My mother is a 4-time cancer survivor – she is immunocompromised. Today is her birthday. She is 84 years old. This means that she is at an incredibly high risk of severe illness and death from COVID19.
She lives in Alabama, which has not reported any cases of the coronavirus as of this writing. However, I live in Maryland. The choices we have made together about keeping safe during this pandemic are based on the best available information we can access. This highlights the need for government scientists to be able to tell us what they know, when they know it–something that seems easier said than done right now. See the blog from my colleague Michael Halpern about how the White House has excluded government experts from meetings about coronavirus response because the discussions were unnecessarily classified.
As those of you who follow me on Twitter have seen, I have been really emphasizing the importance of making sure our family members and friends who are most at risk are taken care of. As such, I have been working to secure my Mom’s safety during this time, while friends are doing the same for their families. As a result of those efforts, I started thinking of many issues regarding the virus that people really are not talking about. I would like to share those with you as you take care of the most vulnerable. I must add that thinking and acting on some of these issues sometimes created more questions than answers. But at least you can add them to your “to think about and worry over list.”
My mother, along with most vulnerable people, was not ready for the very real necessity of self-quarantine. Neither she nor they have enough food for an indefinite stay at home.
My Mom wanted to go to the grocery store, but I quickly mentioned the delivery service that most stores now offered. She had tried it previously she said but found it too complicated. So, I asked her to prepare a grocery list on Sunday/Monday and I ordered her groceries in Mobile, from Maryland, along with special delivery instructions–which were not followed (see my tweet for that story).
She received her groceries on Tuesday afternoon, alleviating one concern for me. However, while I was ordering her supplies, I wondered whether I was creating opportunities for possible infection. I had a very real concern about the health status of whomever would put the groceries together and whomever would deliver them to her.
Unfortunately, I also realize that everyone is not fortunate enough to have their grocery needs addressed.
Some people will be laid off from work with no continuance in their salaries. Some people just do not have the economic wherewithal to buy groceries. In some places, stores are woefully under-stocked. Whether that is because people were told to work from home for the coming weeks and needed to stock their coffers or people regressed to stockpiling food for themselves and their family is unknown.
What is known is that this could have a detrimental effect on the most vulnerable among us–much like what has been observed with the lack of surgical masks and gloves for medical professionals. At times of crisis, we need to think about others also, although that may not be easy if people panic.
One suggestion made by a friend is to really promote the use of Meals on Wheels for the homebound. Again, there is the threat of exposure from the delivery person, but people get to eat. Obviously, putting in place protective protocols for delivery persons would be in the best interest of the clients, but it may not be reasonable.
This is another major issue for those who will be confined for an unknown period. It is a great idea to consider stocking up on prescription medications and negotiating with pharmacies to provide 90-day supplies of medications instead of the standard 30-day supply. This is important for people like my mother, who take medication every day essential to their quality of life. It is also important for those of us who take medication for other chronic health conditions like hypertension or organ transplants and others.
What we do not want to do is create a situation where there is a shortage of medications for those who are vulnerable and to avoid that, we should make those individuals the priority. The good news is that some health insurance companies–like Aetna–recognize and are responding to this very real threat. For example, Aetna decided to waive co-pays for the COVID19 testing and they are relaxing 30-day prescription refills.
We must also be aware of upcoming medical or dental appointments for vulnerable family and friends. It is our responsibility as caregivers to speak to health care professionals to determine whether a medical appointment must be kept or can be rescheduled.
A very real danger of self or forced quarantine is the feeling of isolation. Unless they are staunch introverts like me, most people crave human interaction. That is extremely difficult when they are virtually cut off from society–even if it is for their own health protection.
Of course, the most obvious and the easiest way to address the potential social isolation is to call them regularly when possible. This is almost impossible when dealing with a bedridden person or someone who may have mental challenges–or someone who does not have a telephone or cannot afford to pay their telephone or any other bill.
Another recommendation to alleviate some of the isolation is to use computer platforms like Skype, FaceTime, Zoom and others, or make video calls when possible. Unfortunately, this works for people who have computer and internet access. If someone is in a nursing home, rehabilitation center or hospital, those facilities should ensure that equipment is readily available for this purpose. My Mom and I have used these services before, and I am quite sure we will be using them more frequently in the coming days and weeks.
I use the Nextdoor app. It allows me to connect with people who live in or near my zip code. We need to use this or another similar app to check on our neighbors. Chances are pretty good that there are people using that app who are homebound, who need our help or who just want to stay connected.
A friend pointed out that it is especially important that we create a system to allow us to spend at least some virtual time with folks who are sick and/or homebound. This is important not only for them, but for those of us caring for them.
4. Other Issues
My uncle, Reverend Lebaron Taylor is an Episcopal priest. He likes to visit his sick and homebound members, whether they are at home or in a nursing home. Recently, he visited a nursing home to check on some of his congregants. He questioned the action later, wondering whether visitations are opportunities for infection–which they can be. The same applies to rehabilitation centers and hospitals.
However, not allowing these visits creates problems also. The mom of one of my friends is in the hospital and has been there for a couple of months. My friend travels home to Mississippi monthly to visit her mom. As she was preparing to leave this weekend, she was told that the hospital was not letting anyone visit unless they tested negative for Coronavirus!
As she recovered from this devastating news, she pointed out–and rightly so–that her trips are necessarily only 3 days–Thursday through Sunday–not long enough to get approval to be tested, have the test administered (if it is available) and then receive the results.
An additional problem is that each time she visits from out of town, she would need to be tested again. But her main concern was not with the need to be tested, it was because her Mom would think that no one came to visit her, that no one cared about her, a false conclusion that could lead to depression.
My aunt Betty is in a rehabilitation/nursing home and my aunt Charlotte and uncle Sam are in an assisted living facility. Both live near their children, which is a blessing. They visit regularly and sit with their parents, but I know that eventually something will have to be done to protect all residents and I wonder what those protective measures will be.
When hospitals, rehabilitation centers, nursing homes and other similar facilities decide that visitation will be limited or dependent upon the results of the coronavirus test, their decisions, while in the best “health” interest of the patient, could have far-reaching ramifications when it comes to mental and emotional health–another catch 22.
I cannot overlook the toll that the above issues will have on family and friends. If you cannot regularly check on those who are vulnerable, either in person, by phone or some other method, it is extremely stressful and worrisome. For most of us, even when we are told by others that our loved one, the person we are concerned about is doing well, is safe and secure, we still need to see for ourselves, to reassure ourselves. Nothing can replace that assurance.
5. Others at Risk
Racism is an issue that we must be aware of. The sister of a friend of mine teaches at a predominately African American school in Florida. She has been exposed to the virus from some kids who were exposed at the local Boys & Girls Club. While all gatherings of over 250 people have been banned by the governor, her school of 900 students remains open.
In addition, her husband was ordered to work from home because of his wife’s exposure. People who are already food-insecure or living in areas with little to no access to food are dependent on food banks and other food supplement programs.
We must also consider and worry about people who find themselves in situations that will not provide them any or little protection from the virus. Prisoners, the homeless, immigrants, migrants in despicable camps on the border and those who do not have the means to buy food or communicate with others–those in extreme poverty.
While the government is supposed to take care of the needy and those in dire straits, that does not happen. Unfortunately, this government does not care about the less fortunate. That means it is our responsibility to care for one another.
Finally, I read this blog to my Mom and asked her for her thoughts. As a retired teacher, she had no shortage of words, lol. But what she said that really stuck with me was that she felt that her health is the most important thing for her and our family at this stage of her life.
She said that she has already done what she considers the most important act–giving life to her 5 children. For that reason, staying inside her home right now is not going to be that difficult for her. My Mom is very worried for others and expressed sorrow at the existence of this pandemic. She promised to protect her health and well-being and that of her family to the best of her ability and wishes the same to everyone else, as do I. Be safe, and as always, take care of those you can.