How we can protect the elderly from the coronavirus

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Amidst the uncertainty surrounding the coronavirus pandemic, there is an incontrovertible fact: older people have the highest death rate, especially those with underlying medical conditions.

To date, of the confirmed cases in China, nearly fifteen percent of patients over the age of 80 have died. For those under 50, the death rate was less than one percent.

There is still no evidence that older people are much more likely to get the coronavirus than young people. However, medical experts say that if people over 60 become infected, they are more likely to have a serious, life-threatening illness, even if their overall health is good. Older people with underlying medical conditions are at particularly high risk. Experts attribute some of that risk to a weakening of the immune system due to age.

That makes seniors and their families wonder what additional precautions they should take. There are several ideal practices that have been recommended by Centers for Disease Control and Prevention (CDC, for its acronym in English), the World Health Organization (WHO), geriatricians and specialists in infectious diseases.

Get familiar with the guidelines and follow them

Geriatricians recommend that their patients adhere to current CDC and WHO recommendations, a litany of advice that has become well known: wash your hands frequently with soap and warm water for twenty seconds or clean them with an antibacterial gel at alcohol base; avoid shaking hands; stay away from large gatherings; cleans and disinfects frequently touched objects; Avoid public transportation and crowds. Stock up on supplies.

Cruises are not a good option, nor are non-essential trips. Visiting grandchildren is not recommended.

I’ve had this conversation a hundred times over the past weekSaid Elizabeth Eckstrom, director of geriatrics at the Oregon Health and Science University in Portland. Eckstrom said that the majority of the patients he sees in his clinic are over 80 years old. Everyone has openly expressed their concern.

According to Eckstrom, all of his patients have at least one chronic condition. “Most have three, four, five or more,” he added.

People are wrong to assume that if a medical condition is managed properly by treatment, it is out of danger. Even those who have conditions and are stable should take extra precautions.

“These conditions can limit the underlying reserve and lead to worse outcomes when older people become seriously ill, affecting all organ systems,” said Annie Luetkemeyer, an infectious disease specialist at San Francisco Zuckerberg General Hospital.

Diabetes, for example, can make it harder to fight an infection, and an underlying heart or lung condition may make it harder for those organs to keep up with the demands of a serious COVID-19 infection.“He said, referring to the syndrome caused by the new coronavirus.

Daniel Winetsky, an infectious disease scholar at Columbia University in New York, said that the advice he gave his own parents, who live across the country in San Francisco, have changed dramatically. A week ago, he said, he told them they were safe and even recommended that they go ahead with a trip they were planning to the Everglades region of Florida with a small group tour.

Over the weekend, their fears about the pandemic increased, and on Tuesday he not only asked them not to go, but also advised them to minimize the number of people they had contact with. Visiting of your grandchildren is prohibited.

Winetsky told his mother, Carol, who is 73 and suffering from asthma, to stop attending the meetings she has every two weeks with her knitting group. In addition, he asked Hank, his father, who has had two coronary stents, not to attend either of his two group reading meetings.

Her mother continues to go to the grocery store and avoid crowded places like Costco. With your son’s permission, he still attends physical therapy sessions for a back injury, but he makes sure that his therapist washes his hands and that the equipment is cleaned with disinfectant.

What about non-essential medical appointments?

Some experts are recommending that older adults at risk cancel nonessential medical appointments, including wellness visits. If available, telemedicine services can be a reasonable substitute.

Eckstrom generally agrees, but with his reservations. While it may be wise to cancel non-urgent scheduled visits, he said, “many older adults have problems that require constant monitoring, such as dementia, Parkinson’s disease, falls, and heart problems.” He is concerned that canceling visits will allow these conditions to spiral out of control, but he agrees that telemedicine consultations can help close that gap.

Another helpful step: Talk to your doctor about stocking up on two to three months of essential prescription drugs.

Beware of social isolation

Experts warn that social distancing, the pillar of epidemic control, could cause social isolation, which is already a problem in the elderly population. According to a recent study by the Pew Research Center in more than 130 countries and territories, sixteen percent of people age 60 and older live alone. Loneliness, according to the researchers’ findings, involves its own set of health risks.

Winetsky is aware of the danger, and has suggested to his parents to organize virtual meetings with friends and family, since he has in mind the benefits of social participation. “I’ve tried to explain it like this:‘ Don’t cancel those activities, but opt ​​for Zoom, Skype or FaceTime, ’” he said.

Chat with Home Health Aides

The National Association for Domestic Care and Hospice estimates that 12 million “vulnerable people of all ages” in the United States receive care in their homes, provided by a home health workforce of approximately 2.2 million workers. For many older adults, that involves a constant parade of healthcare assistants who come through their door, some more hygiene-conscious than others.

People should talk to their caregivers about hygiene, suggested David Nace, president-elect of the Society for Long-Term and Post-acute Care Medicine, a professional group representing workers who work in long-term care facilities.

Double check that caregivers wash their hands or use antibacterial gel. Any equipment they bring must be cleaned with disinfectant. Also, make sure they feel healthy.

If you are alone, you may be in a very vulnerable position because you depend on that personNace said. “It can be intimidating. But hopefully maybe there is a relationship so good to start the conversation. “

The Nursing Home Dilemma

About 1.7 million people, the majority elderly, are in nursing homes in the United States, a fraction of the 50 million Americans over the age of 65.

Given the series of deaths at a nursing home in Kirkland, Washington, where the virus affected many people, nursing homes are on high alert. Many have undergone a total quarantine.

The federal government is asking nursing homes to ban visitors from entering, with the exception of “compassionate care, such as end-of-life situations.”

Curtis Wong, 66, a retired Microsoft researcher living in the Seattle area, used to visit his parents frequently. They are in their 90s and live in an assisted living facility in Sierra Madre, California.

On Thursday, the center banned all non-medical visits and said it was changing its access codes to the building. In an email announcing the move, the center’s administration offered to put residents in touch with family members through FaceTime.

Three days ago, Wong said, during a video chat with his father, he worried about the possibility of never seeing him again. “Things got very emotional.”

Stay active, even during a pandemic

Geriatricians fear that social distancing may affect routines in ways that affect the vitality of older adults. They emphasize the importance of maintaining good habits, including enough time to sleep, healthy eating, and exercise.

Exercise may be beneficial in combating the effects of the coronavirus. It can help boost the immune system, decrease inflammation, and have mental and emotional benefits. A patient who relies on daily exercise in the gym but wants to avoid risky situations may just be able to take a walk.

On Wednesday afternoon, Hank Winetsky, 80, had just returned from a round of golf with a small group. The four people were 70 to 81 years old. “Golf is quite safe in terms of human contact“He commented.

However, even golf proved not to be a contact-free sport. “There was a bottle of water in the cart, and everyone thought it was theirs,” he said. “The four of us drank from there. Now we are all scared. “

* Copyright: c.2020 The New York Times Company

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