10/06/2020

Reaching Our “Silent Seniors” During COVID-19

Healthwise Communications Team

There’s a misleading quasi-normalcy in our country right now. Many businesses have resumed operations, and there are more people out and about today than there were back in April. Even new coronavirus information seems to have dried up online: Do a Google search, and you’ll be hard-pressed to find much of substance dated more recently than May.

 

But go to the park, the mall, the grocery store, and look around. Really look. There’s still something missing, something that hasn’t reverted to pre-COVID-19 levels.

Where Are the Seniors?

You’ll still see older adults here and there, but nowhere near as often as in the past. That’s because unlike other age groups, many seniors are still too scared to unnecessarily leave their homes—and with good reason. 8 out of 10 COVID-19-related deaths in the U.S. have been among adults 65 and older.¹ And if they already have other health problems, their odds of dying from the virus are even higher.

Even before the pandemic, many older adults had difficulty getting out of the house. Some can’t drive anymore, while others may be too sick or struggle with mobility issues. Those issues are now compounded by the fact that leaving home could be dangerous. And changes to support networks during shutdowns may also present fewer opportunities to go out or receive in-home help.

Our seniors haven’t disappeared. They’re still here, and they need help more than ever.

The healthcare industry is poised to reach seniors in three key ways: by sharing reliable health education, providing innovative virtual health options, and proactively reaching out to everyone in this age group—especially the silent portion of this population who aren’t reaching out to us.

 

Combatting Fake News and Scams With Reliable Health Education

There are two common ways older adults may receive false or questionable information:

• Scams: Anyone can fall for misinformation, regardless of their age. But older adults are specifically targeted by scammers who hope that isolation, dementia, or lack of tech savvy will make them gullible. Just this week, one Healthwise employee’s mother received an email from someone claiming to be from Medicare, telling her she needed to click on a link to schedule her COVID-19 vaccination or her benefits would be discontinued. Unfortunately, this is just one of many pandemic-related scams targeting seniors Others include selling fake tests door to door (the scammer swabs the person’s nose, then charges money), claiming someone has been “prequalified to receive money from the virus outbreak” in order to gather financial information, or offering “new” cures in return for payment.
• Unverified or false health information: Once upon a time, before the internet, spreading bad information on a large scale was difficult and expensive. Nowadays, anyone can make unfounded health recommendations online. YouTubers, politicians, alternative-health proponents, and bored teenagers can pose as reputable sources of information. In an age where even cats have their own social media channels, determining which sources are reliable and which aren’t can be overwhelming.

Don’t force older adults to weed out the good from the bad. By providing them with medically accurate, easy-to-read health education, you become their trusted source and you give them the tools they need to stay well. Having all the facts about COVID-19 can also help them know that scams like new vaccinations or nasal swabs from strangers aren’t legitimate.

And if they’re still not sure what to believe, they’ll know who to trust with their questions: you, their healthcare provider.

 

Virtual Health Solutions for Older Populations

Most hospital systems and doctor’s offices have some sort of telehealth option in place right now, out of necessity, and it works for some people. However, according to Landmark Health, 1 in 3 seniors still has difficulty using telemedicine. A solution that can reach and be used by the entire population needs to go farther in order to be usable by more older Americans.

• It needs to use simple language so anyone can understand their healthcare options.
• It should be deliverable in multiple ways. For instance, some patients don’t have the bandwidth or camera for video conferences, so it needs to support voice calls and email content as well.
• At least one option should meet ADA guidelines for hearing and sight impairments.
• It should be proactive. Scheduled reminders and automated delivery of health education help keep isolated patients’ health on their radar and show that it’s also on yours.
• Emotional health needs to be a component of your virtual health program. Older adults may struggle with depression and anxiety from self-isolation, the loss of friends, or fear of illness. Incorporate these concerns into your outreach for a holistic approach to patient care.²
• Seek inclusivity in content to reach as many people as possible. For example, African American Medicare beneficiaries have been hospitalized four times as often as Caucasians and contracted the virus nearly three times as often.² Using graphics, language, and delivery methods that make everyone feel included results in more positive outcomes.

 

Proactive Outreach Is Vital for Seniors

Some people are now hesitant to seek treatment for any condition if it means venturing outside. Others feel their doctors are only interested in hearing from them right now if they have COVID-19 symptoms. The result is a large number of people are falling through the cracks with untreated or poorly managed health concerns, and many of them are over the age of 65.

For example, industry reports show that the number of patients being treated for major artery blockages (STEMI) has dropped 38%. That’s a huge drop, and it’s certainly not because 1/3 of the population with artery blockages suddenly got better while being cooped up in their homes over the past few months. The need is still there, but the patients aren’t asking for help.

“When we got back in the home seeing our patients, we found the proportion of our care was different than a few months ago. Rather than 60% routine care, 20% urgent, and 20% post-acute, it was more like 20% routine care and 40% each of urgent and post-acute,” says Michael Le, CMO of Landmark Health.

“Seemingly, people waited longer to address exacerbations and then refused nursing services out of fear, making recovery more difficult. On the urgent care and even routine care front, a lot of what we’ve seen is tied to the worsening of chronic conditions when patients observe stay-at-home restrictions. Some of this is related to the lifestyle disruption we have all experienced. With patients stuck home and having irregular food access, their nutrition and exercise/mobility was worse, impacting patients’ diabetes and kidney functions. However, some of this is related to a hesitancy to engage with the healthcare system during the pandemic.”

Chronic heart failure is also going undiagnosed or untreated during the pandemic for many of the same reasons. Dr. Le believes that more routine screening is key to catching these cases in time to provide help. That means encouraging a full range of screening tests when patients do come for inpatient visits, so providers have as much data as possible and can better assess patients remotely during telehealth visits and virtual interactions.

Regular communication with patients outside the office is imperative right now. Automated delivery of health education, online assessments, and routine telehealth appointments can go a long way toward leaving no senior behind during the pandemic.

 

If You Build It, They Will Come…

No. No, they won’t. Investing in or creating a cool virtual or telehealth experience isn’t enough—no one is going to hear about it on the street and flock to you by the thousands. The key is to incorporate ways to reach out to patients and initiate conversations, whether that’s through texts, emails, calls, or your patient portal. Once you take the initiative to contact patients, you might be surprised by how eager they are to engage with you, especially if they’ve been feeling isolated and forgotten for months.

“The most concerning manifestation of ageism in this crisis is the consideration of age in the allocation of medical treatments,” says Dr. Le. “Such a blunt criterion fails to recognize the diversity among older adults and punishes individuals for their station in life.” While he was referring specially to using age to determine who should get ventilators during shortages, the same can be said for access to medical treatment in general. We can’t let older Americans fall off our radar just because we don’t see them as often.

We have to reach out to them in their homes, hold out our hands, and say, “How can we help?”

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¹ https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html
² https://www.apaservices.org/advocacy/news/older-adults-covid-19