More Seniors May Need Rehabilitative Therapy Due to Sheltering During COVID

The older adult population was the first to get hit by the coronavirus disease pandemic in early 2020. So, to reduce their exposure to the potentially fatal virus, public health experts advised people 65 years old and older to stay at home.

As a result, routine activities, such as going to exercise classes, grocery shopping, and visiting family and friends, came to a grinding halt for seniors. While shelter-in-place orders were meant to protect older adults, many, like Ronald Lindquist, did not realize that the imposed restrictions were affecting their health.

Lindquist, 87, lead an active life prior to the pandemic. However, he spent most of his time in his Palm Springs, California, home with his wife of 67 years. After a while, Lindquist was losing his desire to do things, all he wanted to do was lay around.

As time went on, Lindquist noticed that it was getting hard for him to get out of bed and get out of his chair. He even found it hard to get in and out of his car.

“I was praying ‘Lord, give me some strength.’ I kind of felt I’m on my way out—I’m not going to make it,” Lindquist recalled.

Doctors, physical therapists, and healthcare plan administrators are now confronting the fallout from seniors staying at home for more than a year. While there are no large-scale studies to document the issue, health officials are witnessing first-hand the physical and cognitive decline of older adults.

“Immobility and debility are outcomes to this horrific pandemic that people aren’t even talking about yet,” said Linda Teodosio, a physical therapist and division rehabilitation manager in Bayada Home Health Care’s Towson, Maryland, office. “What I’d love to see is a national effort, maybe by the CDC [U.S. Centers for Disease Control and Prevention], focused on helping older people overcome these kinds of impairments.”

Teodosio said she and her staff have seen a “tremendous increase” in falls, and the worsening of diabetes, congestive heart failure, and other chronic illnesses.

“Older adults got off schedule during the pandemic,” Teodosio said. “They didn’t eat well, they didn’t hydrate properly, they didn’t move, they got weaker.”

Couple Experiences Health Decline

Mary Louise Amilicia, an East Meadow, New York resident, said she had a hard time getting around after gaining 100 pounds during the pandemic. Her difficulty in getting around caused her to fall several times after Christmas, and she was fortunate enough not to sustain any serious injuries.

Amilicia, 67, had been giving round-the-clock care to her 69-year-old husband, Frank. In early December, Frank was hospitalized with a severe case of COVID-19. Mary Louise also contracted the disease but her mild case did not require hospitalization.

When Frank came home from the hospital, he relied on Mary Louise for nearly everything. Frank could not get out of his chair, walk 10 feet to the bathroom or walk up the stairs. So, he pretty much stayed in his recliner, and eventually began using a wheelchair.

The couple decided they needed physical therapy and signed up with a program run by Northwell Health, the largest health care system in the state of New York. Before the COVID-19 pandemic, Northwell began a “rehabilitation at home” program for people who otherwise would have seen therapists on an outpatient basis.

After over a month of therapy, Frank can now walk 150 feet with a walker, according to Sabaa Mundia, the couple’s physical therapist. Mary Louise had strengthening exercises twice a week over a three-week period, and now she can walk up to 400 feet without a walker, Mundia said.

“Older adults can lose about 20 percent of their muscle mass if they don’t walk for up to five days,” Mundia said. “And their endurance decreases, their stamina decreases, and their range of motion decreases.”

Nina DePaola, Northwell’s vice president of post-acute services, said the demand for the program is very strong and the plan is to hire 20 more therapists for the program, which currently serves over 100 residents on Long Island, in Westchester County, and in parts of New York City.

Healthcare Organizations

Some healthcare organizations checked on their older adult subscribers during the pandemic. Commonwealth Care Alliance, for instance, conducted wellness outreach assessments to seniors by phone. Headquartered in Boston, Massachusetts, the organization serves more than 10,000 older adults who are eligible for both Medicare and Medicare,

The healthcare organization’s staff called every two weeks to ask seniors how they were doing, and whether they had any new physical or emotional challenges or any other concerns. Now, calls are made monthly and staffers see seniors in person.

In California, older adults got involved with the Member2Member program offered by Senior Care Action Network (SCAN) Health Plan, which serves nearly 15,000 older adults dually eligible for Medicare and Medicaid.

SCAN’s Member2Member connects older adult “peer health advocates” with seniors who noted physical or emotional difficulties on health risk assessments. It was through this program that Lindquist was paired with peer advocate, Jerry Payne.

Lindquist spoke with Payne, 79, about concerns over his lack of activity during the pandemic. Payne suggested that Lindquist get up every hour and take a few steps. And, when Lindquist went out to walk his dog, Payne suggested walking an extra block.

“Walking was not pleasant,” Lindquist said. “But he was very encouraging.”

Payne also sent Lindquist a Fitbit, a digital device that can track a person’s daily steps, heartbeat, weight, and more. When Lindquist first started wearing the tracker, he walked about 1,500 steps a day. Now, he walks more than 5,000 steps a day. Now, Lindquist has set a goal of walking 10,000 steps a day.

Lindquist is noticing the benefits of becoming active again.

“I’m sleeping better and I feel so much better all around,” Lindquist said. “My whole attitude and physicality have changed. I tell you, this has been an answer to my prayers.”

Links:
https://truthout.org/articles/more-seniors-may-need-rehabilitative-therapy-due-to-sheltering-during-covid/