Seniors

What happens when people avoid health-related in-person care? Rant on. Nearly a third of older adults, according to a National Council on Aging post, are foregoing visits to emergency rooms, afraid of catching the virus. Or they are avoiding outpatient visits, afraid of Covid-19, but also concerned about cost of care.  And the cumulative number of lost visits since mid-March continues to grow.   Family concerns about health and Covid-19 also continue to delay or prevent some move-ins to senior living communities.  Presumably, some avoidance is occurring even in circumstances where there is a pressing need for a move, such as worsening dementia.  But is telehealth viable for the oldest? 

You see PERS news releases on occasion. PERS -- Personal Emergency Response System -- is a long-time market dominated by pendants worn around the neck. Recently Parks Associates sized the PERS market to be $1.1 billion by 2024 -- others think it is a $3.1 billion market today. Also early in the year, Vidapoint was announced as a 'global' low cost offering. LifeStation announced Mobile LTE, small and fast, a pendant linked to a sizable 24-hour call center.  Then in April, Verizon does it again, launches a PERS, this time a smart watch offering, called the Care Smart Watch for seniors.   Let us remember Verizon’s last short attention span for this space. Its Sureresponse™ PERS pendant was new in this research conducted in 2012. The quotes are from executive Jonathan Hinds who departed in 2014, not coincidentally when Verizon stopped selling it. Sureresponse was mostly erased from the Internet by 2016, except for user documentation,  online reviews, some not so hot.   

The articles are beginning to appear here and there.  In the time of Covid-19 lockdowns, some are talking about an increasing use of technology in their nursing homes. Others are discussing the race to enable ‘televisits’ -- noting outreach from AARP to CMS to boost the requirement for enabling technology in nursing homes.  And numerous other articles have appeared that showed nursing homes receiving donations of technology. The State of Florida gave tablets to 150 nursing homes. The attorney general of Massachusetts supplied 750 tablets to nursing home residents. And Texas provided $3000 per Texas nursing home for tablets, webcams, and headphones. The pictures associated with some of these introductions of technology were bleak. Fortunately, some states are now allowing families to visit residents in designated areas outside.

Is sixty-five the new eighty-five – and is ageism trendy?  Note the interesting behavior of ‘leaders’ during the time of Covid-19.  Consider the EU guidance: "The chief of the European Union's executive has warned the block's elderly that they may have to stay in lockdown till 2021 due to the new coronavirus." And in California, as seniors use more technology to communicate with others, the executive director of the Village Movement California, Charlotte Dickson, observed that EU guidance is consistent with Governor Gavin Newsom’s thinking for California and his March 15 order telling the 65+ to isolate at home: "You’re basically disappearing almost 30% of the state of California, and ageism is all about disappearing people … once you retire, you’re done. If seniors are being asked to continue physical distancing for the better part of the next year or two, divisions between generations may calcify."

Nursing homes – consternation, condemnation are words that rule the day. Rant on. It must be tough to be focal points for nursing home policy these days. Even as a task force is being set up to focus on nursing homes, on the one hand, that seems positive. On the other hand, Leading Age CEO was 'enraged' about shortages of PPE.  And seniors (AARP) who are most likely NOT in nursing homes, demand that workers have adequate PPE, that the public be notified which nursing homes have cases of Covid-19, workers are striking at nursing homes, and so on. Go back to 2019, for just a moment. What were the top issues early in the year?  "Challenges facing nursing homes serving primarily long-stay residents covered by Medicaid; workforce challenges, which are unlikely to dissipate; nursing home regulations; and the growing popularity of Medicare Advantage."

The title should not surprise. The month of April had only one subject – no matter where you looked or what you read. Covid-19 and its impact and implications, starting early in the month following event cancellations, travel bans and stampedes, telehealth insurance changes and senior living visitation lockdowns. That was followed by a collection of companies offering free services for use of their technologies in the context of an increasingly isolated older adult population in senior living communities, nursing homes and at home. But it was a conundrum: so many of those older adults lacked access to or knowledge of technology, let alone the ability to acquire it, learn how to use it or participate in family Zoom sessions. In case you missed them, here are five Covid-19 blog posts from an April that was unlike any other:

No understatement, these are very difficult times for nursing homes. First off, thousands of residents have died, and news media organizations are now obsessed with counting and re-counting, totaling up the numbers (more than 10,000 as of today) and then counting some more. So many of the 1.5 million residents of nursing homes were already very frail people, needing help with 3 or more ADLs. 72% of residents are women, most are age 85+, and as noted, 'many also have only a small group of family and friends for support.' Yet there are people who should know better lined up to bash their performance at managing this virus: "If there was any type of senior-care facility that should have been most equipped to manage the COVID crisis, it should have been skilled nursing facilities," said Brian Lee, a former Florida long-term care ombudsman who currently is a member of an advocacy group called Families for Better Care." Right.