June 25, 2020
The Ripple Effect: How COVID-19 Is Impacting Communities & Caregivers
COVID-19 is affecting nearly everyone across the country, but is taking a particularly heavy toll among communities of color, just as Alzheimer's does.
This Alzheimer's Talk, part of our COVID-19 Insight Series, is the first of two programs on health equity challenges presented by COVID-19 in the dementia community. We discussed the effects of the coronavirus on family caregivers of color and what social service providers and health systems are doing now to support seniors. We also shared our latest A-LIST survey results on the pandemic's impact on the Alzheimer's community.
Press the 'Play' button under the image at left to hear the discussion or watch the recorded webcast here on Facebook.
Our panelists were mental health researcher Iris Aguilar, MSPA, of the University of Southern California’s Roybal Institute on Aging; research nurse and educator Angela Allen, PhD, of Banner Health and Arizona State University, a former board member of the National Black Nurses Association; and medical director Lauren Barial, MD, of naviHealth. Host Meryl Comer also spoke one-on-one with caregiver-advocate and author Loretta Veney and former U.S. Surgeon General Dr. David Satcher.
Dr. Satcher noted the higher rates of heart disease, diabetes and neurological disease among communities of color. As a result, he said, “We are set up to be impacted by a pandemic like COVID-19 to a greater extent than people who do not have those risk factors. Already we’ve seen many people die who probably would not have if their blood pressure had been normal, if they were handling glucose normally.”
Satcher added, “Some of these things we can also say about Alzheimer’s.”
Dr. Barial, who is based in New Orleans, noted that some things have not changed since Hurricane Katrina struck the city in 2005. Lack of access to health care continues to affect communities of color in New Orleans disproportionately, which is also true for much of the country.
Dr. Allen noted that many of the diverse communities in the Phoenix area reside in the city’s outskirts, where access to health care is a challenge. In addition, people in these communities often lack access to the technology needed to use online resources such as telemedicine, which has become more common during COVID-19.
Aguilar said that the Roybal Institute on Aging recently conducted interviews with area caregivers, who reported increased stress from burdens such as not being able to take their loved one to an adult day care center for respite care. The Institute also interviewed directors of area agencies on aging. They reported negative effects from the pandemic on some with dementia, from being unable to attend activities that helped keep them engaged. Those effects included further memory loss and confusion.
In her interview, caretaker Loretta Veney commented on systemic bias in health care. For instance, she said, if a person of color goes to a hospital having difficulty breathing, they may wonder if they will even be tested for COVID-19 or if they’ll be brushed off and sent home with no treatment. She urged health care professionals to treat the symptoms and not categorize any individual by race.
Barial responded that another factor contributing to systemic bias is the low presence of minorities in medical professions. For instance, African Americans are around 13 percent of the population but only around 7 percent of physicians in the U.S.
When a person of color describes their symptoms, the doctor may be more dismissive. Allen said this pattern could result from implicit bias on the doctor’s part or from the patient struggling to communicate symptoms in a way that the doctor will understand. Further adding to the challenges, a doctor may have an expectation that a patient of color will not comply with treatment, and the patient may have an expectation that the provider will brush them off and not treat them.
On COVID-19 testing, Aguilar described a breakdown in communication with Latino communities that you can seek services, you should be tested, here’s what testing involves, and this is how your information will be used.
In the fourth UsAgainstAlzheimer’s A-LIST survey on COVID-19’s impact, nearly a third (31 percent) of Alzheimer’s caregivers reported that their stress is now affecting their care for their loved ones. Around 80 percent of the more than 600 respondents reported one or more symptoms of severe stress. The top reported stress symptoms in June were sleep problems, difficulty concentrating, hyper-vigilance, trouble experiencing positive feelings, loss of interest in activities, and irritable, angry behaviors.
Barial noted that periods of prolonged stress can increase blood pressure and contribute to disordered sleep patterns and exacerbated emotions. Caregivers now may need more health care themselves but struggle to get it if no one can step in to take care of their loved one, and they may need more mental health services long after the nation has addressed the pandemic.
Funding of supportive services is a concern, too, Aguilar noted, particularly when cash-strapped state governments are looking at cutting services at a time when people need more support – not less.
Support for the COVID Insight Series and this Alzheimer's Talks is provided by educational grants from the Eisai USA Foundation, naviHealth and Biogen.