Assisted Living with HIV: A New Reality as Treatments Improve

When Bill Rydwels was diagnosed with HIV in 1985, his doctors were handing him what he and all those around him thought was a death sentence.  Today, Bill is 78 and is still living with HIV.  According to an MSNBC article published on June 2, Rydwels is just one of the many senior citizens afflicted with the virus that was once thought to be a disease only of young, gay men.

According to the most recent data by the Centers for Disease Control (CDC), more than 30% of all those with HIV are aged 50 and older.  In fact, one in 10 newly diagnosed HIV-positive persons are aged 50 plus.

Assisted living must meet medical and psycho-social needs

With HIV striking the aging population at an alarming rate and with survivors living beyond their expectancy, assisted living communities and skilled nursing facilities may begin to see an influx of HIV-positive residents.  Not only are these communities going to need to be prepared for the medical needs of such patients but also for the psycho-social needs of the aging survivors. Dr. Brad Hare, the medical director of San Francisco General Hospital’s Ward 86, says many of his older patients have lost all social support structure since so many of their peers died. “There’s a lot of depression,” he said.

Rydwel is just one of the long-term survivors not only dealing with the physical manifestations of the disease but with the emotional ones as well. Every day he says a prayer for the dozens of friends that he has watched die over the past 30 years.  He often questions why he has been spared, while so many others have succumbed to the disease.

Early onset of diseases typically connected to aging

Not only are people such as Rydwel at risk for the complications related to HIV/AIDS, but he is also at a higher risk for developing co-morbidities.  “We see heart disease, cancer, kidney [problems] 10 to 15 years earlier,” Hare says. “Instead of seeing heart disease in people in their 60s and 70s, we’re seeing it in their 40s and 50s.”  According the American Heart Association, long-term exposure to HIV increases the risk of developing several heart related diseases.  The cause is multi-faceted.  The disease itself can compromise the heart and its veins and arteries. The antiretroviral medications can do the same. There is also evidence that those infected with HIV are at an increased risk for kidney disease which has long been linked to an increase in heart disease. Lifestyle choices also are to blame. 60-70% of HIV-positive patients still smoke cigarettes, while only 20% of their HIV-negative counterparts continue to smoke.  The AHA is quick to point out that the aging population, whether HIV-positive or HIV-negative, is at increased risk for developing heart disease.

How can senior living facilities prepare?

HIV rates increasing among seniorsSo, what can be done to help prevent the spread of the virus?   Senior living facilities may need to begin education programs with their residents.  The CDC sites misconceptions about the disease and its transmission with increased sexual activity among older adults as one of culprits in the rise of infection rates.  There is also a sense of “it won’t happen to me” as was the case for Anna Fowlkes, who is spotlighted in a separate MSNBC photoblog. Anna preached safe sex to her children, but never thought it was something she needed to worry about.  After her husband died, she began dating in her 50s.  It was then that she contracted the disease. “We are of a generation where that was not something we have to think about,” she says. “Now I know better.”

The CDC is also working to educate medical providers who may miss the diagnosis of HIV/AIDS because it mimics the symptoms of diseases that are associated with aging.  New guidelines are also in place to provide standard HIV testing to people until the age of 64.

On a practical level, with the average life expectancy of a newly diagnosed HIV patient being over 22 years, patients are being encouraged to continue on with their lives.  In fact, Hare tells his patients when they are first diagnosed to plan for their retirement, “It’s one of the successes of modern medicine.”  Research advances continue to push the average age of the HIV-positive population upward and thus the prevalence of HIV among senior living residents. Armed with proper education and preparation, providers can readily accommodate residents with HIV.

Image Copyright Grow By Love on Flickr Creative Commons

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