Ensuring contact: calling rural Appalachian older adults during the COVID-19 epidemic

Abstract

Introduction: Older adults, especially those aged 85 years or older, remain at significantly higher risk for COVID-19. This group, along with those with pre-existing heart and lung disease and diabetes, have accounted for 80% of hospitalizations and an even higher percentage of COVID-19 related deaths in the USA. West Virginia, the only state in the USA located completely within Appalachia, has a higher percentage of elderly than all but two states in the nation. Rural seniors are hesitant to use hospital emergency departments and attend routine care visits for fear of exposure to the virus. Restricted cell phone and internet service may limit effective technological outreach to more isolated rural older adults. More information is needed to develop effective, safe, and acceptable approaches to care for rural, isolated older adults. Methods: Telephone interviews were conducted with 124 community-dwelling residents in four counties in rural Appalachia between 1 and 22 April 2020. Participants were aged 75 years or Rural and Remote Health rrh.org.au

Providing community services for persons with disabilities during the COVID‐19 pandemic: A scoping review

“…In concordance with previous literature (Ministère de la Santé Preventive measures leading to cancelling home services (Ito et al, 2021) Most adaptations to the COVID-19 pandemic required a reliable Internet service (Beckman, 2021;Joseph et al, 2021;Tremmel, 2020). People with less access to the technological device and less knowledge on how to use the Internet may be excluded from these services despite often being those who most need them (Beckman, 2021;Shapira, 2021;Walker et al, 2021) Technological difficulties (Quinn et al, 2020) Living alone is associated with psychological outcomes such as anxiety, depression and overall decreased well-being (Goodman-Casanova et al, 2020;Walker et al, 2021) Lower socio-economic status, geographic isolation and overall marginalisation was a barrier to access services (Beckman, 2021;Shapira, 2021;Tremmel, 2020) Change in the resource and services modality could affect their content (Lai et al, 2020) Privacy concerns when using video calls were reported (Scheffers, 2021) Decrease the quality of the communication (e.g. lack of nonverbal signals; Scheffers, 2021) Relying too much on informal caregivers can lead to an increased burden or burnout (Franzosa et al, 2020;Sadarangani et al, 2021)…”

“…The professionals interviewed in one study expressed their concerns specifically about reaching vulnerable older adults (Beckman, 2021). On the contrary, three studies (33.3%) reported an equivalent delivery of services before and during the pandemic despite having to adapt to sanitary measures (McKenzie et al, 2021; Tremmel, 2020; Walker et al, 2021). All these studies focused on municipality or government organisations; two provided education services to individuals with disabilities and the other one delivered health prevention services.…”

“…Supported individuals able to maintain some form of socialisation (Walker et al, 2021) Flexibility from the organisation (Tremmel, 2020) Planning ahead for the reopening of the organisation (Tremmel, 2020) Group discussions were easily implemented and provided social support (Shapira, 2021) Online resources allowed the supported people to re-listen to recorded videos, sound messages or advice in their own time, which may support their understanding (Scheffers, 2021) Telehealth reimbursements (Quinn et al, 2020;Sadarangani et al, 2021) Important guidance and structure for remote delivery of physical therapy services from higher levels of organisation Keeping multidisciplinary teams connected (Franzosa et al, 2020) TA B L E 2 (Continued) et al, 2021). Further exploring how to deliver resources and services supporting physical and social activity in people with disabilities of all ages will thus address one of their most important needs.…”

“…These studies were conducted in the US, which could suggest a specific problem in this country regarding the financial accessibility of remote services. Isolation was identified as a barrier to service access only in studies about services targeting older adults (Goodman-Casanova et al, 2020;Walker et al, 2021).…”

A qualitative study of health care access among African American older adults in a socio-demographically under-resourced region during the COVID-19 pandemic

“…However, non-Hispanic Black persons were more likely to report they had received a checkup from a doctor in the past 12 months (93.8%) compared to non-Hispanic White persons (89.2%) ( 19 ). When considering the additional impact of COVID-19, economic hardship, co-morbidities, and challenges with visiting health care providers (e.g., shuttered doors, fear of contracting COVID, telehealth inconsistencies, etc…) worsened access to care for older adults, particularly African Americans, and persons with geographic barriers that made getting to the doctor difficult ( 15 , 20 , 21 ).…”