Dr Rajesh Jacob (Senior Consultant Psychiatrist @ Promises Healthcare) was interviewed by Tamil Murasu on 19th April about his views on ways we can help the elderly during this COVID 19 Circuit Breaker season.
Here’s an English translation of that interview:
1.What kind of mental issues that the elderly can experience during a pandemic like COVID 2019
Physical distancing during this public health crisis is essential in preventing the spread of the virus, but it can come at a high cost to seniors’ mental health and well-being, resulting in loneliness, anxiety, depression, and cognitive problems. Self-isolation will disproportionately affect elderly individuals whose only social contact is out of the home, such as at daycare venues, community centres, and places of worship. Those who do not have close family or friends, and rely on the support of voluntary services or social care, could be placed at additional risk, along with those who are already lonely, isolated, or secluded. It’s hard to escape news updates about coronavirus disease (COVID-19). The constant headlines and media reporting may make some people anxious. In particular, older adults, people with chronic health conditions, and caregivers are likely to be at higher risk for increased stress and anxiety, since they face a higher risk of illness if they contract the virus. Fear and worry about your own health and the health of your loved ones can result in changes in sleeping or eating habits, difficulty sleeping or concentrating, worsening of chronic health problems and increased use of alcohol or tobacco.
2) What are the potential do’s and don’ts that the elderly have to observe during this period of time? (e.g. spreading unverified COVID-19 news via whatsapp)
Maintaining seniors’ connection to their healthcare providers using the telephone or video telehealth platforms is critical and “may be the most important thing we do as mental health professionals.These include greater use of computers or tablets to stay connected to family, loved ones, and friends through video chats and playing online games.Seeing each other’s faces, hearing their voices, and sharing the experience that we’re going through can be therapeutic for everybody.Mindfulness-based interventions and relaxation techniques could also be helpful.There are many computer-based applications for these mindfulness exercises that the elderly folks can try out.
For seniors who are not tech savvy , and have difficulty using smart phones and the internet, just calling their relatives or friends through the phone would be immensely helpful for their mental health and reducing anxiety and fears.
Seniors who are comfortable and confident in using the internet can also sign up to govt websites such as www.gov.sg to obtain correct factual information. Due to widespread internet access, numerous fake messages and videos can be potentially circulated through whatsapp causing increased unnecessary fear and anxiety. This can be avoided by restricting too much exposure to online news and messages and probably watching the news on TV once a day for those who are more prone to anxiety.
GO ON A NEWS DIET
Stay informed, know what’s going on but don’t get locked into endlessly watching “breaking news” on the 24-hour news channels.
3) How can family members in the household assist to ease their worries, concerns and fears?
Children and grandchildren of the elderly who are living alone can also help by being in regular online contact and also calling them on their phones and giving them verified factual information of the COVID outbreak . For family members living in the same household, it is good to regularly update the elderly people about correct factual information about the epidemic. It is also important for the family members to keep the elderly engaged in other activities such as reading, playing indoor board games, chess, and other activities. It is also important for the elderly to avoid going out as they are more vulnerable and family members can help by providing groceries and other household essentials to them.
4) What kind of meaningful activities can the elderly engage at home during this period?
In addition to picking up the telephone, other options that may help seniors stay mentally engaged include practicing hobbies or activities such as knitting, crossword puzzles, “or whatever else works for them. Whatever helps them cope and keeps them occupied during self-quarantine should be encouraged. If there is a positive aspect to the COVID-19 pandemic, it’s that it has forced people to slow down and connect with each other.You may not be able to control the virus, but you can help control your emotional reaction to it.Take breaks from watching, reading, or listening to news stories, including on social media. Hearing about the pandemic over and over can be upsetting.Take care of your body. Take deep breaths, stretch, or meditate. Here’s a free guide on how to meditate from Mindful magazine.
Eat healthy, well-balanced meals.
Relax by doing activities you enjoy. Try crossword or jigsaw puzzles, , cook healthy meals and freeze some for later, and seek out TV shows to watch that give you pleasure. Explore your library’s online offerings.
For those who are not tech-savvy , it would be useful to learn the basics of using the internet and also learning to use online tools such as Facebook or zoom, so that they can get in touch virtually with friends and relatives if they are living alone.
5) How can the community play its part to care for the elderly who have little family/external support and live alone?
It is important for neighbours living in the same floor to look out for the vulnerable elderly living next to them. It is at times of crisis like this, do people need to get more empathetic and concerned about their fellow human beings. Neighbours can check on their well being on atleast twice a day basis, help them to get their groceries and also check on their physical health and get medical help if required.
There are also community agencies run by the government as well as NGO’s who have volunteers who can provide additional support to the elderly living along or with poor family support.
There are organisations which can provide meals delivered to their houses which will avoid the elderly leaving their houses unnecessarily .
6) Taking care of elderly patients especially those with conditions like dementia can be challenging for care givers. How can care givers ease their tensions, worries and stress while taking care of the elderly at home ?
For patients with Alzheimer disease or other cognitive problems, maintaining routine is important. Any change in routine can lead to agitation and behavioural issues in these patients. Share simple facts about what is going on and give clear information about how to reduce risk of infection in older people with cognitive impairment. Repeat the information whenever necessary. Instructions need to be communicated in a clear, concise, respectful and patient way. It may also be helpful for information to be displayed in writing or pictures. It will be also useful for caregivers of patients with dementia to take turns in looking after them to reduce the risk of caregiver stress and caregiver burnout. It will also be useful for caregivers to join online groups where they can share their concerns and other relevant information with similar caregivers looking after people with dementia.