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Coming out of the pandemic, some seniors may need rehab

  • TRIBUNE NEWS SERVICE
                                Large numbers of older adults have become physically and cognitively debilitated and less able to care for themselves during 15 months of sheltering in place.

    TRIBUNE NEWS SERVICE

    Large numbers of older adults have become physically and cognitively debilitated and less able to care for themselves during 15 months of sheltering in place.

Ronald Lindquist, 87, has been active all his life. So he wasn’t prepared for what happened when he stopped going out during the corona­virus pandemic and spent most of his time, inactive, at home.

“I found it hard to get up and get out of bed,” said Lindquist, who lives with his wife of 67 years in Palm Springs, Calif. “I just wanted to lay around. I lost my desire to do things.”

Physically, Lindquist noticed that getting up out of a chair was difficult, as was getting into and out of his car. “I was praying, ‘Lord, give me some strength.’ I kind of felt, I’m on my way out — I’m not going to make it,” he admitted.

One little-discussed, long-term toll of the pandemic: Large numbers of older adults have become physically and cognitively debilitated and less able to care for themselves during 15 months of sheltering in place.

No large-scale studies have documented the extent of this phenomenon. But physicians, physical therapists and health plan leaders said the prospect of increased impairment and frailty in the older population is a growing concern.

“Anyone who cares for older adults has seen a significant decline in functioning as people have been less active,” said Dr. Jonathan Bean, an expert in geriatric rehabilitation and director of the New England Geriatric Research, Education and Clinical Center at the Veterans Affairs Boston Healthcare System.

But many older adults might be able to realize improvements if given proper attention.

“Immobility and debility are outcomes to this horrific pandemic that people aren’t even talking about yet,” said Linda Teodosio, a physical therapist and division rehabilitation manager in Bayada Home Health Care’s Towson, Md., office. “What I’d love to see is a national effort, maybe by the CDC (U.S. Centers for Disease Control and Prevention), focused on helping older people overcome these kinds of impairments.”

Dr. Lauren Jan Gleason, a geriatrician and assistant professor of medicine at the University of Chicago, said many older patients have lost muscle mass and strength this past year and are having difficulties with mobility and balance they didn’t have previously.

“I’m seeing weight gain and weight loss, and a lot more depression,” she noted.

Mary Louise Amilicia, 67, of East Meadow, N.Y., put on more than 100 pounds while staying at home round-the-clock and taking care of her husband, Frank, 69, who was hospitalized with a severe case of COVID-19 in early December. While Amilicia also tested positive for the virus, she had a mild case.

“We were in the house every day 24/7, except when we had to go to the doctor, and when he got sick I had to do all the stuff he used to do,” Amilicia said. “It was a lot of stress. I just began eating everything in sight and not taking care of myself.”

The extra weight made it hard to move around, and Amilicia fell several times after Christmas, fortunately without sustaining serious injuries.

After coming home from the hospital, Frank couldn’t get out of a chair, walk 10 feet to the bathroom or climb the stairs in his house. Instead, he spent most of the day in a recliner, relying on his wife for help.

Now the couple is getting physical therapy from Northwell Health, New York state’s largest health care system. Just before the pandemic, Northwell launched a “rehabilitation at home” program for patients who otherwise would have seen therapists in outpatient facilities. (Medicare Part B pays for the treatments.)

Sabaa Mundia, a physical therapist working with the Amilicias, said Mary Louise can walk up to 400 feet without a walker, after doing strengthening exercises twice a week over the course of three weeks. Frank had been using a wheelchair and is now regularly walking 150 feet with a walker after more than a month of therapy.

“Older adults can lose about 20% of their muscle mass if they don’t walk for up to five days,” Mundia said. “And their endurance decreases, their stamina decreases and their range of motion decreases.”

In California, Member2Member, a SCAN Health Plan program, pairs older adult “peer health advocates” with members who have noted physical or emotional difficulties on health risk assessments. That’s how Lindquist in Palm Springs connected with Jerry Payne, 79, a peer advocate who calls him regularly and helped him come up with a plan to emerge from his pandemic­-induced funk.

“First, he said, ‘Ron, you should try getting up every hour and taking a few steps’ — that was the start of it,” Lindquist said. “Then he’d suggest walking another block when I would take my dog out. It was painful. Walking was not pleasant. But he was very encouraging.”

A month ago Payne had a Fitbit sent to Lindquist. At first Lindquist walked about 1,500 steps a day; now he’s up to more than 5,000 steps a day and has a goal of reaching 10,000 steps. “I’m sleeping better, and I feel so much better all around,” Lindquist said. “My whole attitude and physicality has changed. I tell you, this has been an answer to my prayers.”

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KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues.

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