While the nation continues to grapple with the growing COVID-19 pandemic, one fact is particularly worrisome. Older adults who contract the virus are dying at much higher percentages than younger people.
Minority Nurse turned to experts with the Gerontologic Advanced Practice Nurses Association (GAPNA) to understand the risks associated with COVID-19 and how nurses can work to protect their patients and themselves.
“The effects of aging have a major influence in the response to a respiratory virus or bacteria,” says Michelle Moccia, DNP, ANP-BC, CCRN, GS-C, and GAPNA’s past president. “As one ages the immune system is less responsive to a virus or bacteria with an inflammatory response to fight off the virus and/or tolerate the complications from the virus. The elderly have limited cardiopulmonary reserve thus a compromise in airway and breathing can lead to the inability to breathe thus predisposing individual to complications such as pneumonia.”
And as the medical community gains more understanding about this particular virus, other factors are emerging, says Deborah Dunn, EdD, MSN, GNP-BC, ACNS-BC, GS-C, and GAPNA’s president. “Some experts have theorized that in addition to the pneumonia burden there may be an increased or exaggerated lung inflammatory response to COVID 19 in older adults – leading to the severe respiratory distress and failure seen in older adults.”
What can people in those specific age categories do? “It is best for older adults to avoid crowds,” says Moccia, noting the oft-heard advice about washing hands, staying home if you’re sick, and avoiding others who are ill holds true. And Dunn notes that if a loved one is in a facility and the facility restricts visitors, it’s going to be important to keep up communication with loved ones to keep anxiety and social isolation at bay.
“Prevention and control of the spread of COVID-19 rests on halting transmission,” says Dunn. “Nurses know that in the healthcare setting they play a key role in stopping transmission by frequent handwashing, avoiding droplet contact, and early identification, triage, treatment, and quarantine of persons who may have infection.”
Both Dunn and Moccia say nurses should be especially careful to wash their hands before and after entering a patient’s room, wearing gloves when contact with bodily fluids/blood/secretions may occur, practicing needle precautions, and wearing protective equipment if they are in contact with a patient who has or is suspected to have COVID-19.
As patient advocates, nurses can educate patients and their families. Nurses can help patients with personal hygiene like washing their hands, using hand sanitizer, and disposing of used tissues, says Dunn. Protecting their health while giving them some control also helps with the uncertainty and anxiety people are feeling right now.
“Families with older adults in care settings such as assisted living facilities or nursing homes want to know that their loved ones are being cared for and having their needs met,” says Dunn. “Nurses working in these facilities should facilitate communication about the measures being taken to protect patients from infection, why adherence to the measures is needed, and reassure families about the status of their loved ones health.”
As nurses work through this unprecedented outbreak, they can keep updated with the CDC website about COVID-19. Nurses who work with infectious and contagious illnesses know that staying current with continuing education can be life saving—for them and for their patients. “Nurses in acute care settings and other healthcare setting where they may care for patients with contagious conditions that require face masks during care should be fitted for the N-95 mask and be trained in the proper wearing of the mask,” says Dunn.
As COVID-19 works its way around the globe, the medical community is working hard to prevent the spread, educate the public, and even offer some hope.
“I’m sure we will see a lot more information from infectious disease experts,” says Dunn, “as they are studying COVID-19 underlying physiologic mechanisms closely and develop targeted treatments.”