By Bruce Horovitz, Kaiser Health News
August 5, 2020

What Seniors Can Expect as Their New Normal in a Post-Vaccine World

Imagine this scenario, perhaps a year or two in the future: An effective Covid-19 vaccine is routinely available and the world is moving forward. Life, however, will likely never be the same — particularly for people over 60.

That is the conclusion of geriatric medical doctors, aging experts, futurists, and industry specialists. Experts say that in the aftermath of the pandemic, everything will change, from the way older folks receive healthcare to how they travel and shop. Also overturned: their work life and relationships with one another.

“In the past few months, the entire world has had a near-death experience,” says Ken Dychtwald, CEO of Age Wave, a think tank on aging around the world. “We’ve been forced to stop and think: I could die or someone I love could die. When those events happen, people think about what matters and what they will do differently.”

Older adults are uniquely vulnerable because their immune systems tend to deteriorate with age, making it so much harder for them to battle not just Covid-19 but all infectious diseases. They are also more likely to suffer other health conditions, like heart and respiratory diseases, that make it tougher to fight or recover from illness. So it’s no surprise that even in the future, when a Covid-19 vaccine is widely available — and widely used — most seniors will be taking additional precautions.

“Before Covid-19, baby boomers” — those born after 1945 but before 1965 — “felt reassured that with all the benefits of modern medicine, they could live for years and years,” says Mehrdad Ayati, MD, who teaches geriatric medicine at Stanford University School of Medicine and advises the U.S. Senate Special Committee on Aging. “What we never calculated was that a pandemic could totally change the dialogue.”

It has. Here’s a preview of post-vaccine life for older Americans:

Medical Care

Time to learn telemed. Only 62% of people over 75 use the internet — and fewer than 28% are comfortable with social media, according to data from the Pew Research Center. “That’s lethal in the modern age of healthcare,” Dychtwald says, so there will be a drumbeat to make them fluent users of online healthcare.
1 in 3 visits will be telemed. Ronan Factora, MD, a geriatrician at Cleveland Clinic, says he saw no patients age 60 and up via telemedicine before the pandemic. He predicted that by the time a Covid-19 vaccine is available, at least a third of those visits will be virtual. “It will become a significant part of my practice,” he says. Older patients likely will see their doctors more often than once a year for a checkup and benefit from improved overall healthcare, he says.
Many doctors instead of just one. More regular remote care will be bolstered by a team of doctors, says Greg Poland, professor of medicine and infectious diseases at the Mayo Clinic. The team model “allows me to see more patients more efficiently,” he says. “If everyone has to come to the office and wait for the nurse to bring them in from the waiting room, well, that’s an inherent drag on my productivity.”
Drugstores will do more vaccinations. To avoid the germs in doctors’ offices, older patients will prefer to go to drugstores for regular vaccinations such as flu shots, Factora says.
Your plumbing will be your doctor. In the not-too-distant future — perhaps just a few years from now — older Americans will have special devices at home to regularly analyze urine and fecal samples, Dychtwald says, letting them avoid the doctor’s office.

Travel

Punch up the Google Maps. Many trips of 800 miles or less will likely become road trips instead of flights, says Ed Perkins, a syndicated travel columnist for the Chicago Tribune. Perkins, who is 90, says that’s certainly what he plans to do — even after there’s a vaccine.
Regional and local travel will replace foreign travel. Dychtwald, who is 70, says he will be much less inclined to travel abroad. For example, he says, onetime plans with his wife to visit India are now unlikely, even if a good vaccine is available, because they want to avoid large concentrations of people. That said, each year only 25% of people 65 and up travel outside the U.S. annually, vs. 45% of the general population, according to a survey by Visa. The most popular trip for seniors: visiting grandchildren.
Demand for business class will grow. When older travelers (who are financially able) choose to fly, they will more frequently book roomy business-class seats because they won’t want to sit too close to other passengers, Factora says.
Buying three seats for two. Older couples who fly together — and have the money — will pay for all three seats so no one is between them, Perkins says.
Hotels will market medical care. Medical capability will be built into more travel options, Dychtwald says. For example, some hotels will advertise a doctor on-site — or one close by. “The era is over of being removed from healthcare and feeling comfortable,” he says.
Disinfecting will be a sales pitch. Expect a rich combination of health and safety “theater” — particularly on cruises that host many older travelers, Perkins says: “Employees will be wandering around with disinfecting fogs and wiping everything 10 times.”
Cruises will require proof of vaccination. Passengers — as well as cruise employees — will likely have to prove they’ve been vaccinated before traveling, Factora says.

Eating/Shopping

Local eateries will gain trust. Neighborhood and small-market restaurants will draw loyal customers — mainly because they know and trust the owners, says Christopher Muller, a hospitality professor at Boston University.
Safety will be a bragging point. To appeal to older diners in particular, restaurants will prominently display safety-inspection signage and visibly signal their cleanliness standards, Muller says. They will even hire employees exclusively to wipe down tables, chairs, and all high-touch points — and these employees will be easy to identify and very visible.

Home Life

The homecoming. Because of so many Covid-19 deaths in nursing homes, more seniors will leave assisted living facilities and nursing homes to move in with their families, Factora says. “Families will generally move closer together,” he says.
The fortress. Home delivery of almost everything will become the norm for older Americans, and in-person shopping will become much less common, Factora says.
Older workers will stay home. The 60-and-up workforce increasingly will be reluctant to work anywhere but from home and will be very slow to re-embrace grocery shopping. “Instacart delivery will become the new normal for them,” Dychtwald says.

Gatherings

Forced social distancing. Whenever or wherever large families gather, people exhibiting Covid-like symptoms may not be welcomed under any circumstances, Ayati says.
Older folks will disengage, at a cost. Depression will skyrocket among older people who isolate from family get-togethers and large gatherings, Ayati says. “As the older population pulls back from engaging in society, this is a very bad thing.”
Public restrooms will be revamped. For germ avoidance, they’ll increasingly get no-touch toilets, urinals, sinks, and entrances/exits. “One of the most disastrous places you can go into is a public restroom,” Poland says. “That’s about the riskiest place.”