Lancaster Physician Fall 2020 - 19

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adults. Assessing an older adult's preferred and
available technology and setting it up to work
seamlessly can be frustrating but is a rewarding
endeavor. For many families, the grandchildren
are a valuable technical resource in creating an
easy-to-use interface.
Many older adults come from a generation
of card and letter writing as a means of intimate
conversation. Their children and grandchildren,
thoroughly indoctrinated into an electronic age,
underappreciate this means of communication.
Nonetheless, for those who can bridge that
gap, cards and letters are still a bright spot in
the day of many older adults who suffer from
loneliness and social isolation. Furthermore,
cards and letters have a physical property that
is satisfying. Older adults enjoy holding and
reading written communication over and
over, but they are unlikely to treat electronic
correspondence the same way.
Window visitation has been promoted as
an option for face-to-face communication.
This still requires the use of a telephone and

tolerable weather conditions. Older adults
and their families usually find window visits
preferable to video telephonic communication.
However, older adults with dementia may
find the combination of the window barrier,
using a telephone, and lack of physical touch
confusing and distressing. If visual impairment
is a factor, some older adults respond with
paranoia. In these cases, window visitation is
not recommended.
The Centers for Medicare and Medicaid
Services (CMS) and the Pennsylvania Department of Health have developed guidelines for
visitation in skilled and assisted living facilities
based on the green, yellow, red system. This
allows facilities to determine levels of safe visitation as the pandemic evolves in individual
communities. Visitation privileges during end
of life situations is almost always possible. In
addition, CMS and the Pennsylvania Department of Health have developed guidance for
"Compassionate Care" by family members
who are willing to arrange and pay for serial
testing and to abide by other facility regulations

to provide in-room care to their loved ones in
certain circumstances.
Some of the families in my care have decided
to cohabitate with their older adult relatives.
This successfully removes some of the barriers
to loneliness and social isolation. However, it
is not a solution for every family.
In summary, although the COVID-19
pandemic emergency has aggravated the problem of loneliness and social isolation for older
adults, we have more opportunities to improve
communication than ever before. Emphasizing
love, connectedness, meaning, spirituality, and
what is important in life improve the quality
of intimate conversation. Focusing on what is
positive and celebrating personal activites support mood and function. Reminiscence brings
happier times from the past into the present
for enjoyment. The pandemic is not over, but
it will not last forever. Intentionality, flexibility,
and adaptability in communication can and
will attenuate loneliness, social isolation, and
their detrimental effects on older adults.

MEADOW VIEW, a new memory support community at Garden Spot Village fuses
state-of-the-art technology and person-centered care to create a life-changing environment
for people with dementia, allowing them to live resiliently today and into the future.
Call 717.355.6000 to learn more or schedule a private tour.

433 S OU T H K I NZ E R AV E N U E , N E W HOL L A N D | G A R DE N SP O T V I L L AGE .ORG

LANCASTER

19

PHYSICIAN


http://www.GARDENSPOTVILLAGE.ORG

Lancaster Physician Fall 2020

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