Addressing the At-Risk Elderly population at home during COVID times
Dr. Mahesh Joshi,
Chief Executive Officer,
Apollo Homecare
When it comes to Coronavirus (COVID-19), elderly people, especially those at home are vulnerable to severe illness. Research says that adults 60 years and older and especially those with pre-existing medical conditions like hypertension (High BP), lung disease, diabetes, heart disease or cancer are prone to have severe, or even deadly, coronavirus infection compared to other age groups.
You may be worried if you are caring for an elderly loved one who is at home. Here are some guidelines you may need to know to keep elderly people at home safer, and what to do if they get infected with COVID-19.
Assessing the Risk for COVID-19 in Elderly
If you are an elderly person or you have a member in the family who is elderly, it is pertinent that you do a risk assessment for CORONA infection. The following factors have to be kept in mind
- AGE- 60-70, 70-80, above 80 years – risk increases with every decade
- Associated co-morbid conditions (pre-existing medical conditions) – Diabetes, High BP, Heart problems, Lung problems, Underlying Cancer, HIV or any other immunodeficient condition
- History of being on Immunosuppression medications like Steroids, Methotrexate, etc
- History of contact with a suspected, diagnosed case of COVID-19
- Any family member who has come back home in the last 2 months after being abroad
Any of the above will significantly increase the risk for COVID-19. Consult your Home health care Physician via telehealth if they need to undergo a COVID screening test.
Mitigating Risk of COVID-19 in elderly
- Ensure complete isolation of the elderly in a dedicated isolation room with attached bathroom and TV /internet connection, if possible
- The isolation room must be well lit & ventilated
- Minimise the contact of elderly with other members of the family- Ensure only one person deals with them at a safe distance and that their food etc is also served with caution
- Avoid any visitors for the elderly
- Avoid any outdoor activity like walking, going to grocery etc
- If they have multiple co morbidities – preferred that they use mask to protect themselves from any risk of exposure
- Keep a track of vital signs, any change in activity, behaviour or any new symptom
Addressing pre-existing illness
To reduce the risk of complications, it is important to keep the pre-existing illness in check
- Monitor your BP, Sugar levels daily (for people with these ailments)
- Ensure stock of existing medications for at least 8 weeks
- Ensure you have nebuilser, oxygen concentrator, BIPAPA or CPAP machine at home if you have underlying lung condition
- Do a tele-health consult on a weekly basis to keep a proactive watch on pre-existing illness
- Report any new symptom as soon as possible – do not wait for things to worsen
- Get your routine labs done as per your schedule eg- monthly sugar levels, HbA1c as recommended by your doctor
Handling New Symptoms or Problems
- Report all new symptoms immediately – elderly do not get high fever and may not get the classic signs as we see in young people. Hence, any change in behaviour, symptoms or signs must be reported immediately
- Any cough, breathing difficulty, change in smell or taste function, loose motions, etc. are symptoms associated with COVID-19. They must be immediately reported to your home health doctor, via tele-consult
Ensuring Mobility / Physical Activity
- Maintaining mobility is of paramount importance – hence, just in-bed mobilisation or bedside simple stretching exercises every 4th hour can go a long way in reducing risk for other complications
- Working on Lung capacity /breathing reserve by doing pranayama/yoga – at least for 15 mins twice a day -can help in keeping the airway and the lungs open and prepare you better in case you land up with COVID infection
Ensuring Emotional Well-being
Elderly are likely to be overwhelmed with the entire COVID scenario and they need to be handled very sensitively in these times.
- Keep them active and positive- Yoga/Meditation can help
- Keep them engaged: let them watch Netflix Movies/Serials/Classics of yesteryears
- Revisiting memories: watching old pictures, letters, videos can be a good way of keeping the elderly engaged during this time
- Skype sessions with family /friends on a daily basis
