Older Americans were already in an epidemic before the pandemic began.
In 2018, the AARP released a report about the mental and physical effects of social isolation on older Americans, particularly those living in skilled nursing facilities.
"A lot of people, as they get older, their social circles decrease quite a bit. Family moves away from many of them, and family and friends begin to die," said Lori Smetanka, the executive director of the nonprofit advocacy organization National Consumer Voice for Quality Long-Term Care.
Some residents may have moved to skilled nursing facilities, assisted living residences or senior living communities in part to make new friends and spend more time around other people, sharing meals and organized activities. Now they find themselves more isolated than ever. As the coronavirus pandemic rages on, they're dealing with chronic loneliness on top of the fear of a deadly disease that primarily kills people like them.
"There's the isolation and then also the dual terror of how this disease has just torn through nursing homes," Manuel Eskildsen, a clinical associate professor at the David Geffen UCLA School of Medicine who treats older patients. "I think everybody's scared right now. But it's even scarier to know you're in the absolute most vulnerable group and you can't get away from it."
The effects of loneliness are mental and physical. And they can spiral: Feeling lonely and isolated might make you move around less and not eat as frequently or as much as you should, Eskildsen said, which leads to decreased quality of life and physical health, which can make you depressed, which leads to not moving around and eating less.
Part of the problem is the ways many of us have adjusted to the new normal might not be available to older people. Figuring out video calls can be tricky, and they're difficult to participate in if eyesight or hearing isn't great. Many facilities have enacted strict rules about visitors, so even if someone's offering a masked outdoor visit, they might not be allowed to do it.
Even the brief socialization of a grocery store trip or walk in the park is not possible for people with limited mobility or who don't drive anymore, or whose facilities won't allow them to leave and come back. Inside the facilities, group meals and activities are canceled, and staff interaction is limited to food and medication delivered in full PPE.
Effectively, older adults in skilled nursing and assisted living facilities have been trapped in solitary confinement in their rooms as coronavirus has swept through the places they live. Smetanka called it a "triple whammy" of trauma: the fear of getting sick and dying, the isolation from protecting yourself from getting sick and dying and the high likelihood that your friends, relatives and the people who live and work in your facility are getting sick and dying around you.
"When you think of the number of people who have died in long-term care facilities, residents are losing whole support systems in there; the residents, the one they would sit in the dining hall with or see in activities, a lot of those people have died. And so it really has been very traumatic, the sense of loss, the sense of grief that they're experiencing along with the loneliness and isolation," Smetanka said.
And the impact is grim: "There are, even beyond COVID, a lot of excess deaths (in nursing homes) that would not have occurred" if the pandemic hadn't happened, she said.
Even outside skilled nursing facilities, it's a scary time for older people, said Kimberly Lewis. She's the executive director of the I Did Something Good Today Foundation, a nonprofit that creates programs to help older people combat social isolation and other problems. The foundation runs the chat and crisis line GoldenTALK, where seniors anywhere in America can call and ask for help or just find a friendly person for a conversation. GoldenTALK is available from 8 a.m. to 8 p.m. at 888-604-6533.
She said something a lot of volunteers have been hearing from callers is that they're afraid to go out and do the basic, normal things they didn't think twice about doing a year ago.
"You've got people who are used to going out and getting things on their own, having their freedom and independence. Now they can't," Lewis said.
For older people and for everyone else, help is on the way. The vaccine rollout is now taking place, albeit haltingly, but it will likely be at least a couple of more months before older Americans are all vaccinated, and longer before their family members are able to get the vaccine and safely visit.
In the meantime, here's what you can do to help ease the effects of loneliness and isolation if you're an older person or someone who loves one.
Copyright 2021 Tribune Content Agency.