COVID-19: How older adults can cope with our new normal

Months into the pandemic, here’s what you need to know to help you stay healthy — and happy.

Elizabeth Millard
Mature Black woman wearing a face mask using her smartphone.

As communities continue to open up to varying degrees, social media is filling with photos of people gathering for activities and resuming more of their pre-pandemic routines. Airlines are booking fuller flights, and lakes, beaches and amusement parks are open. Does that mean life has returned to mostly normal? Unfortunately, that’s not the case quite yet.
“This is a challenging time. We’re all tired of the restrictions that came with the stay-at-home orders, and we want COVID-19 to be over and go back to seeing our friends and family again as we always have,” says Scott Kaiser, M.D., director of geriatric cognitive health for Pacific Neuroscience Institute at Providence Saint John’s Health Center.
“But the new coronavirus is still a major threat, especially for older people,” Dr. Kaiser says. 
We know a great deal more about COVID-19, the respiratory illness caused by the virus, now than we did even a few months ago. But information about its spread, symptom severity and high-risk groups is still being uncovered. One thing is certain: Everyone — especially people older than 65 — should continue taking precautions, says Dr. Kaiser. 
As the pandemic rolls on, these four refreshers can help keep you safe, healthy and happy.

#1: The Risk Factors for COVID-19 Have Expanded     

People in their 60s and 70s face a higher risk than those in their 50s, the Centers for Disease Control and Prevention (CDC) warns. And the greatest risk of all, the CDC notes, is among people 85 and older.
Many details about COVID-19 still need to be better understood, says Dr. Kaiser. But he says the higher risk is due to the fact that an older person’s immune system may respond less effectively to infection than a younger person’s. Generally speaking, common age-related changes to your immune system mean you’re at a higher risk for complications for any type of viral infection, such as colds, flu, shingles and pneumonia. Plus, if you do come down with an infection, you may need more time to recover.
That’s the case for a healthy older adult. Add in an underlying condition, such as heart disease or diabetes, and any COVID-19 symptoms can become worse, says Dr. Kaiser.
In late June, the CDC made several additions to the list of underlying medical conditions that increase the risk of severe illness from COVID-19:

  • Obesity (defined as having a BMI of 30 or higher)
  • Chronic obstructive pulmonary disease (COPD)
  • Chronic kidney disease
  • Weakened immune system from solid organ transplant
  • Sickle cell disease
  • Type 2 diabetes
  • Serious heart conditions (including coronary artery disease, cardiomyopathies and heart failure)

In addition, the CDC says the following conditions may increase your risk of severe illness from COVID-19:

  • Hypertension or high blood pressure
  • Liver disease
  • Asthma (moderate to severe)
  • Cystic fibrosis
  • Neurologic conditions such as dementia
  • Smoking
  • Pulmonary fibrosis
  • Type 1 diabetes
  • Weakened immune system from bone or blood marrow transplants, immune deficiencies, use of corticosteroids, HIV or other immune-     weakening medicines
  • Thalassemia (a blood disorder)

Keep in mind that having one or more of these conditions doesn’t definitely mean your symptoms will be more severe if you become infected, Dr. Kaiser says.
But since underlying conditions raise that risk, it’s wise to be extra cautious and follow protective guidelines: Wash your hands frequently, limit your time in public and wear a mask when you’re likely to be around others.
Also, continue to shop during the special hours that some retailers set aside for older customers, or take advantage of delivery services in your area. Try to have a month’s supply of groceries on hand. And ask your doctor if you’re up to date on your vaccines, including those for shingles and pneumonia. 

#2: “Open for Business” Doesn’t Mean It’s Safe to Go There

Depending on where you live, you may see lots of places now open — including restaurants, gyms and hair salons — that were closed for months. 
This can give older adults a false sense of security. There’s a common perception that if a business is open, then it’s safe to frequent, says Edgar Sanchez, M.D., an infectious disease specialist at Orlando Health Medical Group.
But, he warns, anywhere you go will still involve a level of risk. This is especially true in places that aren’t enforcing protections like mask usage. What it comes down to, says Dr. Sanchez, is assessing risk based on your specific situation, not on state and local policy changes.
“Everyone is in a unique position in terms of risk,” says Dr. Sanchez. “Those over 65 are already in a higher-risk group, and that should keep them being cautious.” 

A healthy lady on a walk
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#3: Think Physical Distancing, Not Social Distancing

Months of separation from friends and family is difficult for everyone, Dr. Sanchez says. Staying isolated may keep you safest, but it’s tough emotionally. That’s why now is the time for people to increase their efforts to “see” one another, he says. 
That might include video calls or outdoor visits where you can be separated by 6 to 10 feet, he suggests. Although the virus may be less contagious in an outdoor setting, he emphasizes that risk still exists. Some people wear masks outside even when they’re apart, if family members have underlying conditions, Dr. Sanchez says.
If you and a friend or relative are thinking about seeing each other face to face, the CDC suggests a few ways to socialize safely. First, call your doctor to talk about the pros and cons of seeing others in person, suggests Dr. Sanchez. If you live in a hot spot, it might be best to stick with phone and video calls for the time being.
If you decide that you’re comfortable opening your door again, set some ground rules. Ideally, you and the other person should agree to a two-week quarantining period before the first meet up. You both should agree to wear masks and practice social distancing, not only when you’re together but also when either of you goes out to pick up groceries, medicine or other essentials.
Finally, you should agree to limit your contacts with the outside world. In general, says Dr. Sanchez, the fewer people involved, the easier it will be to limit your exposure. Smaller numbers are better.
“Continue to find ways to connect that don’t involve being physically close,” he says. “Most of all, understand that this virus is spreading more widely, despite what you see on beaches and in bars. I know it’s challenging, but it’s crucial to keep your precaution levels high.”

#4: Have a Heart-to-Heart With Friends and Family

As you know, now’s not the time for casual drop-ins. As those you love start to resume their pre-pandemic lifestyle, ask them to pick up the phone to say hello and catch up.
In his Florida hospital, Dr. Sanchez says he often sees older patients who got  the virus from younger family members who were not practicing social distancing or wearing masks, and who were in large groups recently.
“Many older people know to stay out of groups, which they absolutely should, but they also need to stay distanced from those who’ve been in those groups,” he says.
For example, your 20-something grandson may have gone to an amusement park, a crowded bar or the beach and caught the virus but doesn’t have symptoms. Even if you meet with him one-on-one, you could be exposed, especially if you sit inside and chat for a while without wearing masks, Dr. Sanchez says.
That could even happen at family gatherings. A small surprise party in Texas, for example, resulted in 18 family members testing positive a few days later, according to an Associated Press news report. Most concerning was the fact that older relatives who hadn’t been in attendance were among the 18 infected.
“It’s difficult to overstate how highly infectious this is,” says Dr. Sanchez. “This is not comparable to the flu. Think of the flu as a bonfire, and COVID-19 as a wildfire. Which would you think of as more dangerous?”

Safer at home 

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