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Older Adults with COVID-19 Can Choose Care at Home: Lessons Learned from New York City

Internists often have conversations about goals of care for patients at the end-of-life. Discussions are usually informed by hospital data or a witnessed functional decline over time for patients at home. However, COVID-19 is not usual. Providing ambulatory and inpatient care in the epicenter of New York City (NYC), we have witnessed many frail, older adults acutely decline due to COVID-19. Because hospitals limit or deny visitors to COVID-19 patients, many older adults fear dying there alone and wish to remain at home with their family. Unfortunately, the presentation of COVID-19 often includes rapid onset of delirium, so we miss having these conversations in advance.

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