May 11, 2020
Elder Mental Health in the Time of COVID-19
By: Diverse Elders

by Dr. Octavio N. Martinez, Jr., Executive Director, Hogg Foundation for Mental Health. This article originally appeared on the NHCOA blog. Para leer en español, haga clic aquí.

COVID-19 is caused by something so small we cannot even see it, a virus known as SARS-CoV-2.  This virus is causing illness and death throughout the world; and it seems to be targeting our elders especially hard.  According to recent statistics from the Centers for Disease Control and Prevention, 8 out of 10 deaths reported in the United States of America have been adults 65 years and older.  And the older you are the worse the statistics.  This is a tenuous time for grandmothers, grandfathers, older siblings, loved ones, and neighbors.

Great concern, appropriately so, exists for our elders that live in residential care facilities as well as those that live in multigenerational homes.  But why?  The answer: we are learning daily more and more about how this virus operates, but one thing that has become abundantly clear at this point in time is its predilection for individuals older than 60 and especially those with preexisting medical conditions such as, but not exclusively, heart disease, lung disease, diabetes, the immunocompromised, chronic kidney disease, and liver disease.  COVID-19 is taking a toll on our individual and collective mental health.  It is causing grief, anxiety, and fear.  But there is much an elder, a family member, and/or a caretaker can do.

First, minimize the risk of infection.  Stay home if possible and avoid any type of unnecessary travel.  Have someone else go out on your behalf for essentials; but if you go out, avoid crowds and wash your hands often with soap and water for at least 20 seconds after touching surfaces in public places or using the bathroom.  If you need to cough or sneeze, do so into the bend of your elbow or into a disposable tissue. Keep your nose and mouth covered with an appropriate type mask.

Also, keep your hands away from your face.  Clean frequently touched surfaces in your home, including mobility and medical devices, such as walkers, canes, and handrails.  For elder caretakers, it is of upmost importance that they take care of themselves by following COVID-19 infectious disease guidelines.  Another way to minimize risk is to postpone non-essential doctor visits such as annual checkups and elective procedures; and when available take advantage of telemedicine or telephonic visits.

Second, everyone needs to practice spacial distancing while enhancing social connectedness.  Limit contact with elders to only necessary physical contact and limit in-person visits by family and friends.  However, it is imperative that we avoid isolation and not contribute to loneliness.  Loneliness and isolation are detrimental to an elder’s mental health.  Provide and when needed, educate elders on the use of smartphones, apps, laptops, tablets, and desktops to stay connected through FaceTime, Skype, Zoom, and email.

In addition, we must not forget the power of a note, a card, or a letter from a loved one, friend, neighbor, or acquaintance.  We are social beings and staying connected is part of our humanity.  One’s faith and being part of a faith community is an important aspect of many elders’ social life.  Thinking creatively to keep elders connected to their faith is important and can be done through on-line services, television, and/or the radio.

Another important facet of our mental health is the need to have purpose in one’s life.  Our elders have lived long and fruitful lives full of experiences and wisdom they can share with all, but especially with youth.  Involving them in intergenerational activities strengthens relationships and bonds for all involved.  It can be as simple as having your abuelita tell a bedtime story over the phone to using a video chat to cook together.

Third, to help address stress and anxiety, develop a care plan for and even better with your elder.  Knowing that there is a plan to address the “what ifs” can be very comforting to an elder, the family, and caretakers.  A plan of action helps us all deal with the unknown.  A care plan should summarize the elder’s health conditions, medications, healthcare providers, emergency contacts, and end-of-life care preferences.

The care plan should include real-time preparations such as how much to stock up on prescriptions, over-the-counter medications, food, beverages, pet supplies, and other essentials.  Additionally, it is important for elders, family members, and caretakers to be well informed on COVID-19.  Ensure that information conveyed to elders is done respectfully through a culturally and linguistically person-centered approach.  Facts, symptoms, treatment interventions, and effective strategies to reduce the risk of infection should be delivered in an easy to understand methodology without being condescending.  This is especially salient for elders with limited English proficiency, elders that prefer another language to English, or are dealing with cognitive decline or dementia.

Fourth, support elder well-being.  Though staying informed is necessary, too much news and media can have a deleterious effect on one’s mental health.  It is important to take breaks from watching, reading, and/or listening to news stories and media.  Where possible, and not medically contraindicated, encourage physical exercise such as stretching, yoga, and tai chi.

Keeping the mind occupied with crossword puzzles, chess, or reading books and magazines can be quite useful.  Relaxation exercises are also beneficial.  Teaching and providing time to learn and utilize such relaxation exercises as mindfulness meditation, deep breathing, or guided imagery help to evoke the relaxation response and reduce stress.  Practicing even a few minutes a day can provide great benefit.  Listening to music, playing musical instruments, engaging in an art project, or working in the garden can have wonderful therapeutic effects as well.

COVID-19 is challenging us like no other crisis has this century.  It is targeting one of our most precious resources, our elders.  Individuals with experience and wisdom who raised families, worked hard, helped build this nation, and protected us from domestic and foreign threats. They deserve to be held in a position of highest respect and esteem.  Now they are vulnerable and they need us all to come together to battle COVID-19.




The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.