The COVID pandemic created new challenges, most of which apply to almost all of us; some only to those working with vulnerable adults.
As the ripple effects of the pandemic continue to emerge (not unlike the mutations of the virus itself), let’s remember the words economist Paul Romer spoke in 2004: “A crisis is a terrible thing to waste.” A crisis challenges the status quo and forces people out of their comfort zones. creating an urgency for change and forcing innovative problem-solving.
The pandemic is an opportunity for us to analyze the strengths and vulnerabilities of local systems and use this urgency to explore options or build relationships that were previously viewed as too difficult to achieve.
Ripple Effects: Physical Isolation
The pandemic greatly reduced the amount of in-person visitation in the homes and facilities where vulnerable adults live. Families are less able to visit their loved ones, and social workers or advocates are limited in their ability to monitor physical conditions. Without these extra eyes on site, it is harder to know when neglect or abuse occurs, and there is less opportunity for whistle blowing to call facilities out for misconduct or to advocate for better services.
Strategies emerging to fill this new void in direct contact include visiting through the window/on the porch/in the yard, setting up regular phone/video visits, virtual monitoring by walking the camera around on site, and employing technological tools for remote monitoring. All of these strategies are the successful products of creative problem-solving that respect the limitations of the current situation.
Ripple Effects: Financial Stress
Another concern is abuse by family and friends who have lost income due to the pandemic and turn to vulnerable adults for help. They might move into the homes of their elder relatives, generating a variety of challenges, from the simple (toys left scattered to trip over) to the legal (violation of public housing contracts.) They might get access to the financial resources of elders.
One strategy might be for your MDT to host a discussion about a particular concern and broaden the list of typical invitees. Representatives of local banks and credit unions should be included to discuss strategies for preventing, identifying, and intervening in situations of financial abuse, for example. Even if the financial institutions cite legal limitations on their involvement with Adult Protection Services, for example, their participation in the discussion will inform their awareness, potentially generate their own internal strategizing, and build the local relationships.
Ripple Effects: Access to the Vaccine
Vulnerable adults might hold misinformation about the safety or availability of the COVID vaccine. A recent mailing from the Social Security Administration warned retirees against phone scams that offered faster access to the vaccine, for example. Repeatedly sharing accurate information about processes related to the vaccine will be critical in 2021.
Community gathering spots are closed during the pandemic, which also closes a venue for sharing information. This leaves many elders less aware of the programs available to them and limits educational outlets. New forms of outreach will need to be developed. One such strategy is to place flyers in pharmacy bags because people are still picking up their prescriptions even though they cannot go to the senior center.
Ripple Effects: The Rural/Urban Divide
Two foundational inequities between rural and urban communities are not news to anyone and intensify some COVID-related challenges. Access to healthcare by rural residents has always been a challenge due to geographical distance and options for transportation. The resources of community-based hospitals and mental health services have long been limited and are now approaching or exceeding maximum capacity. The lack of options for hospitalizations complicates strategies for any kind of medical interventions in crisis situations, with any population, not just our elders.
While some brilliant strategies for on-line health care and monitoring have emerged from the pandemic, lack of broadband coverage limits the application of those practices across the state. The capacity of workers who serve elders is also limited by their connectivity, both in terms of their client services and in terms of working from home.
So what do we do with this?
- Assume that ripple effects exist and will continue to emerge. That’s natural.
- Try to anticipate the next generation of ripple effects by making time to discuss that in your MDT meetings.
- Consider having focused discussions about a particular threat. Broaden the invitation list to include allied professionals who might be useful in informing, planning, implementing, or promoting your strategies.
- Remember that the members of your MDT know more about this vulnerable population and their challenges than anyone else does. Periodically take time to update the community about what you are seeing and how others might help.