Transcription:
COVID-19: Caring for Mom and Dad

Caitlin Whyte (Host): The risk for severe illness with COVID-19 increases with age. With older adults at the highest risk. Dr. Christian Bergman, a Specialist in the Division of Geriatric Medicine at the VCU Health Center for Advanced Health Management in Richmond, Virginia, will share what that means for you and your loved ones in this episode of Healthy with VCU Health, COVID-19 Caring for Your Mom and Dad.

Welcome to Healthy with VCU Health, where experts from VCU Health share their knowledge, cutting edge research, and the latest innovations to help you achieve optimal health and wellness. Take control of your health. I'm your host, Caitlin Whyte. So, Dr. Bergman, why and how has COVID-19 affected older adults differently?

Christian Bergman, MD, CMD (Guest): Yeah, thank you for bringing up that important topic. COVID-19 has been a severe illness that increases complications that are associated with age. So, unfortunately, as older adults age, the immune system is not as effective. And so one of the things that we have seen is an increased disproportionate impact of COVID-19 on older adults. For example, eight out of ten COVID-19 deaths reported in the United States have been in adults over the age of 65. Likewise people may ask about your individual risk. So, how would you as an individual characterize your risk compared to younger folks and the CDC States that compared to younger adults, aged 18 to 29 older adults, between the age of 65 to 74 are at five times increased risk of hospitalizations and 90 times higher risk of from dying from COVID as compared to younger adults.

So, it's clear that data points to the fact that older adults are disproportionately been affected by this. And we believe it's because of congregate living settings, such as nursing homes and group homes, as well as independent senior living arrangements or sometimes in close quarters. And you couple that with the immune response, that seems to be one of the explaining reasons why.

Host: So yeah, we see so much in the news that we need to protect our elders, our parents just older loved ones. How can patients in this age range reduce their risk of getting COVID-19?

Dr. Bergman: Yeah, wonderful question. Everybody's asking, you know, neighbors are asking family, friends, even my own family is asking, how can we reduce our risk? We follow the CDC guidelines, you know, wear a mask, wash your hands, stay home, avoid crowds. You know, it's easier said than done, but the CDC specifically has made a point to continue this. And one of the most challenging parts for families, including maybe your own families are you know, around the holidays, you know, people wanted to gather a lot and we kept saying, you know, avoid travel. I think what we want to emphasize in travel is you want to avoid cruise travel. You want to avoid non-essential air travel.

If you do have to travel, perhaps by car. You want to try to limit your potential for spreading the disease. So, we have asked people to isolate at home perhaps seven to 14 days prior to going somewhere. And then when returning from a trip to isolate upon return. That would really help protect the people that you are visiting and your family members.

But it comes down to hand hygiene, staying home, avoiding unnecessary travel, and wearing a mask. And let me emphasize one additional point for everyone. Vaccination has become an important topic here in December and January. And if you want to do something that is going to be very helpful, get the vaccine when it becomes available for your group. That's really going to help everyone in the community, including older adults.

Host: Now, right out the gate when the pandemic first started, it seems like nursing homes and senior living facilities were some of the hardest hit. Can you tell us about how the pandemic has hit these places?

Dr. Bergman: Yeah, that's such a great point. You know, we oftentimes don't think about the 1.6 million nursing home residents that live here in the United States. These are parents, you know, brothers, sisters of our community members. And it's been very difficult. With COVID-19 came isolation precautions, visitors were restricted over the late spring and summer. And all this has led to social isolation, increased anxiety. One in four older adults currently report anxiety or depression. And regards to nursing homes, you've all seen it on the news, but one in three nursing home residents in the United States has contracted COVID-19. As of the middle of January, we were up to 500,000 nursing home residents. That's one third, one out of three nursing home residents. Out of these folks, one of five nursing home residents have died from COVID-19, 100,000 nursing home residents in this country.

And along with this, we have also seen staff, you know, staff who have known these residents for a long time. You know, some nursing home residents have lived for five years, six years in these long-term care facilities. Some even longer. And there have been over 400,000 staff cases among nursing homes, nationwide and 1300 deaths among nursing home staff.

So, this community has really suffered a lot and I want to just called on everybody to be compassionate, empathetic, and to offer assistance and volunteering once visitors are allowed back. This part of your community is really going to need some support.

Host: So, what is VCU Health doing differently to help this patient population?

Dr. Bergman: Yeah. The key thing here is that, you know, as a large academic health care system, we have tried to, you know, pivot quickly to offer access to care. One of the key points is that we are asking every community member to not delay care. So, one of the important things is that the CDC has reported that four out of ten US adults are avoiding medical care because they're concerned about COVID-19. Even in the spring of 2020 here at VCU, we saw a 37% decline in patients seeking emergency care for stroke compared to the same period the year previously. So, the key message is that do not delay care and VCU has offered other access to care. So, we have both virtual and in-person visits available with your primary care doctor and your specialists.

We have expanded our home-based primary care. We have a nursing facility attending service, which services all of the nursing homes in our area within our network. And we have expanded a remote patient monitoring where you can go to the hospital and perhaps you don't need to be admitted, but you can be sent home with a device that will help monitor your vital signs and a team, a remote team dedicated to you to help monitor you safely at home.

And lastly, VCU has worked very closely with the School of Medicine and our trainees. The Geriatric Student Interest Group has offered a social calling hotline. We have also had a letter writing campaign and have placed weekly calls to one of our independent living communities for over 200 residents to connect students and older adults in the community. So, we're doing everything we can. We have a lot more to do. And our current work focuses on the COVID-19 vaccine and making sure that VCU Health is always a safe place for you to get your care. So, please do not delay care and use the resources available.

Host: Now we touched on this earlier, but just what can I do to help myself or my parents or an older loved one?

Dr. Bergman: Thank you so much for asking. Make sure that everyone takes care of yourself. This is again with advice from the Health and Aging Foundation, which is from the American Geriatric Society, as well as our own Eve Flippin who serves as the Aging Life Care Coordinator for VCU Health, we have a couple of key tips that everyone should be thinking about.

Number one, is try to moderate your news intake. The current news cycle has been stressful for many people, and that is sometimes not helpful in the midst of a pandemic like this. Make sure you get outside, you know, staying home. Complying with the social distancing guidelines is important. But It's also important to try to get fresh air and exposure to sunlight. So, make a point to try to get outside, just in the backyard or for a brief walk will be helpful. And lastly, you know, stay connected with family and friends, you know. As stated above, you know, the socially distanced principles are difficult to adhere to, but we have a lot more access to smartphones, computers, you know, internet access even if you don't have internet access, perhaps somebody else in your family does and can help, connect you. You can also write letters. Phone calls, you know, scheduling phone calls with friends that you used to see every Sunday, for instance. You know, scheduling a phone call around noon, to touch base with somebody for 10 minutes, really helpful.

And don't forget about taking care of yourself. Self-care looks different for everyone that we are involved in, but try to do at least one new thing, you know, every week. Maybe trying a new recipe, listening to an old song, or even journaling, if you can. Trying to focus on the positive things in the midst of this pandemic and focusing on self-care is as important as ever.

Host: Well, Dr. Bergman, thank you so much for being with us and giving us a few ways we can help our older loved ones during this pandemic. While the risk for severe illness with COVID-19 increases with age, we have reasons to be optimistic. We've learned how to prevent the spread of this illness through measures like wearing masks and avoiding crowds and a free vaccine will soon be available to members of our community. To learn more about Dr. Christian Bergman, the Division of Geriatric Medicine and the Center for Advanced Health management, visit VCUhealth.org/cahm. This has been Healthy with VCU Health. I'm Caitlin Whyte. We'll see you next time.