Mental Health of the Elderly during CoViD-19

The outbreak of COVID-19 could lead to greater levels of stress in the elderly, as a result of being more at risk of the infection. It could also lead to increased feelings of isolation, especially if they are already experiencing conditions like widowhood, limited mobility etc. Loneliness can increase the risk for depression and anxiety. Those who rely on social contact out of their homes are even more vulnerable to mental health concerns. Additional information can be found at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104160/

The following issues affect the elderly more than other age groups.

• Difficulty in accessing help, support and resources as care-givers are unable to travel and meet them
• Difficulty in connecting with others through social media and technology such as mobile phones, skype, Zoom etc.
• For those who have health complications and age-related disabilities, which require ongoing constant medical care, the disruption due to lockdown may affect their mental health too.

We might observe a range of mental health concerns including

• Disturbances in sleep, appettite and eating, and boredom.
• Worry and anxiety related to death, dying, illness, uncertainty about future
• Hopelessness and/or helplessness
• Sadness, loss of interest, low levels of motivation and energy.

In some cases, mental health concerns can develop into clinical disorders. It is particularly important to pay attention to signs of depression and anxiety related disorders at this time.

The symptoms of depression in the elderly might manifest differently than those in younger people. For example, instead of sadness, one might feel increasingly tired. The following changes may be signs of depression:

1. Physical signs: Tiredness, difficulty in sleeping and changes in appetitie.
2. Mood disturbances: Grumpiness, irritability and anger.
3. Cognitive signs: Confusion, memory and attention problems.
4. Thoughts of dying/suicide
5. Neglecting personal care

The answer depends on many factors

• Duration and course of mental health concerns– Have symptoms of depression been around for a while? How has the person been able to cope with concerns so far? Do they have access to support? In some cases, we might see mental health concerns suddenly worsening as a result of the pandemic.
• Severity of concerns. Concerns that are present most of the day, everyday might indicate greater severity. One also needs to look for signs of risk which would include increased thoughts of dying and not wanting to be alive.
• Motivation for self-care. One might not be able to access motivation to change or engage in self-care in the presence of mental health concerns

The following steps can help the mental well-being of the elderly

• Doing activities together, like looking at old photos, listening to music and playing a game.
• Ensuring there are enough small chores they can be part of and can contribute to
• Helping them reconnect with others using technology.
• A regular schedule of exercise and exercising together
• Reassurance and validation of mental health concerns as a result of the pandemic. In the presence of mental health concerns of greater severity, one might not be able to utilize typically heathy coping mechanisms. In such instances and in the absence of support, it is strongly recommended to reach out for professional support.