The Elderly and COVID-19

Which elderly people with pathologies should be especially careful with regard to coronavirus? Why is coronavirus more dangerous for the elderly?

Aging leads to changes in the immune system that we call immunosenescence, i.e. “diminished defenses”, which means that the cells of our organism that are responsible for acting against an infectious process decrease their response capacity, even by more than 60% compared to young people. For this reason, any infection, however trivial it may be considered in the general population, can be more dangerous and even fatal in the elderly. Likewise, the presence of chronic pathologies represents an added risk for the elderly, since they can easily decompensate and also precipitate a negative outcome. If we add to this a virus such as COVID-19, which is aggressive and has a great capacity to spread among the public, the danger it represents among the geriatric population increases exponentially.

Are the measures taken by some residences to confine caregivers to the elderly effective?

The best measure to control COVID-19 is to nullify its transmission and thus, as epidemiological experts explain, flatten the infection curve.

If we take into account that the main routes of transmission of the virus are through hands and droplets, we will understand that the best preventive measure is to avoid close contact with other people. One of the first measures applied in nursing homes was the maximum restriction of visits to avoid the possible entry of the virus in these centers coinciding with contact with the relatives of the elderly.

After this restriction, it remained to cover the possible risk posed by the professionals themselves as a vector of entry of COVID-19 in nursing homes. To this end, the continuous washing of hands after any activity and the use of face masks throughout the working day will significantly neutralize the risk of contagion.

The total confinement of staff and the elderly within the residence extinguishes any possibility of entry of the coronavirus into geriatric institutions, avoiding the involvement of both users and professionals themselves. However, this drastic measure can probably only be maintained for a short period of time, as it has a high personal impact, especially among the professionals, since it prevents them from continuing to maintain their own family life. For this reason, we must ensure the availability of appropriate medical equipment in residential facilities and the implementation of the described isolation measures, which are theoretically sufficient to protect the elderly and their caregivers.

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What precautions should the elderly and caregivers take against coronavirus?

Precautions against coronavirus are based on avoiding the routes of infection, contact and airborne routes, and, therefore, the main recommendation is not to visit our elderly relatives unless strictly necessary.

In relation to contagion by contact, we should not only focus on hand washing, which is essential, but also on the continuous cleaning of common spaces where we do our daily life, including door knobs, table surfaces, telephone, computer … All those points where it is easy that several people coincide putting our hands. Also, and related to airborne transmission, it is advisable to respect as much as possible the distance between us, ideally more than one meter. If the elderly person lives with a family member who continues to work, the latter should take off his or her shoes, change clothes, keep keys and personal items in an isolated area and even take a shower when returning home. Finally, if at any time a member of the household has a cough or fever, extreme isolation measures should be taken at home, including the use of a face mask if necessary.

How can we help elderly people living alone? What measures can family members or neighbors take to help them?

Unwanted loneliness is already a well-known problem among the elderly population, but now, with the necessary confinement to combat the pandemic, this situation is significantly aggravated as it incorporates practically the entire elderly population. Obviously the best treatment for loneliness is companionship. In this aspect, the new information and communication technologies (ICT) are a fundamental tool, since they allow interaction at a distance without the need for complex mechanisms, even to keep in touch with your geriatric physician. However, given that not all elderly people have access to ICT, a simple phone call, a letter from their children, a drawing from their grandchildren or great-grandchildren… any communicative interaction is already of great value. In addition, we must not forget the indispensable logistical support, such as facilitating their shopping, access to their medicines… always preventing them from leaving home during this period of health emergency, in which we will also avoid close contact with them. We should be able to balance the balance of avoiding the risk of contagion with keeping communication alive.

Together, seniors and not so seniors, we will win.