LIFE IN THE TIME OF COVID-19
Now, as the levels of COVID fatigue mount, emotional issues among the public and providers, especially those greatest at risk, continue to grow. This is producing new cases of morbidity and mortality related to the disease, but not directly due to the virus.
Social isolation is the state of having minimal contacts with the world. Loneliness is an emotion, a feeling of being isolated from others. Each can lead to the other.
Isolation frequently causes loneliness but, conversely, someone who is lonely may further retreat into a self-imposed isolation. Regardless of the etiology, both can lead to significant pathology, both psychological and physical.
Studies have shown that social isolation and loneliness are risk factors, including obesity, in some cases morbid obesity, heart disease, high blood pressure, higher risk of infection, depression and anxiety, decreased cognitive function, Alzheimer’s disease, and by increase of any of these, increased risk of death.
The increased risk of developing dementia is particularly high. This is easy to imagine if we remember that isolating a person has actually been used as a technique for extracting information from someone by altering their mental status.
Effort to decrease the spread of COVID-19 can increase the risk of any and all of these conditions and which by themselves have a significant negative health impact including leading up to death.
Finding the correct balance of risk of contracting COVID-19 with the risk of complications from isolation and loneliness is now a topic of discussion in the medical literature.
There are no answers to what the correct balance is. Prior to COVID, most older adults living on their own or with a partner participated in social activities. This gave them an anchor and a feeling of mattering. They gained pleasure through their interactions and their contributions to society.
The current cutting off of contact with others to protect one’s health can lead to self-devaluation. This state can affect susceptibility to diseases, infectious and otherwise.
Patients in hospitals, nursing homes, assisted living and senior homes are also at high risk. Techniques necessary to protect against spread of disease – banning visitors and keeping residents in their rooms – contribute to the problem. Isolating from family visits that have previously been regular, is particularly detrimental.
So, what can be done?
Technology can play a major role in balancing the need to isolate with the need for contact. Mobile technologies have been instrumental in keeping people in touch and in some cases re-establishing lost
While the technology and apps probably need to be simplified for the elderly, especially for those with cognitive impairment, there is no question that they, with the constraints placed by the pandemic, have greatly expanded the use of these technologies especially for older individuals. (Use your own definition of older. For me it is everyone older than the millennials.)
Something as simple as very regularly contacting someone whether a friend, acquaintance, or even a stranger can greatly help their mental health and probably yours too.