Reconnecting: Strategies for Supporting Isolated Older Adults during COVID-19 through Tele-palliative Care

ABSTRACT

The COVID-19 pandemic has resulted in unprecedented levels of social isolation which has negatively impacted older patients in particular on multiple levels. We present a case of an older patient with several complex psychosocial issues who was hospitalized and died from COVID-19. The social isolation required during the pandemic compounded patient and family stressors and diminished the patient’s access to clinicians and to his usual support network and coping strategies. We describe how technology and tele-palliative care were utilized to reconnect the patient with clinicians and family and to provide clinical care that enhanced coping skills and support. Using telemedicine to restructure the approach to care was crucial in improving multiple domains of care and can be considered a resource for caring for older adults, especially during the challenging times brought on by the COVID-19 pandemic.

KEYWORDS:

• Telemedicine
• end of life
• geriatric
• aging
• coronavirus
• social isolation
• caregiver

Acknowledgments

The authors thank Ms. Angie Lam for assistance with manuscript preparation and Mr. Jonathan T. Goebel for rendering the graphics.

Clinical implications

• This case highlights how palliative care can be adapted to address challenges in caring for vulnerable older adults in the setting of COVID-19.

• The COVID-19 pandemic increases patient isolation and distress via decreased family and staff in-person visits, severe physical symptoms, rapid deterioration in clinical status, and prognostic uncertainty.

• Clinicians can adapt to these challenges through maximized use of technology for communication and interdisciplinary team interventions to provide biopsychosociospiritual support.

• Mental healthcare and palliative care can be adapted via telehealth visits to maximize patient care in this new norm of social distancing.

Disclosure statement

The authors report no conflicts with any product mentioned or concept discussed in this article. The authors report no funding.