Warning Signs of Isolation in Seniors: What Do I Do Now?

April 20th, 2020 | COVID-19 Helpful Information

Most of the conversation during the coronavirus outbreak centers on physical health, understandably. Your first concern should be taking every precaution to prevent infection of family and senior loved ones. If your senior is in an assisted living community, you’ll have the peace of mind that our focus is on every resident’s health and well-being. (see our article “Can Mom Move to Assisted Living During Stay-at-Home? Yes.”).

For the past several weeks, your loved one has been isolated at home, with friends and family running their errands, doing their outside chores and so forth. Your attention has likely turned to their mental well-being. Do you know the best way to measure the effect of your senior loved one's isolation? Measure your own. Now increase by a factor of age, fear of viral vulnerability, lack of mobility, loss of control over your life outside your home and loss of physical touch.

“Cabin fever,” we jokingly call it. But, after prolonged periods of isolation, ordinary, small anxieties can begin to resemble anxiety disorders. Anybody of any age can suffer anxiety after extended discomfort. Seniors have no monopoly on this. The effects of isolation will manifest themselves in recognizable “symptoms,” described on Amintro.com, a site devoted to helping seniors with loneliness:

Are they sleeping? Loneliness makes for erratic sleep, and lack of exercise and increased anxiety aggravates sleeplessness. Find out how they’re spending their day. Brainstorm with them about things they can do to keep their mind active. For physical exercise recommendations, see our article “Home Workouts for Seniors.”

Have they increased buying habits? It may sound odd, but if you’ve observed the behavior, this may make perfect sense to you: study shows that loneliness can increase spending. It’s a substitute for social connection, and you could think of it as a kind of behavioral “comfort food” for some people.

Are they eating well? It’s normal to eat less with age, but a dramatic drop in appetite could signal feelings of loneliness. This may be hard to monitor if you can’t visit, and some seniors don’t want to talk about or simply don’t remember how much they eat. If they are residents of one of our communities, you can ask us to keep an eye on what they consume, since we’re delivering three meals a day to their door.

Have phone calls changed frequency? They may be calling more or less often. Either way, a signfigant change in the number and time of phone calls can signal isolation.

But more important, what can you do about it?

Again, the isolation imposed on all of us during the public health crisis is unusual and may really dial up the feeling of isolation. You may feel, for instance, that more frequent phone calls are better than fewer in these extraordinary conditions. Take advantage of them.

Pay attention to the topics of conversation. You may hear complaints that they feel they are being forgotten. It’s your chance to reassure them.

Be patient and listen, because this may be a simple request for your attention. Our associates frequently check in on our residents, but a loved one living alone in their home may not have this contact for days on end.

Don’t let it stress your relationship. The COVID-19 outbreak is temporary. Your relationship is forever. Nobody has to tell you it’s hard to sit around and watch the minutes tick by. If you notice them making up errands for you or other family members, it’s a way of asking for company. That’s not a bad thing. They love you and don’t know how to say it.

Our answer is Life Enrichment (LE), long a foundational program at all Legend Senior LIving communities, and not just created for the current crisis. Ordinarily, each community’s Life Enrichment Director plans a calendar including daily group games, arts and crafts, musical entertainment, group outings and educational sessions, among others. Since anything with the word "group" is on hold for the duration, our LE directors have turned to imaginative and innovative enrichment activities.

Look forward to every day. Modified for stay-at-home conditions, LE is necessarily less interactive, but very stimulating and uplifting, a vital part of every day. The dominant principle is “Give them something to look forward to,” says Lila Fladwood, Life Enrichment Coordinator at Legend of Broomfield, CO. “We bring the fun to their apartment every day, with reading material, brain builder games, puzzles, Skype reunions, or just helping them write and send greeting cards. We deliver three wonderful meals a day, and make certain they get everything they want or need. We bring the snack cart, every afternoon, to each room.”

“We’re doing the things we can while still observing social distancing,” says Fladwood, “although every employee here is screened before they enter the building every shift.”

Technology – Yes, We Know

A lot of us who aren’t even close to our senior years resist technology and aren’t great at operating the smartphone and programming the DVR, but we have to admit that the current situation has made us try harder to learn. The reality is, social media at its best is very social when any other kind is impossible. Our residents are encouraged to get technology tutoring from our associates, who were practically born with smartphones in their hands.

It’s Enough to Make You Stream

Your loved one may not have the advantage of living in one of our residences and having access to our kind of programmed Life Enrichment. Online technology can provide similar activity, if you’re creative with it. If you’ve run out of reruns and exhausted your cable channels, streaming services put virtually every movie and TV show ever made right at your remote control or smart tablet or smartphone. The same goes for your favorite music and news outlets. Not to mention a bottomless library of the world’s literature, a lot of it free.

But communicating online can put us in touch with a lot more than entertainment. And it’s hardly confined to passive surfing of the internet. Many seniors are finding the interaction with serious forums and “telehealth” services vital when they can’t get to the doctor. Other groups can provide real-time therapeutic and moral support in times of isolation.

Telehealth or telemedicine are generic terms referring to health-related services and information delivered online or by any telecommuniation. Remote patient and clinician contact can provide care, advice, reminders, education, intervention, monitoring and clinical admissions.

GoodRX gives 5 Digital Tools That Are Transforming Mental Health Treatment:

Telemedicine makes it easy to simulate an actual office visit, especially where mental health is concerned. You meet with your provider on the phone or video chat, and there are many to choose from that adhere to government standards for privacy and security. Most insurance companies, including Medicare, also cover telemedicine services. Telemedicine has helped many people continue mental health treatment when they would have otherwise been cut off during the shutdown.
Online support groups can be real lifesavers. Members who share an issue get together, and many find it easier to do online, rather than face-to-face. Topics can include addiction, grief and loss, or postpartum depression or any specific ailment. There’s no pressure to participate and just listening can be quite therapeutic.
Mindfulness and meditation apps are easy to use, inexpensive or free, and always at your side. A pair of earbuds or headphones are the only recommended accessories. Soothing natural sounds (like the Calm app) or vocal meditations have a calming effect and many people like to use them as sleep aids, reducing the dependence on medicine.
Self-help ebooks from any of the major booksellers often have audiobook companion editions, a great option for low-vision readers. Ebooks are frequently used for DIY therapy, but much handier than paper books (they’ll keep your place for you).
Text therapy, quite popular among younger users, gives you a certain distance on your therapist that some may prefer. It may be a less intimdating way to get reluctant seniors to “talk” to someone. Texting may be the least senior-friendly technology, but adult children who can’t always answer the phone encourage it.

New Media

Legend residences are furnished with a fully stocked lending library of books, and those who love to read have a built-in remedy for isolation. On the other end of the spectrum, Justin Hanshaw, Life Enrichment Coordinator at Legend at Rivendell, Oklahoma City, OK‎, is an advocate for new technology that may seem unlikely for the senior age group: Virtual Reality (VR), three-dimensional experiences using the same technology advanced gamers use.

“The residents eat it up,” he reported shortly after the stricter stay-at-home protocols were put in place. “They’re reluctant, and once the glasses go on – they’re converted.”

Hanshaw explains that age is no barrier in this technology: “We create a personalized escape for each individual. Some are thrill seekers who enjoy a rollercoaster or a cage dive with sharks in the open water. Other residents just want to relax on the beach and hear the waves crash, looking up at the blue sky, hearing the birds chirp. We are even currently ‘traveling’ the world through VR. If you’ve always wanted to stand in front of the Eiffel Tower, you can do it in your living room, while others are scraping the cable TV channels for something new to watch. TV can’t compete with VR.”

Ask Them to Tell Their Story

Lila Fladwood says that at Legend of Broomfield “LE” does not necessarily stand for “Lots of Entertainment.” Instead, let the seniors in your life entertain you. You can do this in a series of phone calls or ask them to write it down. But remember the power of “something to look forward to.” What if you said, “Let’s spend an hour twice a week where you tell me our whole history so I can write it down for your grandkids”?

“We engage in conversation much more frequently, encourage them to tell their stories,” says Fladwood, “what it was like for them during the Great Depression and how it affected the entire country, not just their family. We talk about how they survived some of the toughest times in history, and even thrived, and are living to share those stories to a younger generation that thinks this virus is the worst thing ever.”

“In Memory Care, especially, we honor their life stories and create activities that enhance those memories. Social distancing makes this more difficult one-on-one, so we have to get creative. We help spark old memories through music, pictures, exercise, worship, and reminiscing. We involve them in art projects, even if they’ve never been ‘arty.” Now the filters are gone, and they’re free to express themselves without ridicule. They find purpose. Meaning. Living in the moment!”

That’s a perfect description of our idea of senior living. And good advice for all of us. Stay well. Keep those hands washed. We’ll see you again soon.