How to talk with older relatives about the COVID-19 pandemic

According to the Centers for Disease Control and Prevention, people over the age of 65 have a greater risk of severe illness from COVID-19, the disease caused by the new coronavirus.

Like many of us, you might be wondering what this means for your parents and relatives in their 60s and 70s. MUSC Geriatrician Amanda Overstreet, D.O., assistant professor in the Division of General Internal Medicine, offers some of her suggestions for talking with older relatives to help them navigate the COVID-19 pandemic.

Q: What conversations should we be having with our older relatives?

Overstreet: Our older relatives should be following the practice of physical distancing as much as possible. We should also be talking about topics that are sometimes hard to bring up—end of life issues. If our older relatives are frail or have serious illness, they are not likely to survive a COVID-19 illness. We should talk about their wishes at the end of life, and make sure we understand their wishes surrounding life support.

Q: Should my older relatives go to routine medical appointments?

Overstreet: In general, the answer is no. They should avoid the healthcare system if possible to minimize their risk of exposure. Most physicians and advance practice providers have the ability to use telephone medicine or video visits, so they should utilize this option whenever possible. 

Q: How can I keep my extroverted dad from getting socially isolated?

Overstreet: I recommend using technology as much as possible. He should be engaged with his social network using any available technology, whether that be by phone, FaceTime, other video applications, etc. I recommend scheduling these social “activities” throughout the week so that he has something to look forward to. This period of social distancing can actually be a good time to catch up with friends and relatives. 

Q: How can I encourage my parents to stay physically active while self-isolating?

Overstreet: Staying physically active is great for both mind and body. I would set a goal each day (a certain step count, length of time, etc). I’ve encouraged my patients to get outside and walk each day. You can easily walk outside and maintain a safe distance from other people while getting exercise. Another option is to sign up for a free streaming exercise class—there are several applications for smartphones that work well for this. Even patients with limited mobility can engage in some form of physical activity while self-isolating.

Q: Should my parents move in with me?

Overstreet: This is a tough one, and probably depends on the unique situation. In general, if your parents were able to live independently before COVID-19, they probably don’t need to move in with you. They do, however, need you to check in with them by phone often and also bring them anything essential (groceries, toiletries, etc). If your parents need help with their activities of daily living (bathing, dressing, toileting, feeding, etc), then you should consider living with them to help.

Q: My parents receive visits from professional caretakers. Should we cancel this service?

Overstreet: If your parents need help with their activities of daily living (bathing, dressing, toileting, feeding, etc), then you should not cancel this service. I would try to limit the number of caregivers as much as possible, and ask that the caregivers disinfect surfaces often. I would also consider asking the caregivers to wear a mask (if available) to minimize their chance of exposing your parents.

Q: What if my older relative develops symptoms of COVID-19?

Overstreet: If your older relative develops symptoms of COVID-19, you should call their primary care physician as well as help them complete a virtual visit via MUSC Health Virtual Urgent Care. The virtual visit will help determine whether they need testing for COVID-19. Their primary care physician can help triage their care by phone, helping you decide whether they need to seek care in the emergency department. Generally, older adults should only seek care in the emergency department if they have significant shortness of breath or extreme confusion/sedation.