The coronavirus and risk to seniors
As the coronavirus, otherwise known as COVID-19, crosses the country and the world, individuals, organizations and governments struggle with the best response measures. There are enough cases now for serious concern — Italy has basically quarantined its entire country — but other areas may be less affected, some states within the U.S. report no cases at this point and some with 10 or 12.
Pennsylvania at the time of this writing has reported 12 cases statewide, a number of them specifically related to contact with individuals who traveled overseas or who had contact with those who traveled overseas. Washington, New York, California and Florida were especially hard hit. In Washington state notably a single nursing home experienced the largest number of cases.
It is difficult to tell here on the east coast what trajectory the disease will take but the risk is not to be minimized. The goal on a larger level appears to be to institute safeguards sufficiently strict to avoid further outbreak and contain the spread while not inducing panic. For those potentially experiencing symptoms, the expressions self-isolation and self-quarantine have creeped into the language. One of the difficulties is that there are not enough testing kits available to determine just who has the virus and who has another condition with similar symptoms. Until this is available many potential patients will not know what they are experiencing.
As time goes by, a clearer picture of what should be done is emerging. However, it is obvious we were all caught unprepared. Of all the precautions noted the three most common statements have been to wash hands frequently, avoid contact with your face and limit travel and large crowds —especially for seniors and those with chronic health conditions.
The experience of passengers aboard a Princess cruise who were restricted to their cabins and unable for several days to disembark could be instructive. They are only just now able to vacate the ship after several cases were discovered onboard including among the crew. The Centers for Disease Control (CDC) earlier this week issued a warning that travelers “defer all cruise ship travel worldwide “noting that “cruise ship passengers are at increased risk of person-to-person spread of infectious diseases, including COVID-19.” As an aside, it is noted by this author that many cruises attract seniors and the industry is likely to take a very large hit. Similar warnings have been issued regarding air flight. However, passengers by
It is difficult to tell here on the east coast what trajectory the disease will take but the risk is not to be minimized.
plane are typically not onboard for as extended a period of time or socialize as much as those aboard cruise liners.
When it comes to seniors, questions can arise — who is a senior? I have heard as young as 50 years old. Other reports say 60 and above. The point that is being made I believe, is that younger people who test positive have tended to encounter less severe symptoms and many, probably most of the deaths have been among older adults and those with preexisting conditions, especially lung conditions. It is noted that precautions are especially important among this group.
This does not mean there have not been school closings — there have been — including colleges and universities especially in states and areas with the highest incidence of cases.
All of this brings us to the area of nursing homes and senior communities. CMS, the Centers of Medicare and Medicaid Services — a federal agency tasked with, among other things, review of care in nursing homes — recently announced that it will “allow inspectors to focus their energies on addressing the spread of COVID-19.” Inspections (of nursing homes) will exclusively focus on infection control and prevention policies, and other serious health and safety threats,” according to “McKnight’s Long Term Care News” on March 9, 2020.
One of the comments is that “It (the CMS announcement) will make it very clear that (nursing homes) have the… duty to exclude visitors from our facilities (when there is fear of contagion) …” id. Some recommendations are being made for “visits” electronically. Another issue that has come under fire is the lack of attention given to nursing homes generally that can carry through into crisis situations. One commentator from a nursing home group noted that Washington state — the first site of a coronavirus outbreak in the United States — has the third-worst (Medicaid) underfunding in the country. id. Staffing and support continue to be issues for frail seniors in need of care regardless of crisis.
Janet Colliton, Esq. is a Certified Elder Law Attorney and limits her practice to elder law, retirement and estate planning, Medicaid, Medicare, life care and special needs at 790 East Market St., Suite 250, West Chester, Pa., 19382, 610-436-6674, colliton@collitonlaw.com. She is a member of the National Academy of Elder Law Attorneys and, with Jeffrey Jones, CSA, co-founder of Life Transition Services LLC, a service for families with long term care needs. Tune in on Wednesdays at 4 p.m. to radio WCHE 1520, “50+ Planning Ahead,” with Janet Colliton, Colliton Elder Law Associates, and Phil McFadden, Home Instead Senior Care.