Seniors are becoming COVID-19 collateral damage. They're dying because of it, not of it.
Corona virus has changed the way we see life and healthcare. The immediate focus was on infected patients. However, the effects of the pandemic are more common. Here are two patient stories that highlight the far-reaching effects of COVID-19:
►Mr. Smith was an 83-year-old man who was in good physical and mental shape until he fell and broke his hip. He had surgery, but like many elderly patients, he suffered from delirium from surgical anesthesia. His delirium worsened with new medication and no family that oriented him to a normal daily routine. In bed with medical equipment, new medication and without a family is a recipe for disaster. But Mr. Smith could not have his family visit due to the relevant visit guidelines. He spent 30 days in the hospital alone. His delirium worsened and finally his wife decided to move to the hospice so that she could be with him. He died a week later.
►Ms. Jones was 93 years old and had Alzheimer's. She lived in a memory station and was social, interacted with others and enjoyed activities. When she was isolated due to COVID-19 precautions, she became confused and anxious. She could only see her family through a window. Because of their increasing unrest, their medication has been increased. The scope of care monitoring has been reduced. One morning she was found on the floor with bruises on her chin, a broken hip and bleeding in the brain. Her family did not want to get her through the stress of hospitalization and surgery. She was taken to a hospice so that her family could visit her. She died a week later.
In Ventura, California on April 3, 2020.
These cases illustrate the effects of isolation on elderly mortality. Hip fractures are serious in patients over 70 years of age. But for Mr. Smith, his one-year mortality was only about 27%. With family support, he would probably recover. For Ms. Jones, her forecast was poor. Patients with advanced dementia over 70 who break their hips have a 55-month mortality rate of 55%. Without social isolation and the resulting loneliness, restlessness, and increased medication, Ms. Jones might not have fallen and might have had more months to live.
The cost of the silent death of COVID-19
Corona virus is particularly lethal to the elderly. In 14 states, half of COVID-19 deaths are in long-term care facilities, and deaths for residents and workers make up a third of the national death toll. But these are just the deaths of infected patients. Mr. Smith and Ms. Jones did not die from COVID-19. They died of it.
Social isolation and loneliness are known risk factors for increased mortality in patients with advanced disease and age. The implementation of the isolation was not unsuitable for the hospital or for the storage unit. there was a need for public health policies. Nevertheless, it contributed to the death of these two patients and many other patients who were not infected with COVID-19. In the end, the hospice was the only time that these patients were not alone.
Coronavirus Tragedy: My husband's nursing home did everything it could, but we lost it anyway
There are many people who are even less lucky than these patients who spend their last days in facilities without relatives by their side. Universal testing in long-term care facilities and visits to hospitals for the elderly should be a priority. The White House has recommended facility testing, and many states are testing patients and staff, and screening for visitors. The main problem is cost: A group estimates nearly $ 440 million if every nursing home patient and employee has been tested in the United States.
These costs can be reduced. Pooling would enable batch testing, which could reduce costs by up to 80%. While still important, testing and checkups should take priority due to the high cost of longer admissions and the cost of living from preventable deaths.
Visit for elderly patients
In addition to the tests, policymakers should focus on a comprehensive plan to safely allow elderly patients to visit facilities and hospitals. The strategy should include testing for all patients and staff, as well as visitor screening, proper mask use, hand hygiene availability, and a plan to isolate infected patients.
Social isolation: By restricting nursing homes, important family ties were kept away from older people, not from COVID-19
Ideally, this would be cooperation at the federal, state and local levels. The federal government should provide guidelines. However, given the different infection rates, state and local governments need to work with local hospitals and facilities to develop plans that take into account the availability of PSA, infection rates, and the composition of patient populations.
This is a fine line on foot. The death toll at the COVID-19 facility is a tragedy. However, the security of institutionalized elderly patients is often at risk in our healthcare system. We need to understand the impact of this pandemic and develop strategies to combat the silent COVID-19 deaths.
Dr. Martha K. Presley is an assistant professor of clinical medicine at Vanderbilt University Medical Center. Dr. Bill Frist is a heart transplant surgeon, former Senate majority leader, partner with health care provider Cressey & Co., and moderator of A Second Opinion Podcast. Follow him on Twitter: @bquote
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This article originally appeared in the US TODAY: COVID isolation and neglect can be fatal to seniors who don't have it
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