Tag Archives: coronavirus

Rural America hit hard by latest COVID-19 wave

When the pandemic first took hold in America, the bulk of cases were in urban areas, like New York City. I remember at the time reading some opinions from those in rural areas of the country, who thought that being a spread out population would protect them from the coronavirus. While that may have protected them somewhat during the early period of the pandemic, the trend have now reversed, with rural areas of the country being overwhelmed by an influx of COVID-19 cases.

Vaccine hesitancy and the political influence of anti-vaxxers and covid deniers in rural America is playing a role in the rise of cases from the delta variant, but that is not the whole story. What we are witnessing are the critical deficiencies in the rural healthcare system. People are dying needlessly because there is not enough space, supplies and staffing to care for them. With the country’s elder population increasing over the next decades, this is an issue that needs prompt attention.

I witnessed the challenges facing those needing medical care in rural areas when I was a caregiver for my parents. There were no memory care facilities with available beds nearby, so my father was transferred to Roswell, over an hour and a half away. This placed a huge burden on my mother when trying to visit him, as she didn’t drive and had to take a bus to make the trip. She was so tired after one grueling trip that she fell in the middle of the night and broke her shoulder. When my father became critically ill, he was transferred all the way to Albuquerque, a three-hour trip from where my parents lived. He died without family present, as my mother was preparing to visit him.

When my mother became ill, the local hospital was unable to perform her surgery, so they transferred her to Roswell. She spent the summer there, recuperating from surgery at a skilled nursing facility. Instead of making the trip back and forth to my parents’ home in Ruidoso, I lived out of a hotel in Roswell for that summer, a pricey endeavor but I learned how important it was for me to be a hands-on caregiver advocate for my mother during that recovery period. Her follow-up care had to be carefully arranged once she got back home, because the oncologists only visited Ruidoso a few days a month. After she died, I learned that the oncologist group discontinued serving the area, forcing those with cancer to travel an hour and a half away for treatment.

Many rural hospitals have closed. Equipment and beds are limited. It’s difficult to recruit doctors and nurses to serve in rural areas. Ambulance services have also been impacted, meaning people die because they can’t get to a hospital fast enough. Specialty services and tests often require lengthy travel, a burden for many families. You can see how these issues create a perfect storm when a pandemic strikes. Many rural healthcare systems now find themselves at the breaking point.

People should be able to age in place where they wish, but they should also be aware of the challenges in aging in a rural area. It will take a mix of public and private funds along with innovative minds to fix the issues plaguing the rural healthcare system, but it is essential and we must take the hard lessons learned during these times to advocate for change.

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This Mother’s Day, reach out to those who are grieving

My mother’s last Mother’s Day in 2015.

The COVID-19 pandemic has left thousands of Americans motherless this year. One model shared in a study published in JAMA Pediatrics suggested the number of children who lost a parent due to the pandemic could be as high as 40,000, a staggering amount in just a year’s time span. On the other end of the spectrum, adult children grieve their elder mothers who died during the pandemic, some who must grapple with the extra pain of not being able to properly say goodbye.

Having lost both of my parents, I do find that Mother’s Day is harder for me emotionally than Father’s Day. I believe this is because my mother died in the month of May, just a couple of weeks after the holiday. My last memories of her before she became bedridden was reading her Mother’s Day card and admiring the fresh flowers I bought for her. Even though this year will mark six years since her passing, those bittersweet memories are still the first to surface when I’m reminded of Mother’s Day via the endless online ads and TV commercials.

I found this essay by Carol Smith on grief and the myth of closure to be compelling and moving.

For those whose mothers are still alive and perhaps will be seeing in-person for the first time in months due to the pandemic restrictions, I am so thrilled for you and I hope you have a wonderful reunion. We know now more than ever that each moment with loved ones is precious.

If you have a friend who may be grieving the loss of their mother, reach out and offer support in whatever way is meaningful to them. It can be a lonely holiday for those whose mothers are no longer alive, and acknowledgment from caring souls can mean so much.

In honor of Mother’s Day, AlzAuthors is offering free Kindle copies of our first anthology Alzheimer’s and Dementia Caregiving Stories: 58 Authors Share Their Inspiring Personal Experiences.

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Pandemic sparks discussion about end-of-life care options

Over a half-million deaths later, Americans may finally be ready to have more frank discussions about death. It is long overdue, and it pains me that it took a deadly pandemic to raise awareness, but perhaps it can be an important legacy of those who we’ve lost over the last year.

I’ve long championed the need to have “the talk” with elder loved ones, and how my parents’ refusal to discuss their end-of-life wishes created unintended but very real consequences. You can read more about my challenges in my collection of personal essays, The Reluctant Caregiver.

The pandemic showed us what many of us don’t want for our deaths: to be alone with no loved ones present, to be hooked up to machines, to die in a hospital instead of at home, to not be given a proper funeral or farewell ceremony. Hopefully we will take time to reflect upon these tragic, lonely deaths and take action now to better articulate what we would like the final phase of our life to look like.

Some may want to consider a death doula. Practically speaking, death doulas are helpers in all aspects of end-of-life care, from the bodily aspects of the dying process to spiritual concerns. They can assist with logistical issues, such as whether a client would prefer to die at home or in a hospice facility, and help coordinate burial and funeral plans. Doulas can serve as a comforting presence for both the dying and their grieving family. While it may seem awkward to bring in a stranger to what is considered a private family affair, having a compassionate, but clear-eyed presence can be a great benefit in an emotionally-charged setting. To learn more about this option, the International End of Life Doula Association offers a Doula Directory.

If you have not done so already, I hope you will take this time to think about how you’d like your end-of-life care to look and document those wishes. Encourage your loved ones to do the same. The coronavirus pandemic denied many the opportunity for a “good” death but by being more open in discussing a previously taboo subject, we can hopefully move towards a better end-of-life experience for all.

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Rural areas finds winning formula for vaccine distribution

Photo by Artem Podrez on Pexels.com

I spend quite a bit of time on this blog discussing the challenges of delivering health care, and in particular, elder care, in rural regions of America. But I want to highlight a recent success story: West Virginia’s COVID-19 vaccination system.

West Virginia, one of the country’s poorest states and ravaged by the opioid epidemic, seems an unlikely source when it comes to innovations in health care. As of this week, 11 percent of West Virginia’s population has received at least the first dose of the COVID-19 vaccine. In comparison, wealthier states such as Massachusetts and California have only vaccinated 7 percent of their populations. Of course population size has an impact, but considering the bumpy rollout of the vaccine nationally, it’s a fairly impressive feat.

What is the key to West Virginia’s success? Simplicity. The state has opted to manage their vaccine program closely at the state level, instead of delegating the entire complex process to county or city governments like many other states. Vaccine supply is distributed to five hospitals in different areas of the state, which then distribute it to local agencies and medical centers familiar with administering other vaccination programs such as the flu vaccine. They’ve also leaned on the state’s National Guard forces for their logistical expertise.

The centralized approach avoids some of the complications that can arise even with well-meaning collaborations from outside agencies. For example, West Virginia was the only state to opt out of a federal partnership with pharmacy chains Walgreens and CVS that assisted states in getting nursing home residents and workers vaccinated. West Virginia instead utilized the local pharmacies throughout their state and were able to complete the process before many states had even began, according to The Washington Post.

West Virginia isn’t the only success story. Rural communities in other states also have shared their vaccination success stories, many using old school tools like the phone and word of mouth to reach out to residents directly. There is often a collaborative effort in small towns, where everyone from the public health officials to firefighters and librarians willing to jump in and do their part, Reuters reported.

The vaccination effort is leading to a decline in nursing home coronavirus cases, according to health officials.

It’s a good thing these rural communities have found a way to get a jump start on vaccinating their residents, as the lack of medical care resources means those who develop coronavirus may not get the specialized treatment they need in time or have to be moved far out of the area. There is also an increasing worry that issues with vaccination supply may mean rural areas have to wait longer for additional supplies, while urban and suburban areas catch up.

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Navigating the COVID-19 vaccine maze for you and your elder loved ones

The good news is that COVID-19 vaccines have been developed in record time and are being rolled out to the public. The bad news is that the distribution of the vaccines is off to a rocky start.

Front-line health care workers and nursing home residents are supposed to be top priority when it comes to the first phase of vaccine distribution, according to federal officials. The problem is that the coordination and management in distributing the vaccines has been left to local governments, meaning each city/county/state has their own rules on how the public can sign up to get the vaccine. New York City residents report facing a ton of red tape in trying to make an appointment. Some regions have online only appointment systems, which can be a roadblock for those who are not tech savvy. The strict temperature requirements for the vaccines mean that in certain cases, places open up vaccinations to anyone, in order to avoid having to discard spoiled doses. The chaos that has ensued and the lack of efficient communication at the local level has left some elders to contact their local media outlets for assistance in setting up a vaccine appointment.

In short, it’s a mess. I do have some hope that more stable leadership at the federal level will help iron out the vaccination rollout. Getting the pandemic under control will be the top priority, and there should be a greater willingness to partner with local governments to support the success of their vaccination programs. This truly needs to be a group effort. The more effective the vaccination program is, the quicker people can return to the lives they cherish, including spending time with family and supporting the businesses in their community.

So if you are an elder or an elder caregiver, where do you begin? Start with your family physician, who can confirm which vaccine phase group you are in, and offer a general timeline on when you may be eligible to receive the vaccine. Next, reach out to your local health department. Policy & Medicine offers this state-by-state list of local health department resources. Be patient, as websites and hotlines are overwhelmed right now. As the vaccine stockpile grows, there will be more places that will offer the vaccine, including pharmacy chain stores like CVS. Finally, don’t skip the second (booster) shot! It is necessary for the vaccines currently available to the public. I’ve seen several news reports of a steep decline in the rate of people returning to get their second vaccine dose. While a single dose will offer some protection, two doses are necessary for the most effective protection. Johnson & Johnson is working on a single dose vaccine, which hopefully will gain approval soon.

If you or your loved one has received the vaccine, please comment below about your experience.

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Remember those mourning amid holiday cheer

It’s the ninth anniversary of my father’s death, and that also means it is time for my annual PSA (public service announcement) about being gentle and non-judgmental with those who choose not to celebrate the holiday season because they’ve lost someone during this time of year.

The coronavirus pandemic that has claimed more than 300,000 lives in America will put a damper on this year’s festivities. But I also noticed the opposite effect, with neighbors putting their Christmas decorations up well before Thanksgiving. Both are natural reactions and we should respect the way individuals choose to cope.

This year as I reflect upon the anniversary of my father’s death, I remembered a detail I came across in a card he had attempted to write one of his sisters, but no longer had the cognitive function to address and mail. He had written in the card that he had been diagnosed with the swine flu. He had not received such a diagnosis, but the H1N1 pandemic was in the news at the time. Dad had latched on to that to explain what was happening to his body. That memory came back strong this year as the coronavirus pandemic unleashed its fury across the world.

Related to the pandemic and the need to wear masks, I also am reflecting on the fact that Dad would likely have been anti-mask. In 1986, when I was 12, wearing seat belts became mandatory when driving a vehicle in California. I remember many heated arguments in the car because of my father’s stubborn refusal to put on his seat belt. He claimed wearing the belt was constricting and made him feel like he was choking. Sound familiar this year? As an ill-advised compromise, Dad would drape the belt over his torso, but not latch it. Fortunately we never had any serious accidents. According to the Los Angeles Times, my father was part of the majority who at the time did not wear seat belts on a regular basis.

It has been the strangest and most challenging of years and the holiday season is no different. Connect with those you love however you can safely. Offer words of comfort and healing to the many who are grieving.

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Being grateful in a year of turmoil

It will be a different kind of Thanksgiving celebration this year for many families. Smaller gatherings, not getting to hug elder loved ones, some spending the holiday in isolation.

I hope by this time next year, we will largely have put the coronavirus epidemic behind us. Having spent almost the entire year in its grips, we must be resilient for the next few months as vaccines become available. I know many are understandably exhausted, but there does appear to be a light at the end of this tunnel.

There are many things to be grateful for this year.

I am grateful to the healthcare workers, from the ICU nurses to nursing home staff to home health aides, who put their lives on the line each and every day to take care of the rest of us. That is an awe-inspiring sacrifice. (To the thousands who lost their lives to COVID-19 while caring for others, I express my gratitude to their grieving families.)

I am grateful to all of the frontline workers, from grocery store clerks to transit employees to those in food production and utilities. They kept the rest of us who were isolating at home up and running, so we could continue doing our jobs and taking care of our families.

Of course I want to give thanks to the family caregivers. The stress and anguish they have gone through this year is devastating. I’ve read so many heartbreaking accounts of families not being able to visit loved ones in nursing homes because of lockdowns. Watching their loved ones physically and mentally decline via Zoom or standing outside, separated by a glass door or window is something no one should ever experience. Many families couldn’t even be with their loved ones as they died. For those caring for vulnerable family members at home, every sniffle put one on high alert. Trying to keep loved ones at home healthy, comfortable and entertained while reducing their risk of infection is a monumental task. Many caregiver resources have been limited or shut down due to the pandemic, leaving families to fend for themselves.

This Thanksgiving, I hope you are able to find some joy and comfort, even if your celebration has to be altered due to the pandemic. As a token of gratitude, I am participating in a book giveaway. Both The Reluctant Caregiver and CBD for Caregivers are available for free.

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National Family Caregivers Month: Honor, take action

November is National Family Caregivers Month. This year’s theme announced by the Caregiver Action Network is “Caregiving in Crisis.” It’s an appropriate theme as the coronavirus pandemic has propelled family caregiving into the national spotlight. In 2020, many Americans found themselves as caregivers for the very first time.

This year’s election was dominated by the coronavirus pandemic. The new administration will have its hands full in trying to bring the pandemic under control, while initiating economic reforms to stabilize the economy. Once again, caregivers play a critical role in both areas.

Here are a few high priorities on my caregiver wish list:

  • Increased financial support for family caregivers: With unemployment rates still high due to the pandemic, it is critical that we offer ample funds and other benefits to those family caregivers who are at financial risk. You cannot care for others if you can’t care for yourself first.
  • More affordable health care options: The ACA was a start, but has significant gaps. The haphazard federal response so far to the pandemic has left some people with pricey medical bills. Hospitals are closing in rural areas when medical care is needed the most. If we’ve learned nothing else from 2020, it is that affordable and accessible health care is a critical need.
  • Increased pay, benefits for professional caregivers: Family members cannot do it all on their own. But the caregiver workforce in America is woefully underpaid. We must improve the pay, benefits and educational opportunities for caregivers so we can attract the best people to these jobs which the pandemic has illustrated are of immense importance.
  • Build a modern eldercare infrastructure: Our population will continue to grow older, live longer and the majority of people want to age in their own homes. We’ll need to develop accessible housing, strengthen our home care network and improve elder resources, especially in rural areas, so that people can grow old where they want, but safely and with ample support.

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Happy Halloween: May there be more treats than tricks

Many may have mixed feelings about celebrating Halloween in such a difficult year that has been filled with so much real-life horror and death. For those who have lost a loved one, the sight of neighbors decorating their lawns with grave and skeleton decorations may seem insensitive. For those who have children or others in their lives who love celebrating the holiday, it may be important to maintain some semblance of normality.

I definitely feel both of these perspectives when I take the dog on neighborhood walks. Some decorations are quite elaborate and creative, and make me smile. Then I feel an inward cringe when I see the grave markers with RIP stamped on them. I can’t help but think of all of the lives lost this year due to the coronavirus pandemic.

Personally, I love Halloween and enjoy the spooky decorations more than Christmas ones. But I remember feeling a similar ambivalence about Halloween the year my mother died, though she died months before the holiday. I instead focused on the happy Halloween memories we had as a family.

I also had a critical reaction to seeing Christmas decorations being put up at the hospital where my dad lay dying in the ICU. When you are in a family health crisis mode, your perspective narrows. How dare all of these strangers celebrate the holiday when my dad is dying? Realizing the world doesn’t stop for you is a tough, but necessary lesson to learn.

Happy Halloween to those who do celebrate, and hope you receive all treats and no tricks. And if you are grieving and struggling with seeing Halloween decorations, I understand. I hope you can have a quiet night honoring your loved one’s memory.

A free treat for all: You can get both of my books, The Reluctant Caregiver and CBD for Caregivers, for free through this Halloween giveaway.

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Make a plan to vote now

This is not going to be a partisan political post. I truly believe senior care and caregiving is a bipartisan issue and will take the cooperation of members of all parties in order to pass much-needed legislation.

But the pandemic that has changed so much in 2020 is also changing the way we vote. How you vote and where you vote depends upon your local jurisdiction and personal preference; my only advice is to plan now if you haven’t voted already.

There are arguments to be made for and against the various forms of voting available this year. Here in Georgia, I took advantage of absentee voting and have already mailed in my completed ballot. Thanks to technology, I was able to monitor its progress and received electronic notification when it had been received and approved for processing.

For those who prefer to vote in person, check out your options for early voting. Many states are offering expanded voting locations and it may be a good way to avoid potentially long lines on election day. If you decide to go the traditional route and vote on Nov. 3, be prepared to wait in long lines. Hopefully it won’t be as bad as recent elections, due to the massive amount of people who are voting early this year.

And caregivers should keep COVID-19 in mind when making a voting plan, for yourself and your loved ones. Weigh the risks and comfort level when making your voting plan. Check with assisted living centers to see if they have a plan to help residents vote. For those needing a ride to vote, check out promotions from Uber and Lyft. Make sure to mask up if voting in person, and use hand sanitizer after touching the machine. The one caveat I would point out about waiting until election day to vote is with coronavirus cases on the rise in many areas of the U.S., do you want to run the risk of being sick and missing out on the chance to vote? Just something to consider.

After the election, the real work begins on working with those elected to create sensible, practical caregiving policies that offer families the support they deserve.

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