My mother-in-law lives alone, a one-hour drive from our home but far outside the 5km zone of travel allowed here in Victoria. As she does not normally live with us, or require specific care, we haven’t seen her for months. Her health is not so great right now and I can’t help but think this is directly related to her isolation.
She is not alone in feeling isolated. Like many older people ageing in place, she has been entirely on her own for months. For those in residential care, a large number of them living with dementia, this isolation has also been particularly hard. Many have been asked to stay alone, isolating in their rooms, visits from family banned or severely curtailed.
The impact of social isolation
The effects of isolation are extensive. A report published by the Office of the eSafety Commissioner found that “COVID-19 will likely reduce older people’s walking and physical activity and lead to an increase in sedentary behaviour that risks impairing mobility and poor health generally.”
It also found that social isolation increases the risk of cardiovascular, autoimmune and neurocognitive problems – as well as their mental health, with a higher risk of depression and anxiety.
Rik Dawson, a gerontology physiotherapist and director of The Australian Physiotherapy Association, told the royal commission into aged care last month that residents’ social isolation accelerated physical and cognitive decline.
He noted that in some cases, it meant life-threatening falls and other injuries in aged care had almost doubled.
“We don’t have much data on falls, but we do know that the number of hip-fracture presentations has doubled at one hospital and others are noting similar trends, particularly for people with dementia or mental health issues, where the family member has been part of the care team,” he said.
“So often the family goes in and will then, having seen something out of the ordinary, raise issues with their carers,” Mr. Dawson said.
Isolation can also have an enormous impact on nutrition. Leading dietitian, Dr Cherie Hugo, has voiced her concern that malnutrition may end up killing more aged care residents than coronavirus. She says this is something driven entirely by the effects of lockdowns and social distancing.
“Research shows that isolation and loneliness increase malnutrition risk amongst the elderly,” Dr Hugo said.
Too easily, with other concerns taking precedence, the need for good nutrition is lost along the way.
“It’s just imperative, particularly during times of crisis like COVID-19, that we prioritise active measures around food and nutrition,” she said.
Jelica Vrkic, dietician at SPC, further notes that the need for many residents to eat in their rooms due to COVID-19 safety measures, rather than in a facility’s dining room, can have a detrimental effect.
“The change in eating environment can impact on nutritional intake. More meals are being served on a tray to each resident’s room as opposed to the usual dining room setting.”
“This means residents are eating alone. Losing the social experience can impact intake. said Ms. Vrkic.
With families unable to visit in person, a multi-generational fracture is appearing as grandparents lose connection with their grandchildren.
Julie Sweet, psychotherapist and managing director at Sydney’s Seaway Counselling and Psychotherapy, recently told the Sydney Morning Herald, “Grandfathers who see and hear their grandchildren, validating fears and reinforcing love, can be an anchor.”
“The relationship between grandfathers and grandchildren can be a sacred tie that develops in infancy and spans generations.”
These relationships are being lost.
Technology, of course, provides some reprieve to isolation but, sadly, this is not available for all.
For those living with dementia, it can be very difficult to communicate via phone or video conferencing. In many cases, these are the residents who are finding it hard to understand why no one is visiting and why they are unable to move freely within their care home.
Further, the Office of the eSafety Commissioner study found that, of those aged over 70 years, 57% have low to no digital literacy and 74% are digitally disengaged; they are not “digital natives” which makes it much harder for them to maintain contact with family.
Banned from the aged care residential homes of their parents and grandparents, many have missed the opportunity to say goodbye. The psychological scars for this are still to be determined, but there will be many – not just for those who have lost a loved one to coronavirus, but for those whose loved one’s time has come to an end for other reasons.
Just today a HelloCare reader shared a story. Her aunt in aged care, her family was banned from visiting. Living with severe dementia, her aunt was unable to use technology to keep in touch with family and, unable to visit and observe any evidence of decline, the family was horrified to receive a call yesterday to say she had passed. No goodbye.
A broken system
Through all of this we are reminded daily of our fractured age care system in Australia. The royal commission has drawn attention to its faults and highlighted the need for extensive improvements.
Finger pointing abounds within the government and the aged care community. Assessments and studies into what could have been done better are plentiful. Of course, it is important to assess where things went wrong to make sure the same mistakes are not made again.
But let’s work on getting it right. Let’s give our aged the care they deserve. Let’s make sure they have quality nutrition, are able to move their bodies, receive mental stimulation and as soon as possible, most importantly, reconnect with those they love.
The lives of many are dependent on it.
This HelloCare story was proudly sponsored by SPC Provital