Caring For Older Adults During a Pandemic

Multidisciplinary effort helps some students graduate on time

By Debra Melani

(October 2020) For Kristina Slunecka, it was the woman locked down in her assisted-living facility room, unable to leave the confines of her four walls even to go outside because of COVID-19.

For Desirae Martinez, it was the elderly man beginning their first call with, “I don’t have much to say,” and still chatting with his newfound friend an hour later.

The women were two of about 40 University of Colorado Anschutz Medical Campus students who reached out to the pandemic’s most vulnerable population as part of an innovative program launched by the School of Medicine’s Division of Geriatric Medicine and its UCHealth Seniors Clinic.

“We were worried about the patients not having access to care and having a lot of unmet needs,” said Sarah Tietz, a geriatric medicine fellow who created the program with her clinic colleagues. “Older adults have a lot of social isolation, and COVID-19 intensified that.”

When stay-at-home orders curbed non-emergent inpatient visits and isolated the nation’s older adults from loved ones, the Seniors Clinic staff responded with the creative initiative that served a dual purpose.

Answering a double call

Since late March, students have conducted welfare checks via phone calls to the clinic’s 75-plus-year-old patients, who include aging veterans through a partnership with the Veterans Affairs Medical Center next to campus. Additionally, the program was approved to offer clinical hours for some students suddenly unable to meet their graduation requirements.

“It was a life-saver for me,” said Slunecka, a BS/DNP candidate in the CU College of Nursing who still needed 50 clinical hours when most rotation programs were suspended due to COVID-19. “It ended up being a win-win for everyone involved.”

Staff and students from CU College of Nursing, the CU School of Medicine and the Skaggs School of Pharmacy and Pharmaceutical Sciences joined the effort that has benefited students and the community’s older citizens during this time of crisis. “We’ve made more than 400 calls so far, and we will continue throughout the summer,” Tietz said.

Martinez, a fourth-year medical student who connected with the man who went from little to say to an hour of storytelling, joined the effort in part to “remain grounded” in patient care during the COVID pandemic. “It was so enjoyable to be able to provide a listening ear, and it reminded me of the reason why I love geriatrics – connecting with the elderly population and making them feel valued.”

“Pretty overwhelmingly, the patients – even those who didn’t really have any needs – were grateful that somebody just cared enough to call,” Tietz said. Many patients opted for weekly calls, just wanting someone to talk to, she said.

“Most pharmacies have been offering free delivery and mail service,” said Scott Pearson, PharmD, assistant professor of pharmacy who organized and oversaw the pharmacy students. “So, the pharmacy students provided that list as a resource for the other students,” Pearson said. “I think that was certainly helpful for a lot of patients.”

Teamwork across disciplines

Divided into teams with at least one pharmacy, nursing, and medical student on each, the groups met weekly, discussing that week’s patients as well as case studies provided by the Division of Geriatrics. Case studies focused on geriatric issues, including osteoporosis, dementia, diabetes, and falls, and were added to enrich the learning experience for students.

“We pre-rounded on patients,” Holly Truong, a fourth-year pharmacy student said of discussing patient cases each week. “I would look at their medications and see if there was anything I needed to let the other students know before their calls,” Truong said.

Many participants, Slunecka included, found the multidisciplinary aspect highly valuable. “I feel like that’s a really useful tool in my current job (as a patient navigator) and even moving forward in my nurse practitioner career,” she said.

“Coordinating with different disciplines and being aware of their different roles within the team is crucial. Everybody brings something to the table,” Slunecka said. “It was really nice having the pharmacy students reviewing these cases to help guide the care.”

Older adults have a lot of social isolation, and COVID-19 intensified that.

Caring for the elderly

For some students, including Truong, the program attracted them toward geriatric care. “It definitely strengthened my desire to want to help the older patients and maybe specialize in geriatrics after I graduate,” she said.

With a dramatic shortage of geriatric specialists and an older adult population expected to more than double in the next 20 years, that’s good news for the field, Tietz said.

“Really, students going into most fields are going to deal with older adults,” she said. “So, giving them experience with older patients and the medical challenges that come with them is important for all.”

This article was originally published by CU Anschutz Today in June 2020.