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Losses and Learning

In April 2020, someone in my life died of COVID-19 in a hospital in the Detroit area. She was in her 80s, lived her life for her family, and did not have any of them with her when she died. After entering the Emergency Department without her husband because of COVID-19 restrictions, she was treated for a week or more for a non-COVID-19 related medical condition. After surgery and time in recovery, she developed a pneumonia that was the result of contracting COVID-19, likely in the hospital. Her husband of over 60 years got telephone reports on her condition and eventually took the call that she died.

This death has left me completely undone. The thought of my loved one dying in the hospital without the family she held so dear haunts me. It brings tears to my eyes if I let my mind go to this scenario. I’ve been on the verge of tears weekly and more recently, several times a day although her death took place over a year ago.

Recently, in my role in a health system, I had the opportunity to listen to the experience of nurses who worked in the COVID-19 units during the height of the 2020 pandemic. One nurse shared that the greatest trauma for her is that families didn’t see how hard they worked, how much they cared, and how deeply they cried. This has left the care teams looking for connection and resolution with families of individuals who died of COVID-19.

Through counseling, I was able to connect what I wanted most for my loved one and what the care team felt they gave. I have a new sense of peace and I hope that those who were unable to be present with a loved one will find ways to connect with the loving compassion of the health care teams that have been working so hard.

Three things to learn about this week:

  1. CDC COVID Tracker – the pandemic is still killing people, keep yourself knowledgeable
  2. Experience of Nurses During the COVID-19 Pandemic – learn about the trauma nurses experienced
  3. Managing Grief and Loss During COVID-19 – learn about the complexities of grief and loss during COVID-19

Photo by engin akyurt on Unsplash

I’m Hearing You

Over the last few years, several of my loved ones have decided to get hearing aids (finally!). With an improvement in their hearing, they are more engaged in our conversations and seem very happy with their decision. However, it was not an easy decision for them and it took them a longtime to take the step of using hearing aids. Interestingly, less than one in three older adults age 70 or more who have hearing loss and could receive help from hearing aids have ever used them. In fact, nearly 30 million Americans could benefit from hearing aides but do not use them. Primarily, this is because hearing aids can be expensive, difficult to access, and have a stigma associated with them. While these barriers have impacted the quality of life for older adults, improvements are on their way.

Hearing aids can cost thousands of dollars that are not covered as a Medicare benefit. Individuals often must travel to a hearing specialist to receive testing and a prescription for hearing aids. But now, the FDA is working on regulations to allow manufactures to sell hearing aids directly to individuals. This could lead to less expensive hearing aids sold over the counter to people who need them. If more people can afford and access hearing aids, the public perception of hearing aids could improve.

Untreated hearing loss is linked with depression and social isolation in older adults. Reducing the barriers to hearing aids is important to ensure that people have the best quality of life possible. We must all acknowledge the need for less expensive, easier to access hearing aids and work to find solutions to reduce stigma.

Three things to learn about this week:

  1. Quick Statistics About Hearing
  2. Impact of Hearing Loss on Quality of Life in Older Adults
  3. Untreated Hearing Loss Linked to Depression, Social Isolation in Seniors

Photo by Annie Spratt on Unsplash

Getting Back to Health

Now that many people are getting vaccinated and there is a significant decline in the spread of COVID-19, I have begun to re-think my health habits over the last year. In May, after months of delay, I scheduled my cancer screenings and annual physical. I have had to be very intentional about shifting back into healthy routines after a year of disruption. I am not alone; in one study, 61% of adults reported gaining undesired weight, 23% reported drinking more alcohol, and nearly half of adults skipped medical screenings or appointments over the last year. Physicians are now urging us to return to our preventive care, cancer screenings, and healthy behaviors.

At the same time physicians are genuinely concern about the stress levels and poor mental health that Americans are experiencing. Feelings of grief, traumatic experiences, and prolonged stress are leading to an increase in serious mental distress. Essential workers, people of color, LGBTQ individuals, and parents of young children are disproportionally impacted. We need to understand that life will never look and feel the same as it did prior to 2020. For many, professional mental health services are needed to begin to process and heal from the events and experience of the last year. General advice is to remember that you are not alone; attempt to rekindle your purpose and passions; and use techniques such as prayer, meditation, and mindfulness to begin to cultivate resilience.  

Self-care and a focus on wellbeing are important strategies to rebuild your health. Experts suggest creating daily rituals, healthy habits, and exercise routines. There are many articles, videos, and apps that can help you as you get started. While helpful, they do not take the place of trained mental healthcare workers. We must all acknowledge the need for many more trained mental healthcare workers and work to find solutions of increasing their numbers and availability.

Three things to learn about this week:

  1. A New Wave of Pandemic Health Concerns
  2. Why Mental Health Won’t Just Go Back to Normal
  3. How to Replace Pandemic Bad Habits and Get Healthier Now

Photo by Amauri Mejía on Unsplash

What We Can Learn About Treatment and Avoiding Care During the Pandemic

During the pandemic, I, like so many others, delayed medical screenings and was hesitant to seek treatment. According to research, 41% of patients delayed or missed visits, including preventive care, medical and mental health appointments, and medication refills. Over 60% of these individuals reported the medical office was closed or unavailable, over 50% also feared exposure to COVID-19, and a smaller percentage could not afford care.

For some people, waiting for treatment or timely testing had detrimental health effects. For heart attacks, strokes, and other significant medical events, every minute counts and delays can have significant consequences. For high-risk individuals, a delay in cancer screenings could mean a malignant growth has time to advance. Americans may be emerging from the pandemic with unresolved and untreated issues as well as mental health problems from isolation and trauma.  

At the same time, no harm was created by delays or avoidance of care for many individuals. The last 18 months have created an opportunity to create something entirely new, a robust database to compare individuals who received a particular test or treatment with those who did not. It allows medical researchers to re-examine whether many procedures are necessary. Prior to the pandemic, physicians reported that a median of 20.6% of overall medical care was unnecessary, including 22% of prescription medications and 24.9% of tests.

The public health crisis and all its repercussions give us the opportunity to research and understand which treatments and screenings are important and which are areas of unnecessary treatment. We need to call for unbiased, non-financially motivated, and politically neutral research to ensure that Americans have access to the treatment and testing they need while not being subject to those that are unnecessary.

Three things to learn about this week:

  1. Why 41% of Patients have Skipped Care During the Pandemic
  2. Overtreatment in the United States
  3. Pandemic Leads Doctors to Rethink Unnecessary Treatment

Photo by Hush Naidoo on Unsplash

Enough bars

For me, it is easy to imagine using technology to access healthcare, work remotely, and connect with educational resources. However, many communities near me, both rural and in cities, do not have the easy access to broadband internet that I have enjoyed. This became clear during the public health emergency of the last year. Children had to transition to virtual learning, many workers had to work from home, and health care services transitioned to telehealth wherever possible. Virtual learning, work, and telehealth, however are only successful if the broadband that people rely upon is available.

Broadband connectivity is a policy issue that we must follow and advocate for to close the gap between those who have access and those who do not. Often these gaps match the racial, poverty, and rural divides affecting health equity in our country. At this point in our technical advancements, shouldn’t we work towards all Americans being able to afford and have access to reliable broadband internet services? Doesn’t this only expand our ability to educate, employ, and support our citizens?

Congress is interested in accelerating access to the internet. There are also federal agencies such as the Federal Communications Commission (FCC) that play an important role in high-speed internet projects. In fact, currently, there is an FCC program called the Emergency Broadband Benefit to help families and households struggling to afford internet service during the COVID-19 pandemic.

We need bipartisan leadership and support to ensure that American have access to the internet for learning, work, and wellness. Please learn more and contact your representatives.

Three things to learn about this week:

  1. Emergency Broadband Benefit
  2. Accelerating Broadband Connectivity Act of 2021
  3. Connect for Health Act of 2021 Summary

Photo by NASA on Unsplash

Hello…Telehealth?

During the pandemic, medical providers and their patients had to quickly transition to telehealth platforms to communicate instead of in-person office or clinic visits. My mother had a knee replacement on March 10, 2020. She was scheduled to have physical therapy in the local rehabilitation center the week after she returned home from the hospital. Unfortunately, the medical facility closed due to the pandemic. My mother and the physical therapist had to quickly adapt to telehealth visits. Initially, the health care system did not have a process for physical therapy telehealth. They started with phone calls without video for several weeks before moving to FaceTime on an iphone and ipad, and eventually Zoom visits. This allowed my mother to receive her needed physical therapy and exercise guidance. She has recovered and is now enjoying strolls with my father.

Recently, a bipartisan group of 50 senators reintroduced a bill to ensure that Americans continue to have access to telehealth following the Public Health Emergency. Titled the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021, the legislation will expand coverage of telehealth services through Medicare. It will also make permanent the telehealth flexibilities made possible during COVID-19. Additionally, CONNECT for Health Act aims to improve health outcomes and make it easier for patients to safely access their medical providers through technology.

The CONNECT for Health Act was first introduced in 2016. Our world changed dramatically during the COVID-19 pandemic. During that time, the use of telehealth sharply increased so that people could avoid hospitals and other health care settings. Now, we can readily see the benefits from ensuring access to telehealth care in the home.  Sir Winston Churchill said, “never waste a good crisis.” The expansion of telehealth may be one of the positive outcomes from our last year.

Three things to learn about this week:

  1. Trends in the Use of Telehealth in 2020
  2. CMS Flexibilities to Access Telehealth
  3. Connect for Health Act of 2021 Summary

Photo by Roberto Nickson on Unsplash

Keeping Care at Home

Imagine having to move from your home and your loved ones to get the care that you need to survive. For many Americans, this becomes a reality at a time when moving to a care facility causes additional stress, confusion, and decline. Currently only a patchwork of a home and community-based services system exists through Medicaid waivers. The system is based on outdated laws and does not meet the needs of everyone requiring long-term services. It also does not sufficiently support the caregiver workforce.  Wouldn’t a system of less expensive home-based care be better in many situations?

Recently, the Offices of Senators Hassan, Brown, and Casey and Representative Dingell sought comments and suggestions from stakeholders on a draft bill called the Home and Community-Based Services Access Act. This bill would help to establish a criteria for the delivery of home and community-based services across the country. It would create a minimum standard of services nationally while states can enhance the services as part of Medicare. It would also assist states in creating a critical network of providers and homecare workers. Given the growing demand for these services, and the scarcity of a workforce, it is critical to create a strong, sustainable foundation for home and community-based services for people who need the care and those who can provide it.

As we work in our communities, states, and country to improve home and community-based services, let’s look for new and creative ways to ensure there is a foundation of care for our friends, neighbors, and family. We need workforce development, sufficient wages and benefits for caregivers, supports for family caregivers, and policy decisions that strengthen our care delivery system. We also need to ensure the continuation and expansion of successful programs such as Money Follow the Person and the Program of All-Inclusive Care for the Elderly (PACE).

Three things to learn about this week:

  1. Home and Community-based Services Access Act
  2. Money Follows the Person
  3. Program of All-Inclusive Care for the Elderly (PACE)

Photo by Scott Webb on Unsplash

Aging Policy Opportunities

macro photography of brown plank

Many of us have experienced a difficult year. However, older adults faced challenges that many others did not experience. Older adults were more vulnerable to serious illness and death from COVID-19. The virus spread quickly in nursing facilities creating a third of the deaths in Michigan alone. Prior to the pandemic, as a country, we needed to make improvements to address the needs of the growing number of adults over 80 years old and our aging population. The imperative to improved aging policy was amplified by the challenges highlighted over the last year. 

Key aging issues that face our country, community, and our neighbors include rising health care costs, poorly coordinated treatment, and a lack of person-centered center. Our country’s long-term care system depends on a financial model that impoverishes people until their assets are depleted and Medicaid becomes the payer.  Family caregivers attempt to provide the bulk of care in a system where they do not have the necessary training, services, and supports. Transportation systems rarely support the needs of older adults who can no longer drive but want to remain in their community.

To ensure that the people we care about have the infrastructure and supports needed for healthy aging in our communities, we need to support policies and funding that address social determinates of health such a housing, access to food, and transportation. Funding for home and community-based services and caregiver supports can allow older adults to remain in their homes at less cost than living in a nursing facility. Advocating for local transportation programs and systems extend the freedoms and abilities for older adults to live independent lives.

My hope is we assess the challenges in our communities, states, and country with a heart for improving the lives of older adults through policy. The pandemic has shown us what needs to be enhanced so people do not continue to suffer. Let’s lean-in to make sure that our policy makers allocate funding and make policy choices that create a difference for our parents, family members, and neighbors.

Three things to learn about this week:

  1. Healthy Aging in Action
  2. Aging in Place 2011
  3. What Policy Makers Need to Know About Aging in America

Photo by Volodymyr Hryshchenko on Unsplash

Spring flowers remind me of new beginnings


Photo by Annie Spratt on Unsplash

For more than a year, like everyone else, I have been coping with the COVID-19 public health emergency, police violence against black men and women, mass shootings, and destructive political agendas. I have experienced the death of people close to me, the loss of close family connections, and the disappearance of social and cultural activities that enrich our lives. The pandemic created a sense of loss, grief, and changed how we live, work, interact with others, and think about our future. I have been in a fog – plans put on hold and then cancelled. I seem to be always be thinking in terms of what I can do just for today. Each time I start to plan longer term, I realize I am ignoring the current situation, by planning something that isn’t possible, and then feeling let down and disappointed. During 2020, my goal was to make it through each day, and I stopped setting long-term goals.

Only recently have I had the desire to plan activities again and take tentative steps toward setting goals and making plans. It is spring and I am getting a sense that it’s time to rekindle the ambitions and passions I had prior to the pandemic. For me, that means seeking new knowledge and understanding of racial injustice in the United States. It also means revitalize my passion for health and aging policy. It also means exploring new areas of growth such as teaching and life coaching.

General guidance on beginning again encourages us to assess our current condition and consider our options. It is important to practice self-care and focus on our values – what matters most to each of us. Kindness, empathy, and compassion are critical to recovering from the last year. Choosing some paths to explore without commitment helps us activate our curiosity and courage. When you are ready, make a plan with some built-in early successes to increase you confidence. Try to keep at your path everyday but be kind to yourself if you stray or need to rest.

My hope is we will reemerge from our unique year and inspire ourselves to begin again. This blog was a first step for me. As a nation and as a world, let us re-engage and create communities to care for each other for a sustainable future.

Three things to learn about this week:

  1. 5 Ways to Recover and Feel More Rested in 2021
  2. How to Recover from 2020 and Start Afresh
  3. Recovering from 2020

Digging Deep

I have started this blog several times over the last few months. First, I was going to write a reflection on turning 50, then I was going to share my COVID-19 experiences, next came thoughts on how COVID-19 disproportionally impacts communities of color, and lately I’ve wanted to write about racism. Except for turning 50, these topics have been on the hearts and minds of many people.

COVID-19 has been like a shovel digging into the fabric of our fragile illusions of the world we know. We have witnessed how quickly life can change. As a privileged, white woman, my experience is vastly different from people of other races, economics, and status in the United States. While I have been educating myself over the last few years about systemic racism, unconscious bias, our racial history not taught in school, and white socialization, I have much more to understand and change.

Digging deeper means being willing to look at what is beneath the surface of our societal structures and norms. I dig deeper when I am curious and willing to consider how I unintentionally reinforce injustices and inequality. It means finding the strength to have uncomfortable and difficult conversations about experiences, beliefs, and biases.

Margaret Wheatley said, “Be brave enough to start a conversation that matters.” Join me in digging deeper by using tools like Daring Discussions to learn about other’s experiences and perspectives; by accessing books, films, and podcast to learn more about our history, its impact, and our culture; and by building upon what other communities are doing to address racism and health equity, such as Madison, WI.

Three things to learn about this week:

  1. Daring Discussions Tool Kit
  2. List of books, films, and podcast
  3. The power of public health

Photo by Emily Morter on Unsplash