Think About It: Vulnerable me, vulnerable you

“None of us could have imagined spending extended time in isolation at this stage of our lives. We can be forgiven for treasuring each day since we have far fewer days ahead of us than behind us. We can be forgiven for not wanting to spend those days in isolation.”

Those of us 65 years and over are watching unrelenting news stories of the struggle placed on all peoples to protect the most vulnerable, primarily the elderly. We are the elderly, the most vulnerable of modern-day pandemics. We are the vulnerable due to our age and that many of us have underlying medical conditions.

I wrote the book “Old and On Hold: Aging in Place during the Pandemic” — and write now — to keep in front of us the task of protecting ourselves and others. Remember, Washington state’s phased approach has high risk populations including people 65 or older and especially those with serious underlying medical conditions at any age to stay at home until phase 4 and then only go out if able to practice social distancing.

Many of us don’t like to say we’re old, let alone vulnerable. Alas, we are both, a realization around which I commiserate with you. I am as old or older and vulnerable as you, or as the media likes to say, your grandma and grandpa.

We are a population that is more vulnerable to contracting COVID-19 and have a greater potential of dying from it because we are likely to have an underlying chronic disease or condition such as diabetes, heart disease, obesity, chronic lung disease and/or hypertension.

Even if we are blessed not to have a chronic disease, we still have the underlying condition of our aging. Our bodies are less able and less resilient. Just as our vision, hearing and balance is not as acute as when we were 30, 50 or 60, neither is our immune system as robust in its role as the body’s defense mechanism.

We need to have great respect for the coronavirus; it is treacherous. One nurse recently described it as “a monster that attacks the entire body.” Our defensive behavior is our first line of defense. Our defensive behavior also protects others if we have the virus and have not yet experienced symptoms of COVID-19.

‘You can’t let your guard down!’

There are groups in our community that check all the boxes for vulnerability including living in a group setting and requiring help from people who come in and out of their home each day. Anyone following COVID-19 news will recognize these groups such as people living in skilled nursing facilities (SNF).

According to Washington state statistics published June 12, 2020, 8 percent of the confirmed cases of COVID-19 were of people 80 years or older and 52 percent of deaths were of people 80 years or older. (Don’t get too comfortable: 38 percent of deaths were people between 60-79 years of age) Fifty-four percent of deaths nationwide were of residents and staff of nursing homes.

Clallam County has had no deaths to date. That means our SNFs have kept COVID-19 out of facilities. It helps that our county does not have a high incidence of positive cases, but it only takes one infected person coming into a SNF to start a spread.

“You can’t let your guard down.” Heather Jeffers, Administrator of Avamere Olympic Rehabilitation of Sequim, emphasizes the importance of continuous vigilance to protect the residents of her facility.

On March 1, Jeffers and facility staff supported by the Avamere Corporation and aware of the devastation the virus could bring to her facility kicked into motion a fast-forward transition plan to establish procedures to protect 80 residents and 120 staff members from a COVID-19 invasion.

Listening to Jeffers describe the urgency of action, I had the image of orchestrating the arrival of a hurricane of change and bending it to your will in a matter of hours and days.

Visits from family, volunteers and others not medically or nursing needed were discouraged. Group dining and social or therapeutic groups were discontinued. The facility was divided into three distinct areas of residents’ rooms to cut down exposure among residents. Additional staff was hired and trained to assist the nursing staff at mealtime and provide social support to residents. Procedures for virus testing and mask wearing were instituted. On March 23 when Governor Inslee issued stay at home orders, Jeffers stopped entry of all non-essential people into the facility.

Residents were without family visits and without their friends who may be in a different section of the facility. Staff and newly hired hospitality workers took on the role of residents’ only in person support. Jeffers updates families regularly. Facility staff arrange for phone calls and internet chats between residents and family.

Job well done, but no laurels to rest on when Jeffers and we know the virus lurks in the community. Not that SNFs are used to public laurels.

I know that SNFs receive more second looks than the positive recognition that hospitals receive for their hard work. Early on media seemed breathless upon discovering an East Coast SNF experienced 17 deaths from COVID-19 and stacked the bodies in one room. It was as if something sinister happened when it is as simple as SNFs don’t have morgues and the SNF was doing the only thing it could do at the time.

Deaths occur in SNFs but not at pandemic rates. People live in SNFs because they need help and they want to live, not die. People like Jeffers who work in the industry are passionate about giving each resident as much quality of life as possible.

Jeffers’ hope is that the pandemic will result in the public becoming more aware of the important work done in facilities like hers and provide the funding that’s needed to do it well.

Denial blinds common sense

As I wrote earlier, people don’t like to think of themselves as old or vulnerable. Confronting the most vulnerable in SNFs challenges our denial and will until we put a value on those who have found a place of caring in which they receive the help they need.

Denial of aging isn’t nearly as dangerous as denial of the treachery of the virus itself and subsequent failure to protect self and others. Health care professionals tasked with caring for the extremely ill are astonished if not horrified at ignorant disregard of precautions. They know well they will be the ones in danger when careless people or their vulnerable relatives come in for treatment.

There is no civil or human right that allows anyone to brazenly, even stupidly, risk the lives of others especially those trying to save lives.

Bertha Cooper, featured columnist in the Sequim Gazette, spent her career years in health care administration, program development and consultation. Her book, “Old and On Hold: Aging in Place during the Pandemic,” is available online at msipress.com, on amazon.com and retail stores. Cooper and her husband have lived in Sequim more than 20 years. Reach her at columnists@sequimgazette.com.

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