Bucks Montgomery Physician Spring 2021 - 16

FEATURE

Hospitalization (Orthopedics),
Eldercare and COVID-19
by Menachem Meller, MD

E

ldercare has always been a challenge. " The
history of eldercare has largely been shaped by
economic security. In the agricultural economy
before industrial America few individuals saved enough
resources for their declining years. Most elderly people
either continue to work, or live, in dependent poverty.
More than any other factor the lack of a family member
who is willing or able to provide for an elderly relative
resulted in the relative moving to the dreaded poor house. "
In some communities, one child, often the eldest daughter,
was designated as being the healthcare provider for the
older generation. In modern America delegating the
individual to this existence is not considered reasonable.
The COVID pandemic has made this challenge
worse. Early on rehabilitation facilities closed their
doors due to rampant COVID infections and
deaths. Once the doors were open the patients and
their families elected not to consider admission to
these facilities despite the recommendation upon
discharge from acute hospitalization due to the fear
of why these facilities were closed previously.
In the current and ongoing COVID environment,
follow-up care for acute hospital admission is
challenging. The hospital beds are in short supply due

14 BUCKS/MONTGOMERY PHYSICIAN

spring 2021

to the increasing and persistent COVID pandemic. In
the few days of inpatient hospitalization for an acute
condition, such as a hip fracture, following independent
living, the patient and the family are poorly prepared
for a permanent dependent lifestyle change.
The COVID environment has unfortunately resulted in
the furlough layoff of many in the sandwich generation.
While it may seem intuitive as to how to provide healthcare
for the elderly, in practice the full extent of what is
required is often not been thought through. There is
often one family member who seems more capable or
willing to take on the task, however,placing the entire
responsibility on one family member is not realistic.
There is a diametrically difference between grandma
" Betty White " who is warm, effusive, positive, and
inspirational and merrily requires a trip to the supermarket
once per week. This is in contradistinction to " Betty
Black " who may be confused requiring complex medical
care such as pills, wound care, exercise, and constant
attention. This is further complicated by financial
factors that are not significantly changed from those
encountered in early America. " Betty White " may
effectively have no costs attached to her care and may
in fact be independently funded. She may be deemed to
Bucks Montgomery Physician Spring 2021

Table of Contents for the Digital Edition of Bucks Montgomery Physician Spring 2021
