May 1, 2020
By Mary Day
Seniors are our parents, our grandparents, our neighbors, and some of our favorite people. The impact of the pandemic on older adults depends largely on their circumstances. For our most vulnerable seniors, particularly those with low incomes, their ability to access resources to support their emotional, financial and physical well-being is crucial.
“The current public health crisis puts further strain on an already vulnerable population,” said Dimity Orlet, Executive Director of Pro Seniors, a nonprofit organization dedicated to providing legal and long-term care advocacy for seniors. “Fortunately, Cincinnati has a strong network of nonprofit organizations dedicated to serving seniors in need. We have all worked quickly to adapt so that we can continue to meet the needs of seniors.”
Like everyone else in Ohio, by Public Health Order, older adults are to stay at home unless they are working for an essential service, or performing an essential task, such as going to the grocery or pharmacy. While current data from the Ohio Department of Health indicates that 53% of COVID-19 cases are among people age 40-69 (and only 21% of COVID-19 cases are among people over age 70), 74% of people who succumb to the virus are age 70 and over, with over 48% of these deaths among people who are age 80 or over. (Data is current as of 4/13/2020.)
Even many healthy, active older Ohioans are anxious about going to the grocery store due to the greater risk that they will contract the coronavirus because the incidence of illness seems to be higher and more significant for older adults. Ohio’s elderly who have other health issues are at greater risk if they do contract the virus. This includes people living in nursing homes and people living in their own homes who have chronic health conditions, such as diabetes, asthma or congestive heart failure. Many of these at-risk individuals are dependent on caregivers who may also be vulnerable to the infection. Contracting the virus may be more significant for these older adults whose health condition compromises their immune system and their ability to fight off the illness.
“Our senior clients are apprehensive about the current crisis. They are the most vulnerable population to the coronavirus, and are more likely to live alone,” said Mike Walters, Pro Seniors’ Managing Legal Helpline Attorney.
“They rely on communication with friends and family, not only for social contact, but for needed help for tasks they cannot complete on their own. Further still, they are less likely to have computers or smartphones to communicate visually with the outside world. Seniors are also resilient, having lived through hardship, and are adaptable to changing circumstances.”
With the exception of questions about stimulus payments, unemployment benefits, and issues involving closing of the courts and government agencies, Walters noted that Legal Helpline calls continue to fall into the same categories as calls before the pandemic, including problems with Medicare, Medicaid, Social Security and other public benefits, as well as financial exploitation and housing.
“The Legal Helpline works remarkably well, even in a quarantine,” said Walters. “Everything we do can be done remotely with attorneys working from home. We are grateful that the crisis has not disrupted our ability to serve our clients.”
Pro Seniors’ staff attorneys are also working from home on cases for seniors in Southwest Ohio, and continue to provide a monthly Veterans Legal Clinic in partnership with Legal Aid of Greater Cincinnati. The clinic, typically held at the VA Hospital, is now being provided by phone.
The Council on Aging of Southwest Ohio (COA), our Area Agency on Aging, provides essential in-home care services to more than 26,000 eligible older adults and people with disabilities across Butler, Clermont, Clinton, Hamilton and Warren counties. During normal times, these services help vulnerable individuals remain independent in their homes. Now, this assistance is more important than ever. The COA has directed essential resources to respond to the increasing needs of seniors who are already homebound and receiving in-home services.
COA President and CEO Suzanne Burke said her agency has been planning for this since late January.
“While many seniors are staying home, which is good, this is complicating their ability to have food in the home, and we want to be able to do everything we can to satisfy that,” she said.
The agency has called the more than 11,000 participants in its Elderly Services Program to see if they have additional needs. Burke said representatives delivered 7,500 emergency food boxes, each containing a 14-day supply of meals.
“We urge any senior who needs help — or any essential worker who is also a caregiver for an older loved one — to call us so we can try to provide assistance,” Burke said.
Cincinnati Area Senior Services (CASS) has also taken urgent steps to deal with the coronavirus.
“We have made operational adjustments to continue providing crucial services to seniors,” said CASS CEO Tracey Collins. “At the same time, we’re doing our best to protect their health and the health of our employees while complying with government orders.”
The stay at home order has closed adult day programs, senior centers and other locations where seniors depend on having their meals and connecting with friends. While CASS traditionally provides home-delivered meals, they are now looking into addressing the needs of seniors who usually attend their senior centers and other congregational meal sites who now find themselves in need of additional support.
“We have people helping us shop for seniors, people helping us fill-the-truck, trying to fill and give us resources. Like everybody else, we still need paper supplies, shelf stable meals, and disinfectant wipes. We need all the things everybody else needs that we’re delivering to seniors,” said Collins.
Another great way to help is to just check in with your elderly neighbors, many of whom might not have family close by or cannot utilize local senior centers, which are now closed, she said.
Seniors in area nursing homes and assisted living facilities are also experiencing new levels of isolation. To limit the risk to individuals who are most vulnerable, the Ohio Department of Health has instructed facilities to restrict visits. Only a resident whose death is “imminent,” as determined by a medical professional, can have a family visitor. While protecting their physical health is paramount, the social isolation of seniors may contribute to depression, anxiety and physical decline.
Pro Seniors’ Long-Term Care Ombudsman staff, who act as resident rights advocates, have shifted from in-person visits with residents to phone calls and virtual visits using smart phones to connect and advocate for their rights and well-being. Ombudsman volunteers are also contacting families by phone to check in on how residents are doing and how the nursing home or assisted living facility is facilitating a connection with their loved ones via phone calls and other methods.
Ombudsmen are hearing from families who are not permitted to visit with loved ones in the facility, who are concerned about the emotional and physical impact of social distancing. This is especially a concern for seniors who experience the challenges of dementia.
“It’s like a wall has come down between us,” said Lynne, whose mother Eleanor is in a local nursing home.
Eleanor is in the late stages of dementia, and on hospice. She no longer knows how to use a fork or spoon, so Lynne has been going at lunch and dinner to help her mother eat. Lynne spends the 90 minutes needed at each meal to ensure her mother eats at least a portion of the small meals her appetite will now tolerate. While at the nursing home, Eleanor and Lynne sit at a table and reminisce about the people in the photos on Eleanor’s wall. Eleanor was a nurse. Her parents divorced when she was five. Eleanor and her brother were raised by their grandparents. This was very long ago, but these are some of her most vivid memories.
Families also express concerns about the safety of their loved ones if someone in the nursing home gets the virus. While infection control procedures and equipment are more the domain of the Ohio Department of Health at this time, our ombudsman staff educate callers on who to contact to report concerns, and the regulatory requirements for facilities to safeguard the residents.
“We are operating in new territory at this time, and making the most of technology to ensure that residents know that we are here for them,” said Bob Vines, Managing Long-Term Care Ombudsman at Pro Seniors.