Anderson: Isolation, inactivity pose particular risk to seniors

In September, I visited a client in her home — an 86-year-old woman I will call Jessie, living outside of McMinnville.

I had visited her many times before. But this time, I waited longer than usual for her to come to the door.

Guest Writer

Helen Anderson, a registered nurse who holds both bachelor’s and master’s degrees in the field, has been engaged in nursing in McMinnville for 16 years. Over that period, she and has worked in a number of different health care settings. She is currently providing private care management services through HelloCare. The agency, which she founded, develops and manages customized care designed to help seniors remain safe and healthy at home. She also maintains a blog at thenursewho knows.org.

Her voice was raspy when she invited me in. She cleared her throat to fix the hoarseness.

When I asked how she was doing, she replied, “I don’t know, dear. What day is it?” When I told her, she responded “OK” in a flat tone.

I was concerned about Jessie. Her face looked thinner and she seemed confused. So I called Jessie’s daughter, Maddie, who didn’t realize anything was amiss because Jessie never complains or asks for anything.

Maddie hadn’t been visiting because she didn’t want to increase her mother’s risk for COVID exposure. When I told her about my findings, she agreed to begin calling her mother daily, after getting her children online in the morning for classes. We also reviewed CDC guidance for safe visits — masks in place, six feet apart and outside

When I visited Jessie last week, she showed me her Fitbit, which tracks her steps. Her goals are to log 10,000 paces a day and out-walk her granddaughter. Her face was bright and she seemed her usual sassy self.

Hers is a typical situation we encounter with the seniors we care for.

Jessie would not ask her daughter to call her daily; I had to ask for her. But Maddie was thrilled to be able to help and her mom enjoys the calls.

This article represents a request of mine to families of seniors: Many need your support, but won’t ask. Be proactive and find safe ways to connect frequently.

Seniors face a special set of challenges, as the COVID-19 pandemic shows no signs of losing momentum. With 74% of deaths occurring in those 65 or older, the disease is particularly dangerous to adults in upper age ranges and/or suffering from other medical problems.

Keeping seniors safe from various health risks has always been a priority for doctors and nurses specializing in geriatric care, and COVID, of course, is getting all the attention now.

While isolating at home and avoiding groups has saved thousands of lives, it has happened at a cost we are only beginning to understand. Isolation and inactivity are emerging on the horizon as very real problems.

As a nurse working with older adults, I try to notw such problems early, while they are still manageable with a minor intervention like an antibiotic, topical cream or phone call from a dear family member. If these problems go unaddressed, minor intervention won’t be enough. More serious action will be needed — perhaps an IV infusion or hospitalization.

Older adults rebound more slowly from illness and injury. Early intervention serves to keep them  active, on their feet and out of bed.

Inactivity can trigger a downward slide nearly impossible to reverse. This is true for all of us to some degree. In fact, researchers found college students bedridden for just three weeks took nearly a year to completely recover their strength. And it is especially true for seniors.

As the pandemic drags on, with record numbers of new cases and hospitalizations, seniors are taking their safety seriously and staying home. While older adults have always been at higher risk for isolation, the extent and duration of the pandemic is adversely affecting a segment of the population that may experience the most trouble recovering.

The value of socialization is difficult to gauge. However, studies have shown isolation can shorten life expectancy as much as smoking 15 cigarettes a day.

Socialization is important for every age across the lifespan. Being with people who know and care about us is comforting.

It is especially important to the emotional and physical health of seniors, but the pandemic is making it more difficult. A survey conducted in June by the University of Michigan indicated 46% of seniors reported infrequent interaction with friends, compared to only 28% in an earlier survey. And that was early in the pandemic.

While the health risks of isolation seem minor in comparison to contracting COVID-19, they are real and should be addressed. Here are some strategies for supporting senior physical and emotional health during the upcoming months:

n For family members, schedule a daily phone call to give your loved one something to look forward to. Even a brief call can help reduce feelings of disconnection from friends and family. For seniors, check in with your friends regularly, to your mutual benefit.

Recruit other family into the communication circle as well. Scheduling different people to call varies the interaction and removes the stress of one person feeling he or she needs to call every day.

It’s best to have a topic planned for calls. Some families are using daily calls to collect stories from childhood or share recipes for favorite meals. Planning new topics to discuss keeps the conversations fresh and positive.

n Video chatting works even better, using a program such as Zoom, FaceTime or Skype. Keep in mind, however, mastering videoconferencing technology can prove difficult for the tech-challenged.

Some families have gotten a GrandPad for their loved ones. It can be augmented with a companion app and web portal, expanding its utility.

n Loved ones might drop off a home-cooked meal or a care package with favorite snacks and reading material. Another option would be delivering a take-out meal from a local restaurant, supporting our area eateries in the process.

Another idea is visiting through the front window.

Bring a pet if you can, as the antics of a pet are always entertaining. Reminiscing about favorite pets usually brings smiles and laughter, as well.

n Help ensure your loved one is keeping medical appointments. The extra safety protocols at the hospital keep patients and staff safe.

Doctor visits provide an opportunity to raise any concerns about physical or mental health. Delaying care can be risky — riskier than keeping appointments, as studies show you are very unlikely to contract COVID during routine medical visits.

n Seniors, you might want to limit the amount of news you consume. The nonstop cycle of COVID case numbers and deaths can easily overwhelm anyone.

If you are home all day without a distraction, with bad news running constantly in the background, it can cause undue stress.

n Body weight can be a key indicator of health maintenance for older adults. Seniors should weigh themselves at least weekly to monitor this.

Weight loss can result from reduced muscle mass related to inactivity or low appetite. Both of these issues should be discussed with a primary care physician at the earliest opportunity in order to reverse the situation.

You may have found other great ways to connect with your loved ones. If so, please message me through the HelloCare Facebook page. I will share your tips so others can learn from your creativity.

The holidays are a perfect excuse to start new traditions and let the seniors in your life know how much they mean to you.