COVID-19 and What it Means to Senior Care
COVID-19 has hit the senior population the hardest. Caring for seniors is a priority for Highland Hospital and according to Daniel Mendelson, M.S., M.D., FACP, AGSF, associate chief of medicine, there are many positive changes being made in the approach to senior care.
The biggest changes are in outpatient care where many of the visits have become video and telephone visits. “This is working out better than we imagined,” said Dr. Mendelson. “Now families can participate on Zoom and be part of the care for aging parents even if they live across the country.”
“We miss actually being with our patients,” said Dr. Mendelson. “But even when that will be possible again, the video visit is something we will keep in our tool kits. It allows us to see our patients more frequently, because we don’t have to worry about challenges traveling to and difficulties getting into our offices. It’s also a tool we can use in palliative care to involve families who can’t be in the hospital with their loved ones.”
Adult living facilities and nursing homes are being hard hit by COVID-19. Many of Highland’s geriatricians have leadership roles and see patients there. “Physicians like Joe Nicholas, M.D., M.P.H., CMD, and Tim Holohan, D.O., CMD, have stepped up and helped support staff, residents, and families in UR Medicine owned and affiliated nursing homes and adult care facilities,” said Dr. Mendelson.
“The occurrence of COVID-19 in nursing homes is not an indication of quality,” said Dr. Mendelson. “Some of the best of nursing homes have had outbreaks, and for the most part from asymptomatic staff or other visitors. What’s important is how you cope with it once it’s in your facility. It takes strong leadership and skill to guide people through it.”
Collaboration is key in senior care. “Monroe County has a higher density of nursing home and adult care residents than any place upstate, said Dr. Mendelson. “Dr. Holohan is president of the Finger Lakes Medical Directors Association, and they did a great job sharing best practices,” he said. Information is also shared through the New York Medical Directors Society and the AMDA (The Society for Post-Acute and Long-Term Care).
Ryan Gilmartin, Senior Program Administrator, UR Medicine Geriatrics Group (URMGG), and geriatrician Dallas Nelson, M.D, are leading many efforts to ensure safety in nursing homes and adult care facilities. Dr. Nelson worked with Dr. Michael Mendoza, Monroe County Commissioner of Public Health, to deputize URMGG physicians to be able to order testing in adult care facilities so that there would not be delays in care or response. Mr. Gilmartin has been key to a county advisory group that is helping to ensure the appropriate support for Nursing Homes and Adult Care Facilities. “UR Medicine Home Care has been critical in helping patients who might otherwise need a nursing home to be in their own home,” said Dr. Mendelson. UR Medicine Home Care has cared for dozens of COVID-19 patients at home freeing up both hospital and nursing home beds for others.
“This has brought out the best in all of us,” said Dr. Mendelson. “My colleagues and their collaborative work with affiliates and other health care leaders is resulting in better care and outcomes for our community.”
“This is a rough time for the frail elderly with cognitive issues who need to be hospitalized,” said Dr. Mendelson. “Their families can’t visit, and the health care workers they see are wrapped in gowns and wearing masks and shields; that can be scary and isolating for them. However, staff has responded wonderfully to support them.” Highland is using iPads, in addition to telephones, to connect older patients and their families.
“I hope with increased testing capacity and tracing, we can control the rate of disease, but there may be a seasonality to it,” said Dr. Mendelson. “The best case is the development and distribution of a vaccine; I advocate that nursing home health care workers should be the very first to get the vaccine. In the meantime the video visit are a prime tool to keep our seniors safe.”
6/10/2020