Addressing Unique Vulnerabilities for Older Adults, Particularly During a Pandemic

The older adult population already faces numerous health-related challenges due to aging alone. Trends exposed early by the COVID-19 pandemic have only become more established revealing the unique vulnerability of an aging population. We now know older adults are statistically at high-risk of contracting the SARs-CoV-2 virus, and comprise the majority of the most serious, fatal cases. Beyond the threat of avoiding infection, long-term care facilities also must address the challenge of organizing vaccination efforts and manage existing conditions of patients. These vulnerabilities call on health care providers, long-term care facility workers, as well as the public and the federal government to make lasting change to improve care and combat rising mortality rates among older adults. The goal being if we are faced with a public health crisis in the future, we are better prepared. 

Recent data shows that patients with Alzheimer disease and other dementias are dying at increasing rates and the health care professionals put in place to care for these same patients are faced with new challenges because of the pandemic. People with dementia are dying not just from the virus, but from the unintended consequences of social isolation that was supposed to protect them. In the “Diving Into Dementia” column, Freddi Segal-Gidan, PA-C, PhD, discusses the need to open the conversation about death and dying with patients, caregivers, and those working in long-term care facilities who are experiencing new levels of death and loss every day.

In this “ECRI Strategies” column, Victor Lane Rose, MBA, NHA, FCPP, CPASRM, emphasizes the steps in designing effective and data-informed vaccination campaigns and discusses the discrepancy between patient and staff vaccination rates. We have seen a variety of global efforts to administer the available COVID-19 vaccines to eligible populations and are now navigating what Mr Rose refers to as the greater good vs individuals’ rights. Vaccine acceptance varies among patients and facility staff and this column explores the question: is the drastic effort of mandating vaccination necessary?

Finally, the feature articles in this issue focus on the unique vulnerabilities faced by older adults regardless of the pandemic. Rohani Manda, MD, and colleagues, review and discuss the management of vulvovaginal disorders in older women, an issue often overlooked or missed, suggesting that increased guidance is needed to improve quality of life for affected patients. Deborah Dowd, RDH, MS, and colleagues, present data on oral health assessments and added risks for older adult patients. Their research includes insight into assessment processes and how to improve oral self-care among long-term care facility residents.