“Lord, give me back my memory.”
For months, as Marilyn Walters has struggled to recover from COVID-19, she has repeated this prayer day and night.
Like other older adults who’ve become critically ill from the coronavirus, Walters, 65, describes what she calls “brain fog” — difficulty putting thoughts together, problems with concentration, the inability to remember what happened a short time before.
This sudden cognitive dysfunction is a common concern for seniors who’ve survived a serious bout of COVID-19.
“Many older patients are having trouble organizing themselves and planning what they need to do to get through the day,” said Dr. Zijian Chen, medical director of the Center for Post-COVID Care at Mount Sinai Health System in New York City. “They’re reporting that they’ve become more and more forgetful.”
Other challenges abound: overcoming muscle and nerve damage, improving breathing, adapting to new impairments, regaining strength and stamina, and coping with the emotional toll of unexpected illness.
Most seniors survive COVID-19 and will encounter these concerns to varying degrees. Even among the age group at greatest risk — people 85 and older — just 28% of those with confirmed cases end up dying, according to data from the Centers for Disease Control and Prevention. (Because of gaps in testing, the actual death rate may be lower.)
Walters, who lives in Indianapolis, spent almost three weeks in March and April heavily sedated, on a ventilator, fighting for her life in intensive care. Today, she said, “I still get tired real easy and I can’t breathe sometimes. If I’m walking sometimes my legs get wobbly and my arms get like jelly.”
“Emotionally, it’s been hard because I’ve always been able to do for myself, and I can’t do that as I like. I’ve been really nervous and jittery,” Walters said.
Younger adults who’ve survived a serious course of COVID-19 experience similar issues but older adults tend to have “more severe symptoms, and more limitations in terms of what they can do,” Chen said.
“Recovery will be on the order of months and years, not days or weeks,” said Dr. E. Wesley Ely, co-director of the Critical Illness, Brain Dysfunction and Survivorship Center at Vanderbilt University Medical Center. Most likely, he speculated, a year after fighting the disease at least half of the critically ill older patients will not have fully recovered.
The aftereffects of delirium — an acute, sudden change of consciousness and mental acuity — can complicate recovery from COVID-19. Seniors hospitalized for serious illness are susceptible to the often-unrecognized condition when they’re immobilized for a long time, isolated from family and friends, and given sedatives to ease agitation or narcotics for pain, among other contributing factors.
In older adults, delirium is associated with a heightened risk of losing independence, developing dementia and dying. It can manifest as acute confusion and agitation or as uncharacteristic unresponsiveness and lethargy.
“What we’re seeing with COVID-19 and older adults are rates of delirium in the 70% to 80% range,” said Dr. Babar Khan, associate director of Indiana University’s Center for Aging Research at the Regenstrief Institute, and one of Walters’ physicians.
Gordon Quinn, 77, a Chicago documentary filmmaker, believes he contracted COVID-19 at a conference in Australia in early March. At Northwestern Memorial Hospital, he was put on a ventilator twice in the ICU, for a total of nearly two weeks, and remembers having “a lot of hallucinations” — a symptom of delirium.
“I remember vividly believing I was in purgatory. I was paralyzed — I couldn’t move. I could hear snatches of TV — reruns of ‘Law & Order: Special Victims Unit’ — and I asked myself, ‘Is this my life for eternity?’” Quinn said.
Given the extent of delirium and mounting evidence of neurological damage from COVID-19, Khan said he expects to see “an increased prevalence of ICU-acquired cognitive impairment in older COVID patients.”
Ely agrees. “These patients will urgently need to work on recovery,” he said. Family members should insist on securing rehabilitation services — physical therapy, occupational therapy, speech therapy, cognitive rehabilitation — after the patient leaves the hospital and returns home, he advised.
“Even at my age, people can get incredible benefit from rehab,” said Quinn, who spent nearly two weeks at Chicago’s Shirley Ryan AbilityLab, a rehabilitation hospital, before returning home and getting several weeks of home-based therapy. Today, he’s able to walk nearly 2 miles and has returned to work, feeling almost back to normal.
James Talaganis, 72, of Indian Head Park, Illinois, also benefited from rehab at Shirley Ryan AbilityLab after spending nearly four months in various hospitals beginning in early May.
Talaganis had a complicated case of COVID-19: His kidneys failed and he was put on dialysis. He experienced cardiac arrest and was in a coma for almost 58 days while on a ventilator. He had intestinal bleeding, requiring multiple blood transfusions, and was found to have crystallization and fibrosis in his lungs.
When Talaganis began his rehab on Aug. 22, he said, “my whole body, my muscles were atrophied. I couldn’t get out of bed or go to the toilet. I was getting fed through a tube. I couldn’t eat solid foods.”
In early October, after getting hours of therapy each day, Talaganis was able to walk 660 feet in six minutes and eat whatever he wanted. “My recovery — it’s a miracle. Every day I feel better,” he said.
Unfortunately, rehabilitation needs for most older adults are often overlooked. Notably, a recent study found that one-third of critically ill older adults who survive a stay in the ICU did not receive rehab services at home after hospital discharge.
“Seniors who live in more rural areas or outside bigger cities where major hospital systems are providing cutting-edge services are at significant risk of losing out on this potentially restorative care,” said Dr. Sean Smith, an associate professor of physical medicine and rehabilitation at the University of Michigan.
Sometimes what’s most needed for recovery from critical illness is human connection. That was true for Tom and Virginia Stevens of Nashville, Tennessee, in their late 80s, who were both hospitalized with COVID-19 in early August.
Ely, one of their physicians, found them in separate hospital rooms, frightened and miserable. “I’m worried about my husband,” he said Virginia told him. “Where am I? What is happening? Where is my wife?” the doctor said Tom asked, before crying out, “I have to get out of here.”
Ely and another physician taking care of the couple agreed. Being isolated from each other was dangerous for this couple, married for 66 years. They needed to be put in a room together.
When the doctor walked into their new room the next day, he said, “it was a night-and-day difference.” The couple was sipping coffee, eating and laughing on beds that had been pushed together.
“They both got better from that point on. I know that was because of the loving touch, being together,” Ely said.
That doesn’t mean recovery has been easy. Virginia and Tom still struggle with confusion, fatigue, weakness and anxiety after their two-week stay in the hospital, followed by two weeks in inpatient rehabilitation. Now, they’re in a new assisted living residence, which is allowing outdoor visits with their family.
“Doctors have told us it will take a long time and they may never get back to where they were before COVID,” said their daughter, Karen Kreager, also of Nashville. “But that’s OK. I’m just so grateful that they came through this and we get to spend more time with them.”
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For Immediate Release: 10/14/2020
New elder law mini-series with Attorney Anthony J. Enea to present action steps for Older Adults
Albany— 10/14/2020 — The Association on Aging in New York (AgingNY) announce a new bi-weekly video series to be presented by Attorney Anthony J. Enea of Enea, Scanlan and Sirignano, LLP. The elder law video series will begin Monday, October 19, 2020 and run through December 14, 2020.
“We are excited to present the elder law video series to older adults and their families,” said Becky Preve, Executive Director at AgingNY. “It is paramount that older adults and their caregivers have access to education regarding advance care planning and long-term care services and supports. This video series is a tool for individuals and families to utilize when making these important decisions.”
The five part mini-series will present elder law topics in short 10 to 15 minute segments and will be aired on the AgingNY website and social media pages. Attorney Anthony J. Anea will discuss the following topics and action items:
• Don’t Put Your Plans on Hold: Remote Options for Estate Planning (October 19)
• Protecting Assets from the Cost of Long-Term Care (November 2)
• Basic Elements of a Last Will and Testament (November 16)
• What is an Advanced Directive and Do I Need One? (November 30)
• Broaching the Topic of Estate Planning with a Loved One (December 14)
About the Association on Aging in New York
The Association on Aging in New York (AgingNY) supports and advocates for New York’s mostly county-based Area Agencies on Aging (AAAs) and works collaboratively with a network of organizations that exist to promote independence, preserve dignity, and provide support for residents of New York State as they age. For more information, visit www.agingny.org or call 518-449-7080. Facebook: @agingnewyork
About Anthony J. Enea, Esq.
Anthony J. Enea, Esq. is a member of Enea, Scanlan and Sirignano, LLP of White Plains and Somers, New York. Named Westchester County’s Leading Elder Care Attorney at the Above the Bar Awards and Best Lawyers’ 2019 Trusts & Estates “Lawyer of the Year” in White Plains, he focuses his practice on Wills, Trusts and Estates and Elder Law. Mr. Enea is the Past Chair of Elder Law and Special Needs Section of the New York State Bar Association and current Chair of the organization’s 50+ Section. He is the past president and founding member of the New York Chapter of the National Academy of Elder Law Attorneys. Mr. Enea is the president of the Westchester County Bar Foundation and a past president of the Westchester County Bar Association. He can be reached at (914) 948-1500 or at email@example.com.
Association on Aging in New York | firstname.lastname@example.org | 518.449.7080
New York State Office For the Aging Announces Launch of New Online Tool to Help Older New Yorkers and Other High-Risk Individuals Protect Themselves from COVID-19
Public-Private Partnership between New York State Office for the Aging, BellAge, Inc., and Association on Aging in New York
CV19 CheckUp Tool Developed by BellAge Offers Individualized Support Options to Help Reduce Risk and Enhance Quality of Life for High Risk New Yorkers of All Ages: newyork.cv19checkup.org
The New York State Office for the Aging (NYSOFA), in partnership with BellAge, Inc., and the Association on Aging in New York (AgingNY) has announced the launch of CV19 CheckUp in New York State, a free, anonymous, personalized online tool that evaluates an individual’s risks associated with COVID-19 based on their life situation and individual behavior and provides recommendations and resources to reduce those risks.
“There has been a lot of misinformation about COVID-19 and the risks associated with contracting and spreading the virus,” said NYSOFA Acting Director Greg Olsen. “This tool, which we will make available to all New Yorkers, helps individuals understand their risk based on their life situation and personal behavior and offers recommendations to reduce those risks while also connecting people to services, if needed.”
The tool was developed by BellAge to help people be safer, healthier, and ensure their individual needs are met during the pandemic. CV19 CheckUp fills a critical need for a comprehensive resource that educates, advises, and empowers individuals to help protect themselves from COVID-19.
CV19 CheckUp employs artificial intelligence to analyze data each person provides by completing an online questionnaire. It is designed for those who are considered high risk, including older adults, low income individuals, ethnic and racial minorities, and LGBTQ communities. The tool’s algorithms are driven by science and medicine, using data from the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). CV19 CheckUp is free to users. It is anonymous and does not require a name, email address, or identifier of any type.
Upon completion of the anonymous questionnaire, CV19 CheckUp immediately delivers a personalized report.
The report answers questions such as:
Some high-risk individuals are not following all the recommended behaviors to lessen their chances of becoming infected, and some may be experiencing unmet service needs due to Matilda’s Law. And as New York State continues to move forward with reopening, some lower-risk individuals have begun to relax social distancing and practice unsafe behaviors, which threaten the health and well-being of those who are at higher risk.
CV19 CheckUp assesses each person’s unique situation and presents options to help reduce risk and enhance quality of life.
Jim Firman, Chief Innovation Officer, BellAge, Inc., said, “CV19 CheckUp was developed to fill an urgent public need. Our team realized that although there are many resources with information about the virus, all of them require a lot of effort by the user. The average person has to spend considerable time on numerous websites, digging through pages of information looking for answers that are relevant to their specific situation. CV19 CheckUp does the work for them. We developed a hyper-personalized tool that makes it easy for anyone to understand their level of risk and take steps to reduce those risks.”
Becky Preve, Executive Director, Association on Aging in New York said, “The ability to provide this tool to older New Yorkers, their families, and caregivers will ensure accurate information and screening of those at risk. We are extremely excited for this partnership, and for our network to continue to provide such vital services to New York State. The Association on AgingNY is thankful to NYSOFA and BellAge for this innovative new approach to combating the spread of COVID-19.”
Prabhjot Singh, M.D., Ph.D., Chief Medical & Scientific Advisor, BellAge, Inc., said, “As New York continues reopening, at-risk residents need personalized and scientifically sound information to stay safe during the ongoing pandemic. CV19 CheckUp was developed to ensure that every New Yorker has access to guidance that fits their circumstance.”
In addition, through CV19 CheckUp, governments and health organizations also receive data that will help facilitate developing methods to help target populations that are at high risk for COVID-19. Data are completely anonymous, and findings can be used to gain insights on:
About the New York State Office for the Aging and Health Across All Policies/Age-Friendly New York
The New York State Office for the Aging (NYSOFA) continuously works to help the state’s 4.3 million older adults be as independent as possible for as long as possible through advocacy, development and delivery of person-centered, consumer-oriented, and cost-effective policies, programs, and services that support and empower older adults and their families, in partnership with the network of public and private organizations that serve them.
New York is nationally recognized for being the first age-friendly state in the nation. Using the state’s Prevention Agenda as the overarching framework, in 2017, Governor Andrew M. Cuomo launched a Health Across All Policiesapproach, where public and private partners work together to positively impact population health by marrying health care, preventive health, and community design, in concert with addressing social determinants of health, to improve the lives of all New Yorkers, young and old.
Stay connected—download the NYSOFA mobile app for iOS or Android; visit the NYSOFA Facebook page; follow @NYSAGING on Twitter and NYSAging on Instagram; or visit aging.ny.gov.
About BellAge, Inc.
BellAge, Inc. is a public benefit company founded in April 2020 by nationally recognized leaders in aging, technology and artificial intelligence. The company’s mission is to help millions of older adults across the world age better through systems that use artificial intelligence and emerging technologies. BellAge’s first expert system, CV19 CheckUp, was developed to provide hyper-personalized assistance by educating and informing people of their risk levels associated with COVID-19, and offering recommendations about how to mitigate those risks. More information is at https://bellage.org.
About the Association on Aging in New York
The Association on Aging in New York (AgingNY) supports and advocates for New York’s 59 mostly county-based Area Agencies on Aging (AAAs) and works collaboratively with a network of organizations that exist to promote independence, preserve dignity, and provide support for residents of New York State as they age. For more information, visit www.agingny.org or call 518-449-7080.