Tips to look after Elderly in COVID times

As the world nudges towards normalcy, it is imperative that the elderly continue to practice lockdown norms. The year 2020 has been particularly harsh to them. Not only are they more vulnerable to serious infection due to Covid 19, their lifestyle and social pillars have been disrupted by the newer norms of living , dictated by the virus. Leaders from all over the world have expressed concern about the welfare of the elderly.

Why are the seniors more vulnerable?

The elderly account for more than 50 percent of the total COVID deaths. Seniors in UK, USA and Italy have also borne the major brunt of the disease. Let us try and understand why old people are more prone to infection by SARS COV 2. The explanation of the generally heightened risk of the geriatric population lies in a growing understanding of “Immunoscence”. Older people are not as good at reacting to micro-organisms they have not encountered before. When faced with a new virus like SARS COV2 , they are not able to produce virus fighting chemicals due to depletion of naive T cells. Naive T cells are cells which mount a specific response against a ‘never before seen microbe’. The specific response of the body to the virus is thus too little and too late. This allows the initial non-specific response of the body to remain in overdrive producing a cytokine storm. The body immune response is thus ineffective and produces great ancillary damage in the lungs causing Acute respiratory distress syndrome, the commonest cause of death in COVID.

Challenges faced by the elderly

The seniors find themselves particularly susceptible during this COVID era. They find almost every aspect of their existence threatened and challenged. Physically, not only are they in greater peril of succumbing to the disease, the structure of house help and care givers that they had put in place for their convenience is shattered. Also, prior to the COVID era, Senior citizens in India led an active social life. They kept in regular touch with extended family and friends. They took active part in satsangs, religious activities, festivals and social programs. Such meetings were frequent and provided recreation and solace to the old-timers. They looked forward to such occasions as they added value and meaning to their life. All these activities stand disrupted in the new era leading to social isolation, frustration and bleakness. Depression, loneliness and anxiety are the new companions. Instances of violence against the aged are also showing a rising trend. The fact that the end appears nowhere in sight is only adding to their dilemma.

Practical tips for Seniors to look after themselves

• Sanitizing, masking and distancing remain the mool mantra for protection.
• Practise physical distancing not social distancing. Keep in touch with your friends and extended families via telephones and digital platforms. Continue to share and care, but digitally.
• Group activities which involve talking, singing or eating together are best avoided in person. Such activities can be arranged digitally. Use watts app group chats or zoom meets to organise such meets and remain in touch with your satsang groups or breakfast club.
• Social activities like group exercises can be promoted as long as you maintain at least six feet distance at all times. Schedule them in open spaces. Yoga or such fitness exercises where people remain restricted to their mats can be organised. Keep group size small. Maintain social distance at all times.
• Wear mask and face shield when you venture out of the house.
• If you travel by car, keep the windows open. Wear a mask and face shield during the ride.
• Avoid travel, hotels and that visit to the market.
• Avoid talking to unmasked people.
• Avoid meetings in closed spaces.
• Eat simple nutritious diet. Immune-boosters like Chywanprash, amla, tulsi, cloves, cinnamon, black pepper and ginger should be a part of your daily diet. Avoid excess salt, sugar and oil.
• Exercise daily. Practise meditation or yoga daily. Watch your weight.
• Take your medications regularly. Add supplements of Vitamin D, Vitamin C and zinc.
• Get your immunity status assessed at regular intervals. Keep in contact with your doctor.

Precautions while hiring Care-givers

Restrict the number of care givers. It is better if the care giver is exclusively working for you. It is important that the care giver takes all precautions which are relevant in today’s scenario. SMS is the golden rule. According to a recent study, one in four individuals may have developed immunity to COVID. It is a Good Practice to hire care givers who have developed specific immunity (IgG antibodies to COVID). You could get their immunity profiles checked to see if they are safe for you and your family.

What can we do to ease their pain- Tips for family and friends

Just like a herd protects the vulnerable by keeping them well sheltered in the centre, keep your seniors well cocooned. Be a buffer in between the elderly and the outside world for some more time. Teach and encourage the old folks to use chat platforms to remain in touch with friends and family to uplift their spirits. Keep them involved in family discussions and projects. Ask for advice or that recipe you always wanted. Connect with your elderly Aunts, Uncles and well wishers regularly. Just call in to say ‘I care.”

Author:
Dr Vibha Tomar
Consultant Pathologist
Tomar Foundation Pathology Lab

2019 Novel Corona Virus Outbreak was first detected in Wuhan , China, and soon spread to other major countries globally including USA, UK, UAE , Hongkong, Australia among other countries. Over sixty thousand cases have been detected up-to-date. India has also reported three confirmed cases.

It is caused by a new strain of Corona Virus called COVID -19 which is a Beta corona virus. Corona virus are a group of zoonotic viruses that cause disease in animals such as camels, cats and bats. Rarely these viruses can infect humans. Early cases of this disease in China had some link to a large seafood and live animal market suggestive of animal to human spread. Person to person spread has been reported in countries outside China.

Transmission of this virus from person to person is via respiratory droplets produced when an infected person coughs or sneezes and the droplets land on the mouth or nasal mucosa of people who are nearby. It is currently unclear whether a person can get COVID -19 by touching a surface or object that has virus on it .

People who have been in China within past two weeks, caretakers of patients with established COVID-19 infection and health professionals involved in the care of such patients are at serious risk. The incubation period is 2-14 days after exposure. Most patients show symptoms within 5- 6 days.

Patients typically develop mild to severe respiratory illness. Warning symptoms are fever, cough, and shortness of breath and breathing difficulties. In most severe cases, it can lead to pneumonia, kidney failure and even death.

WHO analysis shows that while 82 percent of cases are mild, about 15 percent progress to severe and 3 percent are critical. Most of the fatal cases were in senior citizens and people with underlying conditions like Diabetes and Hypertension. Lab diagnosis is based on Serological tests and Viral culture. Treatment is largely symptomatic.

As there is currently no vaccine to prevent 2019-nCoV infection,the best way to prevent infection is to avoid being exposed to the virus. General public has been issued a list of recommendation by CDC to prevent the spread of infection. Here is the list of do’s and don’ts.

Avoid close contact with people who are sick.

Avoid touching your eyes , nose and mouth with unwashed hands.

Stay Home when you are sick.

Cover your cough or sneeze with a tissue. Discard tissue in trash.

Wash your hands with soap and water frequently.

If soap and water are not available ,you may use alcohol based hand sanitizer with at least 60 percent alcohol.

Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

Use of face mask [ CDC guideline ] –

People who are well do not need to wear masks.

People with symptoms of 2019 Novel Corona virus and care takers need to wear mask.