COVID insights for the future—Summer 2021

As the pandemic seems to be winding down, we all hope we’ve seen the last of COVID. In this issue we look at insights gained during the past 16 months that can help you as a family caregiver make wise decisions on behalf of your aging loved one and yourself.

Dementia (memory loss) and COVID

Did you know that older adults with dementia were almost half again as likely to get infected by COVID? What’s more, the COVID death rates were nearly double for older adults who had dementia (32%) compared with the average for all older adults (17.5%).

A steeper decline. Even those who were not infected were severely impacted by social isolation. This was especially true in facilities. The rate of memory loss greatly accelerated. With room quarantines, residents lost important routines. They lost daily stimulation. They also lost the happy smiles and gentle touch of their caregivers. Many became depressed and withdrawn.

What can you do to protect your loved one? The unvaccinated will have the most risk if COVID comes back. That means they will need the heaviest restrictions to stay safe. It’s wise to get your relative vaccinated. Also, to require that hired caregivers—at home or in facilities—be vaccinated.

Improve precautions. People with dementia don’t remember to use precautions. If COVID returns this fall, consider these safeguards:

  • Hand-washing reminders. Post signs in the bathroom and the kitchen. Frequently wash hands together as a way to reinforce the habit.
  • Hand sanitizer. For an easy reminder after an outing, keep a 60% alcohol-based sanitizer at all entry doors.

Maintain social and intellectual stimulation.  

  • Reduce the need to wear masks. People with dementia rely heavily on facial expressions to engage with others and feel loved. Create safe situations where masks are not needed.
  • Emphasize outdoor gatherings. Spending time with others outdoors is low risk. Masks will probably not be required, especially by the vaccinated.
  • Ask about policies at facilities. It’s perfectly appropriate to ask about COVID policies. How will they preserve routines? Provide for safe social opportunities? Stimulating activities?
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Signs of safety in long-term care

Does your loved one need the full support of a memory care unit? Perhaps they only need the gentle boost of assisted living. Either way, families are understandably worried. Are long-term care facilities safe, especially if COVID returns?

Most everyone was caught unprepared in the beginning. But now we’ve had 16 months to learn what works best. Here are questions that can help you determine how COVID-ready a facility is:

  • Are temperatures checked before staff enter? Are masks required? All facilities are experiencing turnover and staff shortages. You want to pick one with the lowest rate. What percentage of the staff have been there for a year? How long has the leadership been in their position?
  • What kinds of precautions are in place? Is outdoor visiting allowed? How did they handle remote visiting during lockdowns?
  • Communication with families. How will you be kept abreast of your loved one’s health? If they get COVID? If others get COVID (staff or residents)?
  • Socialization and stimulation. What did they do to offset social isolation during lockdowns? How have they made sure people with dementia receive adequate contact? Mental stimulation?
  • Testing, quarantine, and reentry. Who gets tested (staff and residents)? How often? Under what circumstances? If a resident or staff member tests positive, what happens next? If a resident has to go to the hospital—or even just out to the doctor or dentist—what protection or quarantine process is in place when they return?
  • Vaccination policies. You cannot ask if a particular caregiver has been vaccinated. You can, however, require that your loved one be cared for only by vaccinated members of the staff. Are unvaccinated residents allowed in the facility? If so, how are they protected?
  • What if there’s an outbreak? What are the procedures in place to isolate and contain the infection? Is there a separate COVID ward?
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Could it be "long COVID"?

If you or your loved one got the virus—even mildly—and don’t feel you’ve fully recovered even months later, you may have “long COVID.” Researchers are just starting to focus on these post-COVID symptoms, which seem to occur in 10%–30% of COVID survivors:

  • Shortness of breath
  • Fatigue
  • Insomnia
  • Chest pain or palpitations
  • Depression and anxiety
  • “Brain fog” (difficulty concentrating or thinking)
  • A host of other flu-like symptoms such as headache, fever, stomach upsets, intestinal upsets

Symptoms may be severe and debilitating. Up to one third of “long haulers” report difficulties returning to work or even just completing their daily tasks of self-care (much less caring for someone else!).

If you think you or your loved one may have long COVID:

  • Talk to the doctor. Ask if there’s a post-COVID care center nearby or one with telehealth capabilities. Otherwise, ask for referrals to individual specialists.
  • Treat the symptoms. Take medication for symptoms such as headache, nausea, or diarrhea.
  • Consider getting vaccinated. Many long haulers mention that symptoms went away quickly after they got vaccinated. Long COVID is so new, however, no research has been completed. Talk to your doctor.
  • Check out SurvivorCorps.com. This is a grassroots online community of COVID survivors who share their long-COVID experiences with each other. Participants also have the option to anonymously share with researchers. The goal is to help scientists quickly learn what works and what doesn’t work to address these serious post-COVID responses.

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