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Some timely suggestions for social care for older people

How can we care for the mental health and wellbeing of older people at this time? Researcher Dr Joyce Siette has some practical suggestions, including virtual visits to zoos.


Joyce Siette writes:

While some parts of society are celebrating the easing of the novel coronavirus spatial distancing restrictions and lock-downs, we must not forget those disadvantaged populations who will need support recovering from this period of isolation and managing the uncertainty ahead.

Prolonged spatial distancing will likely continue to affect older adults who are dealing with chronic illnesses or disabilities, and those who are particularly vulnerable to social isolation.

It is essential we consider how this isolation during the pandemic may have worsened or triggered mental health problems and what our role as a society should be now.

Spatial distancing does not mean we have to be disconnected. What is our role now to ensure that older adults’ mental wellbeing following these “soft” lockdowns are looked after? What can older adults do now to ease the distance?

Health in isolation

It was well known in research prior to COVID-19 that long-term chronic isolation for older adults  can accelerate risk factors for poor physical and mental health, serious illness and increased mortality – loneliness and social isolation are associated with a 50 percent increased risk of dementia, a 29 percent increased risk of heart disease and a 32 percent increased risk of stroke.

While research on the psychological toll of social distancing during epidemics is limited, a recent review provides some pointers.

Many individuals who were quarantined during outbreaks of SARS, H1N1 flu, Ebola and other infectious diseases since the early 2000s experienced both short- and long-term mental health problems, including stress, insomnia, emotional exhaustion and substance abuse.

Despite recent steps to ease restrictions, older adults are still encouraged to remain at home and keep 1.5m apart from visitors. Spatial distancing is still utterly necessary.

Digital and social connectivity

Population‐based survey research in Australia and the United States (US) supports the view that older members of the population are increasingly adopting and using technology in their lives. This alone does not guarantee strong social bonds.

Despite two-thirds of US seniors owning smartphones and over 80 percent being Internet and social media users, adults over 80 years of age barely use technology-based communications. So, what can be done?

For older adults who have some digital literacy, families and friends could highlight existing, familiar and free video chat platforms (for example, FaceTime, Whatsapp, Skype) as a means of maintaining connections.

Social media is seen as an increasingly important platform for sharing news and information, experiences and engaging in meaningful social exchange with one’s family and friends.

Relevant apps that increase individual personal wellbeing (for example, Headspace), physical activity (for example, Silversneakers GO, Zwift), community awareness (for example, Old Time Radio 24), brain health (for example, Luminosity) and personal interest (for example, Audible) are readily accessible and can be installed by family members remotely.

Families can also highlight websites with new features such as ‘virtual’ galleries of international museums and live streaming of churches and zoos to ensure their older member remains connected with their communities.

For older adults who are not digitally savvy, as a neighbour, a friend, a family member, or a member of the general public, we can provide social support for them in many other ways.

A regular check in with your older neighbour through simple greetings, sharing stories at a distance and providing meals will ensure they continue to be kept up to date with their community and improve their psychological resilience along the way.

Engaging in a volunteer telephone buddy system and writing cards and letters to at-risk individuals are only some recent ‘old fashioned but new again’ initiatives. Many more will come as we embrace these changes and highlight the supportive role of our community during this crisis.

Role of telemedicine

Appropriate use of telemedicine would be particularly useful with preventing or limiting adverse health impacts of social isolation in older adults during this time, especially those with multiple chronic conditions who usually have frequent healthcare visits ordinarily.

Telemedicine has taken an important role of communication among patients during this pandemic.

Digital healthcare services reduce the need for in-person appointments, lower the cost of care, reduce costly visits to the emergency room, and improve patient satisfaction. Many patients can now be screened remotely prior to being seen by clinicians in person or attending test centres.

As restrictions ease, to remain a strong and resilient society, we must focus on rebuilding central social foundations for our vulnerable members.

The value of creating and sustaining meaningful relationships with our oldest members of the public must not be forgotten.

Dr Joyce Siette is Research Fellow, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University.

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