Isolation and well-being: the elderly at the time of COVID-19

Marta Cristofanini

Social isolation is a condition that can pose a threat to seniors’ well-being. Here’s how not to lose sight of good habits

2020 is the year in which we were called upon to face a pandemic for the first time in a century, the pandemic caused by the rapid spread of the SARS-CoV-2 virus. COVID-19-induced isolation of the elderly is having and will have enormous repercussions on their well-being.

In most of the countries involved, one of the most effective restrictive measures implemented was quarantine. A lockdown has kept the vast majority of the population in their homes in strict social isolation.

The elderly population is obviously the most affected. The peak mortality rate in Italy – at least based on the currently available data – is estimated at around 7.2%. Compared to 2.3% reported in China our rate is incredibly high.

According to a report by Il Sole 24 Ore, inspired by a detailed survey by the Echo di Bergamo (a local newspaper from one of the most affected areas), mortality is similar in the two countries up to the age group 60-69 years (about 3.5%); the data start to diverge as age increases in Italy. Respectively 12.8% and 8% in the age group 70-79 years and 20.2% and 14.8% in the over 80 class.

isolation of the elderly during COVID-19 and the effects on their well-being

The elderly in the balance between isolation and well-being

But what effect has this isolation of the elderly during COVID-19 had – and will it have – on their general well-being? While considering the imminent loosening of social containment measures, the over-65s should still be required to pay more attention. How? Possibly still preferring to stay at home until the emergency is completely over.

Isolation and well-being: a delicate but fundamental balance, which needs to be thoroughly investigated, given the typical fragility of the ageing process.

The effects of pre- and post-emergency isolation mainly involve two areas:

The physiological area, from dietary-food changes to those concerning mobility and physical activity.

The psychological area, linked to emotional stress and loneliness, which may lead feelings of panic and depression.

Don’t overlook good habits

According to data provided by ISTAT (the Italian National Institute of Statistics), in Italy the over-65s exceed 13 million.

This is an huge number, which reminds us of one of the most interesting peculiarities of this country, second for longevity only to Japan.

Establishing a virtuous circle of optimal habits to stay healthy is more than desirable; and the elderly should not interrupt it even during the isolation due to COVID-19.

Sports activity is essential to slow physical decay: the SIOT (Italian Society of Orthopaedics and Traumatology) advises not to give up light physical activities even within the walls of the home, such as free body gymnastics, Tai-Chi and Pilates, disciplines that strengthen coordination and harmonious movement, tonicity and elasticity, and of course the mood, given the massive release of endorphins.

Nutrition also remains a key element of daily well-being. It’s necessary not to include drastic changes in one’s diet, such as the arbitrary elimination of certain foods.

On the other hand, the metabolism of the elderly is different. The ever-decreasing energy expenditure and the reduced digestion and absorption of vitamins and minerals; the decrease in taste and smell; these are just some examples of what often leads to a lack of appetite or a poor and messy diet.

Let’s not forget hydration. According to AIRC Foundation for Cancer Research, drinking 8 glasses of liquid a day (2 litres for women, 2.5 for men) would be ideal, even when one does not feel thirsty.

Do not underestimate the effects of isolation of the elderly

Various components characterize active ageing, all useful to promote a gradual transition to senility. There are various factors to monitor, from socio-cultural participation to physical and mental activity and access to health services.

According to the World Health Organization, active ageing is “a process of optimizing opportunities related to health, participation and safety, in order to improve the quality of life of older people“.

Logically, in a historical period such as the one we are experiencing, there are many obstacles that this model encounters on its way. Loneliness is an epidemic that can be just as contagious.

In a joint note, the seniors’ association and some voluntary ones – specifically Auser, Anteas, Ada – stressed the possible onset of very serious consequences due to prolonged isolation.

Technological barriers

According to a document promulgated by the Italian Ministry of Health on mental health and psycho-social support, the elderly (and not only them) will have to face delicate situations in which they will feel more anxious, angry, agitated or depressed.

The importance of staying in touch with friends and family is of paramount importance; the need for specialist support has also a certain priority.

The problem is often that many of them don’t have easy access to technological devices. And of course they are the most effective ways to keep long-distance relationships active today.

Transform the distance

This type of concern can only affect family members. Not being able to personally ensure how our loved ones are doing is a source of anxiety and emotional stress.

Even if we are only at the beginning, the technological and digital revolution in remote assistance – or RPM, Remote Patient Monitoring – could be of great help, as the extreme case of the current epidemic is well highlighting.

Mario Cardano is Professor of Health Sociology at the University of Turin; he points out some important considerations about the tragic outcomes in Italy.

One of the reasons why the RSA model failed in this emergency was the almost impossible structural isolation of sick patients; in addition most of the staff did not have adequate expertise in infectious diseases. Structured home care would have been simpler and – perhaps – more effective.

New tools, new hopes

According to a recent survey conducted by Cambia Health, 64% of American caregivers use a digital device as a care aid.

As shown by CES 2020, a great interest is developing not only in health-related technologies but also in personalization algorithms (such as Kibi!), which can create an ad hoc mapping of the needs of the person being cared for.

Remaining updated on the habits of loved ones even at a distance would relieve the strain on them and us.

We must accept the isolation of the elderly throughout the COVID-19 period as a remedy to protect their health. Today more than ever it is necessary to invest in home automation and the active reduction of social isolation.

Hoping that the situation will work out for the best, we look to the future with more conviction and awareness than before.

After all, the best cure is prevention. Using every means and knowledge to stay healthy is one of the most effective solutions at our disposal.

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