April 16 (UPI) -- Social distancing is a must in the age of COVID-19, but experts are calling attention to the need for older adults not to ignore other conditions that are already threats to their health.
As important as it is to protect at-risk people from the virus, it is vital that older adults continue to receive necessary care, support and medical treatment, especially during the pandemic, according to a commentary published Thursday by JAMA Internal Medicine.
Nearly 640,000 Americans have been infected with SARS-CoV-2, the virus that causes COVID-19, according to Johns Hopkins University. More than 30,000 have died, and estimates from the U.S. Centers for Disease Control and Prevention suggest the majority of those who have succumbed to the virus have been 55 years and older or have had underlying health conditions, like heart disease and diabetes.
"Older people should not neglect their health conditions and care-giving needs due to fear of COVID-19 -- a balance is required," commentary co-author Dr. Michael Steinman, a professor of geriatric medicine at the University of California, San Francisco, told UPI.
"It is prudent to pull back on in-person contacts with clinicians or care-givers if the situation is routine and can safely be deferred for a few weeks or months, but staying away from doctors and hospitals when there are urgent or time-sensitive health care needs, or staying away from caregivers when the services they provide are important for keeping someone healthy and safe, can create more dangers than it prevents," he added.
The care of older adults has drawn significant attention since one of the earliest outbreaks of COVID-19 in the United States occurred in a long-term care skilled nursing facility near Seattle after a staff member became infected. Within two weeks, according to a CDC report earlier this month, 30 percent of the facility's elderly residents -- many of them with other health problems -- tested positive for the virus.
Older adults -- particularly those living in nursing homes and assisted-living -- have care needs beyond COVID-19, Steinman and his colleagues note. In the absence of routine visits by healthcare providers or family members because of social distancing many may become lonely or depressed, stop exercising, taking medications or eating properly, among other concerns.
To address the general care needs of older adults, while protecting them during the pandemic, Steinman and his colleagues recommend the use of "telemedicine" -- or video chat or telephone visits with care providers -- to continue care and management of chronic conditions.
Older people should also mention care and support needs to their healthcare providers and caregivers, as some routine services -- like meal delivery or social visits -- have been disrupted because of social distancing measures to slow or stop the spread of COVID-19.
"For some older adults, some families are opting to bring a family member home during this time, which is great, but for others this isn't possible because the care needs are too great," Dr. Carla Perissinotto, an associate professor of medicine at UCSF and a co-author of the JAMA Internal Medicine commentary, told UPI. "So while it is tempting, be clear on what the responsibilities are before taking the person home. Do you have the right equipment? Can I really help my mom or dad to the bathroom and shower? What if I have to return to work?"
Many elective medical visits and procedures have been postponed because of COVID-19. While these may be less essential for younger people, they may be vital for those who are older, both for overall health and for quality of life.
The authors of the commentary acknowledge "there are no easy answers and difficult decisions need to be made about the use of scarce medical resources and the challenges for post-procedural care," but add that "greater attention to issues of aging can be facilitated by including in the decision-making geriatricians and other clinicians who have assumed greater responsibility for the care of older adults."
"Many nursing homes do not have any medical professionals with geriatrics expertise among their leadership, and thus it is no surprise that they are unprepared for this crisis," co-author Dr. Laura Perry, an assistant professor in UCSF's Division of Geriatrics, told UPI. "We need a lot of public pressure on our elected officials to address this crisis. People whose family members live in nursing homes should contact their local, state and federal elected officials to advocate for better support."