Early in the pandemic it became clear that older adults and people with disabilities were at risk of severe infection and death from COVID-19. In California alone, 76% of COVID deaths happened to people 65 years and older.
“What we saw in every single peak, was that the age group that was obviously most disproportionately affected with serious illness and death, was the older age group,” said Dr. Sara Levin, an internist with Contra Costa Regional Medical Center, at an April 12 EMS briefing on aging and the pandemic.
But pandemic-related lockdowns exposed another harsh reality – for vulnerable seniors, isolation has proven to be almost as dangerous as COVID itself.
“We always tell older adults do not isolate, it will negatively impact your health,” remarked Debbie Toth, the Director of Choice in Aging. “But in order to save lives, we told them they had to isolate. And now we are dealing with trying to reconcile with what happened.”
Seniors had to cope with limited access to care and services and overcome technological barriers. They had difficulty finding testing. It led to a worrisome trend – a slow down in getting vaccinations and boosters.
In the United States, 15 million older adults are not fully vaccinated or boosted, not because of an anti-vaccine issue, warned Tom Frieden (ex-CDC), but because our chaotic healthcare system fails “to ensure people are up to date.”
One third of people over 60 remain unboosted.
Now older adults trying to break out of pandemic-driven isolation face new risks from a resurgence of COVID-19 infections driven by the latest variants.
Can the healthcare system help seniors navigate out of isolation and rebuild their social lives?
At the briefing, health experts agreed that access to vaccines and services at adult care centers could do just that.
The first step is to promote vaccines and boosters, “a key preventive measure to protect these groups,” said Susan DeMarois, Director of the California Department of Aging. People can reach information, assistance and referrals locally via a network of Aging and Disability partners which offer community-based resources, across all 58 counties in California.
DeMarios acknowledged that partnerships with direct services provided by adult day centers, boarding care partners, nursing homes, and assisted living facilities, played a pivotal role in getting through the pandemic.
One example, said DeMarois, was Choice in Aging, the innovative adult care center in Pleasant Hill, Contra Costa County, where the briefing was held. This type of adult daycare facility or senior center could connect older adults to the information and resources they needed within the community.
“We will meet them where they are and connect them to services and supports in their community services.”
The county is closing the digital divide locally by providing technology devices, access to broadband, and data plans, said DeMarios, “so that individuals can access and engage socially with technology.”
Californians can get information, assistance and referrals in their own communities via 24-hour helplines, added DeMarios. They can call 1-800-510-2020 to link to local services and supports, including insurance counseling, caregiver supports, legal services, home modifications, falls prevention, nutrition, and direct referrals for housing or transportation.
A Friendship Line (888-670-1360) established at the start of the pandemic, is available 24/7 to anyone who wants a live, warm conversation for some emotional support, while family caregivers can call 1-800-445-8106 to find a Caregiver Resource Center.
Now, individuals 50 and older who are undocumented, will be eligible for MediCal, with full access to all services and supports from the state Medicaid program. DeMarios advised anyone who is eligible for MediCal to update their contact information to ensure that eligibility or benefits stay current with medical services when the public health emergency concludes.
She suggested using My Turn, a universal access point, for anyone who needs a vaccine or booster in their home, or if they need free transportation to an appointment.
Contra Costa County responded to the low uptick rates for vaccines by pioneering a mobile clinic network to take vaccines to hard-to-reach patients. The county implemented its mobile clinic project in partnership with 500+ boarding care homes and the federal Pharmacy Partnership Program, said Dr. Levin. This community-based collaboration paved the way for state and federal partners to focus resources and efforts on the most marginalized in the community.
“I’m so proud that as a public health department and as a health care system, in this county, we were able to partner with organizations like Choice in Aging, to try and mitigate and reduce the deaths and the suffering that occurred,” Levin added.
The mobile clinic program for vaccines and boosters evolved after people who were most vulnerable did not show up for their shots. It targeted those who were most at risk, most underserved, and the most marginalized. The county rolled out its mobile vaccine and booster clinics at skilled nursing facilities, senior centers, faith-based organizations, residential care facilities for the elderly, low income, and senior housing complexes. Caregivers of people living in those places were able to get vaccinated. The county even sent nurses to administer shots for the homebound elderly.
“I just want people to know that, again, those treatments are out there,” added Levin, including at pharmacies listed on the county website, through primary care physicians and a hotline at the local health department.
At Choice in Aging, director Debbie Toth recalled that, “the last two years were unbelievably difficult for our aging population. The fear of death was real,” she said, especially when reading every day in the newspaper about older adults dying and falling ill at “extremely high and scary rates,” when they were so often invisible in society.
Asking seniors to isolate in order to save their lives is counter to what is productive for an aging population, added Toth.
“We need to be able to have community to come together to share a language, a culture of friendship, and vaccines. And boosters are the only things that have made this possible for our aging population.”
“We need to socialize, we’re social creatures.”