COVID-19 is likely to stay for several years now- a fact that is been accepted by organizations like WHO and CDC. While mass scale immunization is definitely going to tilt the balance to our favor, it is not likely to be completed in next 3-5 years. Statistics of how the disease is affecting the elders as a cohort is confusing and there is conflicting data from WHO, ICMR and CDC on whether COVID-19 causes significantly higher death rates and complications in elders. COVID-19 kills elder but not at any higher rates than diseases that already cause death in elders- like heart disease, Stroke and many more. As with any other acute disease like an infection, co-morbid conditions or chronic diseases contributes to the overall outcome of the disease. This is same with COVID-19. That’s why elders with chronic diseases need to be more careful with COVID-19.
The New Approach
So, what should we do now? Can we let our guard down and live or co-exist with COVID-19 ? The answer is certainly NO. The course of COVID-19 is unpredictable. We haven’t fully understood the disease or the virus. The treatment protocol too is not established. What we know is that we can prevent the infection by being careful and vigilant. It would be impossible for us to stay isolated in lockdown as we are now. It is necessary that we approach the COVID-19 in a new way- an approach that looks at the overall health of the elder, at the same time provide effective barriers against the virus.
We cover this approach based on adaptations to the 7 dimensions of wellness.
Basics First!
COVID-19 spreads mainly by droplets produced as a result of coughing or sneezing of a COVID-19 infected person. This can happen in two ways:
Direct close contact: one can get the infection by being in close contact with COVID-19 patients (within one Meter of the infected person), especially if they do not cover their face when coughing or sneezing.
Indirect contact: the droplets survive on surfaces and clothes for many days. Therefore, touching any such infected surface or cloth and then touching one’s mouth, nose or eyes can transmit the disease. Wash your hands frequently with soap and water for at least 20 seconds .
So,
Keep your hands away from your face.
Disinfect commonly touched surfaces using house hold disinfects as frequently as possible.
Minimize the risk of COVID-19 infection
Postpone unnecessary doctor visits. If you are feeling well, consider postponing elective procedures, annual checkups and other non-essential doctor visits.
For routine visits, ask the doctors’ offices if they offer telemedicine, which enables doctors and patients to communicate over video, email or other means rather than face-to-face.
Physical Wellness- Can’t go for walk or run- MOVE !
For elders who are home bound due to co-morbidities, some form of structured exercises in the form of Chair Exercises, Resistance exercises with Therabands is recommended. For elders with high risk of falls, such exercises should be done under supervision
Yoga and flexibility exercises for elders with arthritis.
Elders who have walking path around your house or apartment can venture out for walks.
Make sure you wear a mask covering your nose and mouth before going out.
Wear disposable gloves if you have to touch any common surface like a lift button or handrails to reach the walking area. Properly dispose the gloves after the walk.
Wash hands with soap and water after you come back.
Avoid crowd or walking as a group.
Take Medicines on time. Keep adequate stock of all the regular medicines and emergency over the counter medicines.
Check vitals- Blood pressure, Fasting blood sugar as advised by the doctor at home. You can buy good quality medical equipment nowadays from local pharmacy or online stores like amazon or flipkart.
Eat balanced diet and make sure your diet is reviewed by a nutritionist once in 6 months. Check your weight once in a month.
Ensure fall prevention strategies are in place. A fall and fracture is the last thing you want at this time.
Social Wellness- Make Technology your friend
Socializing is very essential to keep up the good spirits and stay positive. But during this crisis, elders are encouraged to stay indoors and limit social visits.
If friends or family is visiting, make sure that they are wearing mask even inside the home. Make them compulsory hand wash after they come in and wash hands before they leave. Avoid too many visitors at a time. Disinfect high touch areas after the visitors leave.
Use online social platforms like Facebook, Facetime, Whatsap Video and skype to call and converse with friends and family.
You can also be part of many groups in social forums to engage in meaningful conversation online or over phone.
Elders who feel lonely or depressed due to lock-down or extended social distancing can contact counselors or psychologist over phone and seek help.
Emotional Wellness- Stay Positive
Staying alone or with spouse or with limited family members without any outside social interaction can cause emotional stress, anxiety and panic attacks. Insomnia is common is elders who are isolated.
Fear, anxiety and stress adjustment disorders in elders are common in times of pandemic. Given the fact that accessing help in the usual form will be difficult now, it is suggested that elders keep themselves engaged most of the time and seek help through alternate means.
People who are already depressed find the situation more challenging especially those who had good support group and counselling sessions.
The mantra to good emotional health is in engaging in hobbies or activities which interest you. Keeping a positive mind depends on your ability to channel your thoughts into something creative or new.
Talk to friends and family over phone. Talk to next door neighbor and form small groups among neighbor. Be part of online support groups.
Vocational Wellness- Best time to Learn!
At home means that you have all the time to learn new things. Also, to do things which you wanted to do but didn’t have time. Many elders the author knows has ventured into terrace gardening.
Online tutorials are available- most of them free now, from how to do use digital cameras to how to cook Chinese food at home.
Getting involved in new learning process also helps in the emotional wellness and keeps mind occupied.
Elders who are still working should restrict time spend out and try to conduct their work mainly from home.
Intellectual Wellness- Keeping the Brain Strong
This pandemic brings to the elders all the risk factor for cognitive decline- social isolation, stress, depression, anxiety and boredom.
Intellectual wellness involves the keeping the brain fit and preventing memory impairment.
Activities that stimulate the brain- games like Sudoku, crosswords, painting, reading, learning new task and all helps.
Elders already diagnosed with cognitive impairment can become more confused with the new arrangement. A structured daily routine helps in managing them better at home.
Spiritual Wellness- The Healer Dimension
Spirituality can be used as an effective tool to compensate for the challenges elders face during the COVID-19 crisis. Spirituality is not just been religious, but it is more about having a life purpose or sense of meaning. A spiritual community can provide social connection as well as solace for health issues and other questions and concerns that come up as we age.
Start practicing any form of prayer you know- songs, hymns; start showing gratitude of the blessing we have.
These times also gives us time to rest- take a break from responsibilities which have been your companion for many years. Utilize the time to reconnect to a long disconnected friend or family member over phone.
Meditate, practice breathing and utilize these tough times to sooth your mind and heart.
Environmental Wellness- Keep yourself Safe
Environmental wellness means to take mindful care of the environment around us. It also means that we take adequate precaution to make sure that the surrounding is safe for us.
Keeping the surfaces disinfected; properly disposing mask and gloves and be mindful of not spreading the infection are key aspect of environmental wellness during COVID-19.
Note about the Author: Rahul Padmanabhan is a consultant in Geriatrics and Gerontology based in Coimbatore, India. He specializes in home and community based Geriatric Care. Dr Rahul’s Elder Care provides complete solutions to the healthcare needs of the elders.