and children perhaps that they now have at home. People can reach out to home care agencies and providers in their community.”
Are some seniors at more risk than others during a quarantine for negative health impacts of isolation?
HOGAN: “When we think of loneliness in older adults, it does come with some health risks. That's why keeping in contact with your with your loved one is really important in making sure that they're getting proper nutrition and hydration and a little bit of exercise, even if it's just limited to what they can do in their living room can go a long way because we can see negative health impacts on older adults in the form of obviously poor mental health anxiety and depression. But it could also impact their mobility, if they're not able to get out and about like they usually are. So, if we can continue to encourage our older relatives, even during this time of social distancing to be a little bit active and to continue to engage socially in and eat healthy foods as much as they can and stay hydrated. It'll really go a long way and in terms of their health, and well being.”
Can isolation have negative health impacts on seniors?
HOGAN: “We do see negative impacts. Obviously depression and anxiety can be harmful to an individual's health, but we also see an increased risk of chronic conditions. Chronic conditions can be heart disease, dementia and other things like diabetes and an increased risk for stroke. So there are some negative health impacts that we see in older adults who are isolated and that's why it's so important to be checking in on our older loved ones during this time.”
Can a senior self-assess if they are feeling negative impacts of social isolation?
HOGAN: “If a senior wants to self kind of check in with themselves, they can ask themselves how are you feeling? Are you feeling isolated from others? What would help you feel more connected? Of course it would be best to connect in person but if that's not possible, what are what are some ways that they feel connected and maybe it's connecting over the phone or maybe that there's something that they can do from the comfort of their home that can help others reaching out to family and friends in various ways. So, asking themselves if they're feeling a lack of companionship or feeling left out or feeling isolated, just kind of checking in, can help them assess.
“Also ask them about ways they prefer to engage because everyone's a little bit different. Some people might like to talk on the phone while others find handwritten notes to be a better way of corresponding.”
How do elderly who are quarantined and unable to leave their apartments in assisted living facilities keep mentally healthy?
KIETZMAN: “If they're in an assisted living and their staff there can help facilitate things like making sure people have music or movies or games that they can play. … One facility is putting a little card with a special note for the resident and little things like that sounds like a small thing, but it can brighten someone's day.
“I think that staff of these assisted living facilities or skilled nursing facilities can set up another idea, which would be to get people set up with iPads so that they can see things that are streaming or access virtual tours and things like that. It would help people occupy their time and keep their mind off of being alone and engaged in social interaction through telephone or internet.
“You could do something very simple on an iPad and get it set up for somebody with a couple simple features that they could go to. Or if you can get someone set up on Skype, so they can have virtual visits with their family members, I think that can make a huge difference.”
As a preventative measure, will the state Senate provide paid leave to employees living with seniors who have underlying health issues?
KIETZMAN: “I think that's part of the package that the federal government passed. So some extended family leave. That was part of what was on the table so that it wasn't just paid sick for people who are sick but also leave for family members who are providing care. I think that is really an essential part of what we need now and will need going forward is support for the caregivers of people who are sick or who are socially isolated or quarantined.”
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