by Dr. Steven Plunkett
My Mother lives alone in a senior living facility. She is a remarkably healthy 98-year-old. Her last hospitalization was 65 years ago when my younger sister was born.
She still walks to Trader Joe’s to buy her groceries, and hand carries her purchases back home with her. She is also an optimist. Every day is a good day, and she never admits to having any aches or pains, in spite of the fact that I know 98-year-old people are never without some discomfort. I’m sure she has health issues lurking beneath that optimistic surface in her 98-year-old body.
My aunt Genevieve, Mom’s sister, just turned 97. She lives in the same senior living facility,but in a separate unit on another floor. Although generally healthy, she has periodic bouts of bronchitis and a non-productive cough. She’s also an optimist, never having a particularly bad day. She too is quite active, and often accompanies Mom on her walks to Trader Joe’s (although my Mom has to carry the wine back, because it’s too heavy for Genevieve).
My mother and aunt live 244 miles away from me. As a physician, I understand, perhaps more than others, the fragility of life, especially for the elderly. I know clinical decline can occur quickly and unexpectedly, often with serious consequences. I’m also acutely aware that early detection and timely intervention are critical to making a healthy recovery.
With the current Covid-19 pandemic and the accompanying mandates for social distancing and isolation, it becomes increasingly difficult to assess the status of our loved ones in senior living facilities. The elderly are at highest risk, and senior living facilities have been particularly hard hit during the pandemic. As of mid-April, over 10,000 nursing home residents have died of Corona Virus, and over 1/5 of all deaths in the US have occurred in nursing homes or other senior living facilities.
To date, no treatment has been proven effective, and currently there is no vaccine.
A common symptom of the virus is shortness of breath and/or difficulty breathing. Most patients who become critically ill present with respiratory rates of 30 breaths per minute and higher. This virus is highly contagious. Those who are elderly and compromised have much greater risks of irreversible organ damage. It is likely they develop a sepsis-like syndrome in which the virus spreads internally and impairs the function of multiple organ systems.
And it’s not just the Covid-19 infection that is of concern in the senior population. Even without the current pandemic, the elderly remain at significant risk for other life-threatening conditions, including generalized sepsis, pneumonia, pulmonary embolus, heart failure, and medication overdoses. Respiratory rate change is an important early warning sign of these other conditions as well.
Senior living facilities have taken measures to limit the Covid-19 risk by restricting visitors. Residents are spending more time alone. It has become difficult for family members to have one-on-one contact with their loved ones. Although social distancing restrictions will likely be eased going forward, the elderly are at such high risk, social distancing in some form will likely remain in effect for this group.
As I became increasingly concerned about the health of my mother and aunt, I searched for an effective way to monitor them in a reliable, unobtrusive way. The Keenly Virtual Medical Assistant was the ideal solution. With it, I have the ability to know when they go to bed, how well they have slept, and when they leave the bed. Even more important, I have an ongoing real time assessment of their respiration.
The dashboard is very user friendly, and I can change the settings to follow the data over a number of hours, days, or a week at a time. The monitor is easy to read, and the feedback is extremely helpful. I can log on anytime to obtain a real time assessment of their status. As they become more debilitated and require health care personnel to check on them, the device will also allow me to determine that the nurses are visiting them at the appropriate intervals. During a quarantine in which visitation isn’t possible, I can still monitor their condition on a regular basis.
With the Keenly device I have the assurance of knowing that my mother and aunt are stable and healthy. I don’t have to rely solely on their telling me they “feel fine”, and I don’t have to worry if, for some reason, they don’t answer the phone when I call. I have learned that by knowing they are healthy and getting a good night’s sleep, I get a good night’s sleep as well.
Steven Plunkett, MD