Why is mental health of the geriatric population at a higher risk during the COVID-19 pandemic?

The COVID-19 pandemic continues to spread havoc across the world with more than 200,000 new cases reporting every day. Till date, the pandemic has taken the lives of around 800,000 people. Studies suggest that the serious illness condition and mortality from contracting COVID-19 virus is more often seen in the geriatric population (Tandon, 2020). This creates an increased feeling of insecurity and anxiety among these older adults. In collectivistic societies including Asian countries, the disease and the associated containment measures have led to social isolation and increased vulnerability among the geriatric population. This calls for the need of special care for older adults.

Presence of life stressors

Besides the constraining psychosocial impacts of the COVID-19 lockdown (Mackolil & Mackolil, 2020), the geriatric population is troubled by a distinct set of problems that can be categorised under the problems of ageism. Lower immunity and other associated comorbidities including chronic pulmonary and cardiac conditions, hypertension and diabetes are the biggest stressors that put older adults at a higher risk for fatality due the virus. Recent studies about the infected individuals reveal a 3.6% mortality rate among people in their 60’s, which further increases up to 18% for individuals above 80 years of age (Meo et al., 2020). Declining physical health and cognitive abilities not only restrict the functionality of older adults but also make them highly dependent. There is also a regression in economic status owing to retirement or inability to work. In addition, older adults often have to deal with the emotional toll associated with the death of their spouse or peers. Further, the opportunities to seek help are limited due to problems related to immobility. These stressors are topped by the increase in elder abuse during the pandemic. Studies show that elder abuse has increased by ten times during this pandemic which includes physical, verbal and emotional harm; financial exploitation and neglectful behaviour with low dignity (World Health Organization, 2020). These can have severe psychological effects which often go unattended.

Lack of technological expertise

The need to socialise during these adverse times is often met through online media. Online platforms are used to stay connected and to avail services and products without being in direct contact with others. However, older adults belong to the age group that is neither skilled nor comfortable with using technology and online platforms. This places them at a disadvantage as their social needs are not met. In addition, they are at a higher chance for ill-information and fake news as they might lack the skills required to check for authenticity of the news. This could lead to issues related to health anxiety, fear and loss of hope. They are not able to avail any of the services that is now offered online including religious/spiritual services, medical assistance, home-delivery services and virtual therapy sessions. This further affects their immunity and quality of life as they are forced to live with limited access to services and necessities. With these increased vulnerabilities, they are at a higher risk for panic and anxiety.

Adverse effects of social isolation

For older adults who live alone, the arrival of family members and visits of dear ones are a major source of social interaction and joy. The social distancing measures due to COVID-19 require people to confine in their homes with limited contact to the outside world. This leads to social isolation among older adults and an intensified worry about the safety of their loved ones. Social isolation can have detrimental effects on the geriatric population including cognitive decline (Wilson et al., 2007), reduced physical wellbeing and higher mortality. Studies have shown that health risks due to isolation equate to that of smoking and obesity (Holt-Lunstad et al., 2010). Social isolation and loneliness are specifically damaging in the geriatric population due their increased dependence on others. They depend on servants or other family member for their day-to-day functioning including medication, dietary needs and housekeeping. The containment laws have adversely affected older adults as servants have stopped providing service and relatives are no longer visiting them. The irony is that, the social distancing measures introduced to ensure protection of older adults have led to a reduction in their overall quality of life and increased the likelihood of depression. In addition, some older adults might not be able to comprehend instructions regarding self-hygiene, respiratory etiquette and safe distancing leading to hostility, neglect and isolation. This can push older adults into loneliness, worry and depressive thoughts of being a burden.

What is the role of mental health professionals?

The first step towards mitigating the problem is creating awareness about these vulnerabilities and providing timely interventions. Ensuring that older adults receive authentic information about the pandemic, helping them stay connected with family members (over the phone) and providing necessary psychological assistance can help to curb problems related to ageism and anxiety. In addition, mental health professionals should prioritize contacting older adults with disabilities as they might not get the opportunity to seek help. Providing updated directories of helplines and equipping the geriatric population with self-help and stress management skills can help to reduce elder abuse. Further, avoiding unhealthy practices including overthinking and substance abuse can ensure psychological wellbeing during this pandemic.

Funding source

This research is not supported by any funding.

Declarations of Competing Interest

None.