Experts say keeping our distance from others is the best defense against spreading the virus, but there are concerns that this period of isolation could sow long-term health problems for some of those we’re attempting to protect: our older relatives and neighbors.
“We’re having to force people into social isolation, essentially,” said Carla Perissinotto, the associate chief for geriatrics clinical programs at the University of California at San Francisco. “We’re doing that in the short term to protect people from covid without really understanding what the long-term effects are.”
Even before stay-at-home orders swept the nation, the National Academies of Sciences, Engineering, and Medicine published a report in February finding that social isolation and feelings of loneliness put older Americans at risk of larger health issues and higher mortality rates.
The Washington Post spoke with six experts in geriatrics for advice on the best ways to connect and empower those who are remaining at home.
First, don’t assume. Ask what someone might want or need from you.
Try to start these conversations with a simple question: What do you need?
And, you can be prepared to offer some ideas. It could be picking up an extra gallon of milk at the grocery store or a weekly game night on FaceTime. Whatever you offer, provide ample opportunity for the older adult to say no.
“This person has the right and the ability to say no, and there may be many reasons for that,” said Sonya Barsness, a gerontologist and adjunct lecturer at Georgetown University. “Try to understand their perspective in really an honest, active-listening kind of way.”
If you have concerns about a neighbor or loved one grocery shopping on their own, for example, have an open conversation with them, Barsness said. Discuss the risks involved, and try to come to a mutual agreement about how you can help.
“There is a constant balance of autonomy and risk that we all are negotiating,” Barsness said. “That really is no different for an older person … even though they might be considered ‘vulnerable.’ ”
Have a goal for video calls. And, if it helps, schedule calls ahead of time.
We’re using FaceTime and Zoom to bridge the physical gaps between each other, but Barsness said any video call should simply be a tool for a larger solution.
A bit of creativity can make for a more engaging video call instead of simple, mundane updates about daily life. Although this advice can be applied to video calls with anyone in your life, this could be an opportunity to help loved ones become more comfortable connecting with technology.
An older family member could teach someone how to knit with weekly calls. The grandkids could hold a musical recital in their living room for friends and family. You can collectively watch the same movie or enjoy a recorded performance from a symphony orchestra.
“There’s a lot of ways that people can connect rather than traditional phone calls,” Barsness added.
You can also ask whether someone would prefer to have weekly calls on the calendar, every Saturday at 7 p.m., to have something to plan for and look forward to. It’s all about figuring out the “right frequency” to check in and connect with loved ones, Perissinotto said.
None of these solutions are perfect, but Linda Fried, the dean of the Mailman School of Public Health at Columbia University, said there’s a way to reframe our situation positively as an altruistic act.
“We’re not socially isolating; we’re physically isolating,” Fried said over the phone. “Not just to protect ourselves, but to protect our community.”
Help family members connect with doctors over video.
Older Americans still need to manage chronic illnesses they have while isolating at home. Some health officials are concerned that there will be a spike in medical complications because existing problems are not being addressed, said Cathleen Colón-Emeric, the chief of the geriatrics division at Duke University’s School of Medicine. People are no longer going into the doctor’s office for regular appointments and check-ins.
Family members and loved ones should make sure seniors know how to schedule “telehealth” check-ins with their health-care provider using their computer, phone or tablet. Colón-Emeric said the patients she has worked with love the ease of talking to their doctor over a video call.
“I had a patient tell me the other day that she was never coming back into the office again,” Colón-Emeric said. “It avoids a lot of the hassles of transportation and parking. … There are actually a lot of patient-centered benefits.”
Family members can also join their loved one from afar for a videoconference with a doctor, and Colón-Emeric said that has been a great way to make sure everyone is on “the same page about goals” for any health conditions.
“That’s one of the bright spots of this epidemic for me,” Colón-Emeric told The Post over the phone. “I think it’s actually going to really change the way we deliver health care in a positive way.”
Exercise is key. Meet at a park or go outside for a walk.
Rather than visit an older relative or neighbor at home, make plans to talk outside at a nearby park. A stay-at-home order doesn’t mean you’re under house arrest. It just means you should avoid other people, especially in enclosed spaces, David Roth, the director of the Johns Hopkins School of Medicine’s Center on Aging and Health, told The Post.
Just staying at home is too simplistic, Roth said. People should avoid “high-risk situations,” but he added that you should get outside to enjoy the beautiful spring weather when possible.
It’s important older Americans stay active, rather than isolated inside. Older adults tend to lose their strength faster during periods of inactivity than those younger than them, Colón-Emeric said. The National Institute on Aging offers workout routines for older Americans on YouTube. Those enrolled in Medicare Advantage can also sign up for SilverSneakers, which provides on-demand exercise programs and how-to videos.
“This doesn’t require a gym. This doesn’t require special equipment,” Colón-Emeric said. “There are simply things you can do at home that will fit a variety of styles.”
Perissinotto told The Post that she’s worried about how the virus has forced us into these sedentary lives. Many older Americans were already homebound before the stay-at-home orders. And, Perissinotto said, it’s important to keep in mind that there’s a wide range of ways to stay active depending on someone’s physical abilities.
“Everyone assumes that physical activity means you have to go for this massive walk or run,” she added. “But, for some people, it may just be standing up, stretching your legs, walking across the room, if you’re able to.”
Make plans for eventual in-person family dinners or game nights.
Our everyday lives won’t return overnight to what they were six months ago. It’s more likely that the next couple of months will be a gradual regression from strict distancing to safe, responsible, in-person connections.
At some point, later this summer or in the fall, Colón-Emeric said health officials will start encouraging people to resume some of their normal activities, because the dangers of social distancing are going to outweigh the benefits. The question is: What’s the right timing for that?
Take the time to review the severity of the coronavirus outbreak in your community. The restrictions will probably lift at different times place-to-place depending on the number of cases in each area and guidance from regional health officials. If and when you do plan to meet face-to-face, remember to wear a face mask as a precaution.
“It’s probably going to be doing things with just a few people first,” Colón-Emeric said. “But, figuring out the right timing for that is going to be tricky for all of us.”
Instill some hope, and start a conversation with your older neighbor or relative about when you can meet again in person and what may need to happen for them to feel comfortable, Perissinotto said. Even if you’re itching to get back to normal, don’t go from zero to 100, she added. Try to space out visits responsibly in the coming months.
Let your neighbors and relatives help you, as well.
The older adults in our lives have lived through wars, famines and major economic downturns.
“We have to recognize that older people have tremendous gifts, talents, knowledge and experiences to share,” Barsness told The Post. Younger generations can learn how to cope with the challenges brought on by the coronavirus.
Talk to relatives or neighbors about your challenges during this time of isolation, and give them opportunities to help you. We’re social beings, and that connection comes from not only receiving, but also from giving help, said Lis Nielsen, the director of behavioral and social research at the National Institute on Aging. Our well-being, regardless of our age, depends on “exercising those social muscles,” finding purpose through community and offering assistance — such as volunteering or cooking for friends.
People derive meaning from these interactions. There’s emerging research to show the benefits these relationships can have on our health, Nielsen said.
“It’s kind of a two-way street,” Nielsen said. “The quality of our relationships isn’t just dependent on me giving to you; it’s dependent on that interaction.”