{"id":6441,"date":"2021-02-26T07:26:33","date_gmt":"2021-02-26T12:26:33","guid":{"rendered":"http:\/\/www.silvercentury.org\/?p=6441"},"modified":"2021-02-26T07:26:33","modified_gmt":"2021-02-26T12:26:33","slug":"older-covid-patients-battle-brain-fog","status":"publish","type":"post","link":"http:\/\/78.142.243.82\/~silvercentury\/2021\/02\/older-covid-patients-battle-brain-fog\/","title":{"rendered":"Older COVID Patients Battle \u2018Brain Fog\u2019\u00a0"},"content":{"rendered":"

Most older people who develop COVID-19 survive it, but release from the hospital is often followed by a long and difficult recuperation. Journalist Judith Graham explains what that\u2019s like and what needs to be done to help them. She wrote her article for <\/span><\/i>Kaiser Health News, <\/span>and it was posted on the <\/span><\/i>KHN website<\/span><\/i><\/a> on Oct. 20, 2020. It also ran on <\/span><\/i>CNN<\/span><\/i><\/a>. <\/span><\/i><\/p>\n

\u201cLord, give me back my memory.\u201d<\/span><\/p>\n

For months, as Marilyn Walters has struggled to recover from COVID-19, she has repeated this prayer day and night.<\/span><\/p>\n

Like other older adults who\u2019ve become critically ill from the coronavirus, Walters, 65, describes what she calls \u201cbrain fog\u201d\u2014difficulty putting thoughts together, problems with concentration, the inability to remember what happened a short time before.<\/span><\/p>\n

This sudden, cognitive dysfunction is a common concern for seniors who\u2019ve survived a serious bout of COVID-19.<\/span><\/p>\n

\u201cMany older patients are having trouble organizing themselves and planning what they need to do to get through the day,\u201d said Zijian Chen, MD, medical director of the <\/span>Center for Post-COVID Care<\/span><\/a> at Mount Sinai Health System in New York City. \u201cThey\u2019re reporting that they\u2019ve become more and more forgetful.\u201d<\/span><\/p>\n

Other challenges abound: overcoming muscle and nerve damage, improving breathing, adapting to new impairments, regaining strength and stamina and coping with the emotional toll of unexpected illness.<\/span><\/p>\n

Most seniors survive COVID-19 and will encounter these concerns to varying degrees. Even among the age group at greatet risk\u2014people 85 and older\u2014<\/span>just 28 percent of those with confirmed cases end up dying<\/span><\/a>, according to data from the Centers for Disease Control and Prevention. (Because of gaps in testing, the actual death rate may be lower.)<\/span><\/p>\n

A year after being critically ill with COVID, at least half of older patients will not have fully recovered.<\/b><\/p><\/blockquote>\n

Walters, who lives in Indianapolis, IN, spent almost three weeks in March and April heavily sedated, on a ventilator, fighting for her life in intensive care. Today, she said, \u201cI still get tired real easy and I can\u2019t breathe sometimes. If I\u2019m walking, sometimes my legs get wobbly and my arms get like jelly.\u201d<\/span><\/p>\n

\u201cEmotionally, it\u2019s been hard because I\u2019ve always been able to do for myself, and I can\u2019t do that as I like. I\u2019ve been really nervous and jittery,\u201d Walters said.<\/span><\/p>\n

Younger adults who\u2019ve survived a serious course of COVID-19 experience similar issues, but older adults tend to have \u201cmore severe symptoms, and more limitations in terms of what they can do,\u201d Chen said.<\/span><\/p>\n

\u201cRecovery will be on the order of months and years, not days or weeks,\u201d said E. Wesley Ely, MD, co-director of the Critical Illness, Brain Dysfunction and Survivorship Center at Vanderbilt University Medical Center. Most likely, he speculated, a year after fighting the disease at least half of the critically ill older patients will not have fully recovered.<\/span><\/p>\n

The aftereffects of delirium\u2014an acute, sudden change of consciousness and mental acuity\u2014can complicate recovery from COVID-19. Seniors hospitalized for serious illness are susceptible to the often-unrecognized condition when they\u2019re immobilized for a long time, isolated from family and friends and given sedatives to ease agitation or narcotics for pain, among other contributing factors.<\/span><\/p>\n

In older adults, delirium is associated with a heightened risk of losing independence, developing dementia and dying. It can manifest as acute confusion and agitation or as uncharacteristic unresponsiveness and lethargy.<\/span><\/p>\n

\u201cWhat we\u2019re seeing with COVID-19 and older adults are rates of delirium in the 70 percent to 80 percent range,\u201d said Babar Khan, MD, associate director of Indiana University\u2019s Center for Aging Research at the Regenstrief Institute, and one of Walters\u2019 physicians.<\/span><\/p>\n

Family members should insist on rehab therapy after a patient leaves the hospital and returns home. <\/b><\/p><\/blockquote>\n

Gordon Quinn, 77, a Chicago documentary filmmaker, believes he contracted COVID-19 at a conference in Australia in early March. At Northwestern Memorial Hospital, he was put on a ventilator twice in the ICU, for a total of nearly two weeks, and remembers having \u201ca lot of hallucinations\u201d\u2014a symptom of delirium.<\/span><\/p>\n

\u201cI remember vividly believing I was in purgatory. I was paralyzed\u2014I couldn\u2019t move. I could hear snatches of TV\u2014reruns of <\/span>Law & Order: Special Victims Unit<\/span><\/i>\u2014and I asked myself, \u2018Is this my life for eternity?\u2019\u201d Quinn said.<\/span><\/p>\n

Given the extent of delirium and <\/span>mounting evidence of neurological damage<\/span><\/a> from COVID-19, Khan said he expects to see \u201can increased prevalence of ICU-acquired, cognitive impairment in older COVID patients.\u201d<\/span><\/p>\n

Ely agrees. \u201cThese patients will urgently need to work on recovery,\u201d he said. Family members should insist on securing rehabilitation services\u2014physical therapy, occupational therapy, speech therapy, cognitive rehabilitation\u2014after the patient leaves the hospital and returns home, he advised.<\/span><\/p>\n

\u201cEven at my age, people can get incredible benefit from rehab,\u201d said Quinn, who spent nearly two weeks at Chicago\u2019s Shirley Ryan AbilityLab, a rehabilitation hospital, before returning home and getting several weeks of home-based therapy. Today, he\u2019s able to walk nearly 2 miles and has returned to work, feeling almost back to normal.<\/span><\/p>\n

James Talaganis, 72, of Indian Head Park, IL, also benefited from rehab at Shirley Ryan AbilityLab after spending nearly four months in various hospitals beginning in early May.<\/span><\/p>\n

Talaganis had a complicated case of COVID-19: his kidneys failed, and he was put on dialysis. He experienced cardiac arrest and was in a coma for almost 58 days while on a ventilator. He had intestinal bleeding, requiring multiple blood transfusions, and was found to have crystallization and fibrosis in his lungs.<\/span><\/p>\n

When Talaganis began his rehab on Aug. 22, he said, \u201cmy whole body, my muscles were atrophied. I couldn\u2019t get out of bed or go to the toilet. I was getting fed through a tube. I couldn\u2019t eat solid foods.\u201d<\/span><\/p>\n

In early October, after getting hours of therapy each day, Talaganis was able to walk 660 feet in six minutes and eat whatever he wanted. \u201cMy recovery\u2014it\u2019s a miracle. Every day I feel better,\u201d he said.<\/span><\/p>\n

To recover from a critical illness, sometimes what patients need most is human connections. <\/b><\/p><\/blockquote>\n

Unfortunately, rehabilitation needs for most older adults are often overlooked. Notably, a recent study found that one-third of critically ill older adults who survive a stay in the ICU <\/span>did not receive rehab services at home<\/span><\/a> after hospital discharge.<\/span><\/p>\n

\u201cSeniors who live in more rural areas or outside bigger cities where major hospital systems are providing cutting-edge services are at significant risk of losing out on this potentially restorative care,\u201d said Sean Smith, MD, an associate professor of physical medicine and rehabilitation at the University of Michigan.<\/span><\/p>\n

Sometimes what\u2019s most needed for recovery from critical illness is human connection. That was true for Tom and Virginia Stevens of Nashville, TN, in their late 80s, who were both hospitalized with COVID-19 in early August.<\/span><\/p>\n

Ely, one of their physicians, found them in separate hospital rooms, frightened and miserable. \u201cI\u2019m worried about my husband,\u201d he said Virginia told him. \u201cWhere am I? What is happening? Where is my wife?\u201d the doctor said Tom asked, before crying out, \u201cI have to get out of here.\u201d<\/span><\/p>\n

Ely and another physician taking care of the couple agreed. Being isolated from each other was dangerous for this couple, married for 66 years. They needed to be put in a room together.<\/span><\/p>\n

When the doctor walked into their new room the next day, he said, \u201cit was a night-and-day difference.\u201d The couple was sipping coffee, eating and laughing on beds that had been pushed together.<\/span><\/p>\n

\u201cThey both got better from that point on. I know that was because of the loving touch, being together,\u201d Ely said.<\/span><\/p>\n

That doesn\u2019t mean recovery has been easy. Virginia and Tom still struggle with confusion, fatigue, weakness and anxiety after their two-week stay in the hospital, followed by two weeks in inpatient rehabilitation. Now, they\u2019re in a new assisted living residence, which is allowing outdoor visits with their family.<\/span><\/p>\n

\u201cDoctors have told us it will take a long time and they may never get back to where they were before COVID,\u201d said their daughter, Karen Kreager, also of Nashville. \u201cBut that\u2019s OK. I\u2019m just so grateful that they came through this and we get to spend more time with them.\u201d<\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

\u201cLord, give me back my memory.\u201d<\/span><\/p>\n

For months, as Marilyn Walters has struggled to recover from COVID-19, she has repeated this prayer day and night.<\/span><\/p>\n

Read more Older COVID Patients Battle \u2018Brain Fog\u2019\u00a0<\/span> ›<\/span><\/a><\/div>\n

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