By Jennie Griggs, MA, Founder/Principal at Aging Collective
Suzy Kassem once said, "You are never too old to learn something new, or too young to learn too much.” Until March of this year, our well-being was not entirely determined by technology. Today, with the pandemic, technology serves as the primary means for the aging population to communicate. Think about it. Today during this sequestration without technology, we could not communicate, socialize, exercise, worship, order food, go to school, or receive medical treatment and advice.
Throughout my life and vocations, I have continued to try to learn something new and been excited to be able to better my skill sets through the latest technical tools. Although I must say, it has never come easy for me and many in the older generation. I know that as a result of new practices within the IT arena, we are more efficient, can communicate on a higher level, and accomplish tasks that otherwise would never have been feasible. Yes, for many boomers and older generations, the continually changing adaptation to technology has been a struggle, and numerous members of the aging population refuse to learn. I admit that, but let's look at this a bit differently. Most older people can communicate in ways that do not depend on technology. Although a strong supporter of technology and Telemedicine, I admit to feeling a bit different after my observations and personal experiences during the pandemic. With that said, I would like to share both sides of the story.
I am fortunate to be the Program Director for the Northern and Eastern Wake Senior Centers. Every day it seems that God winks at our team, presenting solutions to issues we are facing. We have been able to aid the aging population with issues from hunger to depression. In most cases, this could not have occurred without platforms such as Zoom, Facebook, YouTube, our websites, or even cell phones. Without such capabilities, engagement with the aging population during this time of sequestration could not have occurred. For that reason, we immediately developed training programs utilizing high school volunteers to assist our members in understanding and being able to participate through these various virtual platforms.
I am fearful that many active aging adults have stopped being active and social because of today's pandemic lifestyles. Dependence and habits based on virtual solutions may be hard to change as well as being unhealthy. If they get out of the practice of socializing, going to the gym senior centers or church, will they ever regain their healthy lifestyles? Did you know: On average, it takes more than two months before a new behavior becomes automatic — 66 days to be exact. And how long it takes a new habit to form can vary widely depending on the behavior, the person, and the circumstances." (Clear,2020). Potentially, we will have experienced this new habit for more than three months. So will the new habits outweigh the old?
Secondly, in my role as a geriatric care manager, I want to make everyone aware of this. I experienced telehealth during this fearful COVID19 time. Until my personal experience, I was a promotor of the new system. I must tell you that I was woefully discouraged at what occurred with my client. He had been losing weight and showing signs of decline for some time. One evening he could not breathe, and his blood pressure was very high, so we rushed him to the hospital. He was treated and released because of the pandemic. We went to his primary care a few days later. Upon examination was told he needed additional testing for cancer and other possible issues. Because of the virus, his visit to have further testing never occurred. The solution was a Telemedicine conference. I was excited to engage in one first hand. I must tell you that the results of the conference call left me as a professional caregiver feeling helpless and frustrated.
These are the things we need to understand regarding Telehealth, which is undoubtedly a solution. However, I do not believe this platform is universally ready to address the aging population, and here is why:
1) Only 4% of seniors surveyed have had a video-based Telehealth visit with a doctor via smartphone or computer (Poll, 2019)
2) Only 49% of video visits are successful for various reasons. (Porter, 2019)
3) Ageism "permeates the attitudes of medical providers, the mindset of older patients, and the structure of the health care system, having a potentially profound influence on the type and amount of care offered, requested, and received. (Seeert, 2019) .
4) Technological interventions may not be "person-centered." This philosophy demands that interventions match the specific needs of the individual senior. For example, providing a hearing aid can improve communication and reduce loneliness. If there is a hearing problem, phone contact and Web-based support programs are less than positive towards the well being of the patient.
5) There are few geriatric clinical specialists in our healthcare system today. In fact, "there are roughly 7,300 certified geriatricians currently practicing in the U.S. today. Unfortunately, the American Geriatrics Society expects 30,000 geriatricians will be needed by 2030.” ( Castellucci, 2018). Not to mention, few physicians want to take Medicare and Medicaid today due to simple economics.
6) “Communication can also be hindered by the normal aging process, which may involve sensory loss, the decline in memory, slower processing of information, lessening of power and influence over their own lives, retirement from work, and separation from family and friends. At a time when older patients have the greatest need to communicate with their physicians, life, and physiologic changes make it the most difficult.” (Robinson, T., White, G., & Houchins, J.,2006).
The last two points defined my personal Telehealth experience with a 72-year-old client. I had the Health Care power of attorney, which was already documented in the system. Never once in the conversation, although the physician knew I was there, did a question come my way, or was I allowed to comment. My client has been hindered by the normal aging process, which was never addressed in the conversation. His cognitive abilities have been affected. They asked him how was he feeling; he said better. The real issues impairing his well-being and needed future treatment were never discussed. The physician had forgotten that my client may have been subjected to Agent Orange as a result of two tours in Vietnam, or had cancer as a result of being a smoker for the majority of his life. Wanting desperately to get off of the phone and not communicate, my client accepted the clinician’s solution, “We will extend your medications.” The underlying issues regarding his near death experience when he was taken to the emergency room because he couldn’t breath were never addressed. Neither were the reasons he may have lost 30 lbs in a short period of time. The conversation ended at least until we have to rush him to the emergency room the next time.
I ask you, is Telehealth a gift or a curse that can minimalize our aging population?
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