COVID-19 and the Vulnerabilities of Community-Dwelling Other Adults: Findings From a Statewide Survey of Home-Delivered Meals Recipients.

COVID-19's impact on community-dwelling older adults, especially those in rural and underserved areas, as well as those who are homebound, is of interest to policy makers and clinicians, now and in the future. This study aims to examine the consequences of the COVID-19 pandemic on community-dwelling older adults with the greatest social and economic needs residing in a mostly rural state. Using a self-administered survey, we collected data from 1852 home-delivered meal recipients, age 60 years and older, served by Nebraska's eight Area Agencies on Aging. Results highlight three areas of importance: social connections, healthcare access and utilization, and technology. We found that while most older adults maintained social interaction, despite the restrictions imposed by the pandemic, feelings of loneliness persisted or even increased, with 35% of respondents feeling lonelier because of the pandemic. Our findings further reveal that 42% of older adults skipped or postponed healthcare visits during the pandemic, although the majority expressed interest in using telehealth. Finally, the rural-urban divide was evident in our data, with less than one-half of respondents (45%) having access to reliable internet. Suggestions on how to prepare the most vulnerable people for similar crises are included.

Intergenerational conversations on death and dying during the COVID-19 pandemic: a pedagogical approach.

This exploratory study examined how twenty-two undergraduate students and fifty-six older adults experienced discussing dying, death, and the COVID-19 pandemic with one another, using the book Tuesdays with Morrie as a conversational guide. The timing of these conversations is significant as discussions took place in March 2021, one year into the COVID-19 pandemic. Thematic analysis of students' and older adult's reflections on the discussion was employed and three themes were identified: the inevitability of death, gaining and giving perspective, and the importance of relationships. The pandemic was especially influential within two of the three themes. The findings highlight the benefits of bringing previously unknown people together to engage in conversations about dying and death during the pandemic using contemporary literature. This study also presents a pedagogical technique for educators to use to help students engage in discussions about death and dying.

End-of-Life Planning: Normalizing the Process.

End-of-life (EOL) planning occurs across the United States at a frequency of below 50%, suggesting a new approach to encourage action is in order, especially as COVID-19 and other potentially lethal conditions emerge. Utilizing data from a multi-year survey of 2,614 adults in Nebraska, this study examined demographic factors related to completion of EOL planning documents, and identified people with whom EOL wishes could, and had been discussed. Logistic regression estimates indicated more reliance on non-health care providers for EOL discussions. This shift with whom people would discuss EOL wishes may afford others an opportunity to encourage EOL discussions.