Tucson doctor urges caution, not fear, for older adults during holidays

As a surge in COVID-19 cases is happening in Arizona and states across the country, one local physician who specializes in the care of older adults, tells his patients, “This is the time not to be scared. It is the time to be smart.”

The traditional holidays of large gatherings and the reunions of family and friends will be different this season — as much of 2020 has been.

For safe holidays, health experts are advising no large gatherings this year, and advocating for small celebrations limited to a family’s household, or to a small circle of people who are part of a family’s hub, said Dr. David Schoenbaum, a family physician in practice for 20 years.

“I think people need to remember that small gatherings are OK. Four to six is a fair number, but make sure it is not more than 10,” said Schoenbaum.

“Hand-washing, wearing masks and social distancing in the house with relatives or friends is a good idea, and if it is not too cold — put the table outside for the holiday meal. Being outdoors will drastically reduce the risk of transmitting the disease,” said the physician who treats mostly geriatric patients.

“No one is suggesting you need to sit at home alone to be safe. Just be wise about your small gathering,” said Schoenbaum. He said another option is for a few people to drop off a dish and visit for a few minutes before they go on their way.

However, experts are advising against cross-country travel for the holidays, citing crowded airports, and close quarters on airplanes. “Being trapped in an airport for hours, and on planes can certainly increase your risk of exposure,” said Schoenbaum.

A traveler in their 20s to 50s with no high-risk medical condition can pick up the COVID-19 virus during their travels and can be asymptomatic. Then, they can pass on the virus to grandma and grandpa.

“The latest statistics from the Centers for Disease Control and Prevention are that folks over the age of 70 have a 25% chance of hospitalization for coronavirus, and that does not account for the health conditions many older adults have that puts them at even higher risk,” Schoenbaum said. “Relatives have to think about that.”

“The younger people who are healthy with no medical conditions that put them at higher risk have a less than 1% chance of dying from the virus. People over 50 have up to a 2% risk of dying, and for age 60 it jumps up to a 10% risk,” he said.

“Those who are 70 have a 20% risk and those who are 80 have a 30% risk of dying,” said Schoenbaum, explaining the risk climbs with age because of health conditions. He said the CDC data is an average of everyone with or without medical conditions.

There are many older adults who live independently and are quite resilient and doing well. They remain in contact with relatives who live out of state, he said.

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For those who have relatives in Tucson, many of their relatives have stepped up and are making sure they do grocery shopping, errands and take their loved ones to medical appointments. Caregivers are also doing more to keep their clients busy and engaged in activities, said the physician. Some have plenty of relatives who live locally and are used to regular visits and large family gatherings, but the contact has decreased because of the coronavirus, affecting their morale.

“But, surprisingly many are computer-savvy and are staying connected with family and friends through Skype, Zoom or FaceTime,” Schoenbaum said.

For those who do not know, they may get help from relatives or friends, and even get virtually connected through the use of one of their relatives’ smartphones for the holidays, said Schoenbaum.

However, said Schoenbaum, the coronavirus pandemic has also impacted other seniors who feel isolated and lonely. “Some panic. Some are drinking a bit more or taking more prescription drugs — tranquilizers or narcotics to help them sleep or to deal with their depression and anxiety,” he said.

“We are seeing people with a history of depression relapsing, and there are many patients showing depression symptoms for the first time,” he said.

He said these may include older adults who have outlived their family and close friends, and they no longer can gather with their poker group or knitting circle because the groups are no longer meeting.

“Some may be scared to go outdoors because of the virus, but you can take a walk out in the sunlight and breathe in fresh air in your yard, neighborhood or a park,” said Schoenbaum. “If people are not nearby, you do not have to wear your mask. Put your mask on when people are near and remember to social-distance. You can use hand sanitizer or wash your hands when you get home,” he said.

Health experts say exercise is necessary for everyone, and it can be done at home. Older people can sit on a chair, if needed, and do leg lifts and arm exercises. “I can’t emphasize how important physical activity is for depression. We know for a fact from studies that physical activity has similar affects on the brain chemistry as antidepression medication,” said Schoenbaum.

He said exercise increases serotonin, norepinephrine and dopamine, which are body chemicals that make people happy.

Other activities to avoid depression can include projects such as making a family tree, painting, gardening, writing letters, or taking an online course, he said.

“I wish everyone happy and safe holidays, and stay smart,” said Schoenbaum.