Dawn Carr, PhD: Geriatrics Face Difficult Hurdles During COVID-19 Pandemic

Dawn Carr, PhD

The mental aspect of the indefinite social isolation due to the coronavirus disease 2019 (COVID-19) pandemic can be daunting, particularly for geriatric individuals.

Many older people are concerned about the health of their loved ones and themselves as the death counts continue to rise every day. This anxiety is currently coupled with some economic fear, as millions are recently unemployed and worried about their future.

In an interview with HCPLive®, Dawn Carr, PhD, an associate professor in the Department of Sociology at Florida State University, explained what some of the challenges are for the segment of the population and how they can cope with the social isolation.

HCPLive: How important is it for older people to feel comfort in this situation?

Carr: It is probably making them more vigilant about their behaviors. For anxiety and their mental health, there are consequences and manifestations that can accumulate and cause some very profound problems.

I think it is the combination of anxieties coupled with social isolation makes this much worse because what you have is people are unable to communication or engage with other people. Without that [connection], it can lead to sort of a downward spiral.

I think that is a big concern and there are some organizations that have come up with a solution for that.

For example, AARP recently put out Friendly Voices, which is part of the Community Connections program. They are getting people to check in on the vulnerable and have a chance to talk and ask questions.

HCPLive: Does the social isolation aspect that is needed make it significantly more challenging for older individuals who may sick and nearing the end of their lives?

Carr: I generally think that’s what makes this unusually awful. I mean, one of the main reasons we feel happy to be alive is because of the people in our life. Being alive is great, but much of the meaning we get from our lives involve our social life.

When we are being prevented from being able to communicate with loved ones, I think this is particularly bad.

The person who is at risk is in the minority relative to the whole and this really increases with age. So, people who are over 80 are much more likely to be of concern.

I think it is important to recognize the people in highly intuitional settings are cognitively impaired, physically impaired, that’s a very small percentage of the population. They’re the ones who I think have very different issues. They’re at much higher risks of having bad outcomes. If they are already in isolation, they are pretty socially isolated already.

The people in the community have a little more flexibility in how to deal with this. This is absolutely a rare situation. Oftentimes, the very thing that physical health can provide in families is connection, When someone gets sick, people come together to work together as a team.

I think this particularly illness goes against our best instincts on how to deal with things.

HCPLive: What role does technology play in keeping older individuals in social isolation engaged with their loved ones?

Carr: I feel really strongly that this is a useful tool. There was a study in 2015, where people over 80, two-thirds had a computer in their house. That is a pretty substantial amount.

That doesn’t mean they have access to video, but there is a good number even in the much older ages, but don’t use them because they’re not comfortable. I think this circumstance they may actually say “Okay I really do want to see my granddaughter and I’m going to go ahead and figure this thing out.”

I'm really hoping that if you use technologies more and try to use them more effectively, then it is going to meet their social needs.

Given the situation that all the grandkids are at home all day, if they can get through, keeping in touch with their grandkids is difficult because they have school and after school activities and practices and homework. They might be doing homework right now, but they are doing it at home, and they have more flexibility because it’s online.

HCPLive: How difficult will it be for people who lose a loved one not to be able to get the closure from a traditional wake or funeral due to social distancing and isolation norms?

Carr: I don’t really know the answer to that question. This has never happened before. People come together and grieve as a community, but you can’t do that. You hear these awful stories about people whose family members are across the country and they can’t see them when they are sick and then they die. These are times where we most need our community and rely on our social world.

HCPLive: How much anxiety is there for patients who already have some medical issues but may neglect those issues out of fear of going to a doctor’s office or a hospital?

Carr: I think there is going to be a balancing act. We don’t want to go to a doctor’s office right now, but if you have a serious medical issue that requires care there are certainly circumstances where we need to connect with our professionals.

One thing I would say is there’s been a shift to telemedicine. I would say when possible people shouldn’t be afraid to reach out to the medical community and connect with and try to get at least a call from them.

HCPLive: How would you handle the financial anxiety attached to what is currently happening in the country?

Carr: First I would say never dip into your 401k and certainly don’t that now. I understand times are tough. Hopefully there will be a little bit of relief coming from our government, but a significant portion of the population aren’t going to have an income. I think as people navigate these waters they have to hope for the best and once we are able to go out and go back to normal many of these jobs will be available again.