Covid-19: Our older citizens live in isolation – but can they cope?

Covid-19: Our older citizens live in isolation – but can they cope?
Covid-19, Ecosystems

The corona crisis has triggered many good initiatives aiming at mitigating loneliness amongst older people. It is a positive development since loneliness is a risk factor that might lead to a variety of diseases, and even early death. Therefore, there is a need for interventions, that can mitigate the increasing solitude – both during this corona period, but also in general – since the number of lonely older people is increasing, says Karen Lindegaard, Welfare Tech

Family and volunteers are in numerous ways trying to reach the older people, who are living in isolation often while being sick and weak. Among the initiatives appearing are street singers, and choruses singing outside nursing homes, so the homes can open the windows, and the elderly can enjoy the singing, together with the employees. Red Cross, DaneAge Association and lots of non-organised groups are offering to play music and to sing, when still keeping distance. Voluntary visitors are arranging phone calls, instead of meeting in person.

Ideas and motivation to mitigate loneliness are emerging in these months, forecast shows that the need will increase further in the future. Therefore, we improve our capacity of supporting lonely and isolated older people, continuing some of the many activities, there has either been triggered by the corona crisis, or has existed for a long time, says Karen Lindegaard, project lead at Welfare Tech. Through various projects regarding the elderly, and dementia, she has achieved insights regarding the challenges of loneliness and isolation amongst older people.. 

More older people = More loneliness

In Denmark 350,000 adults are lonely, and 50,000 of those are more than 65 years old, numbers from the foundation “Ensomme Gamles Værn (Guardians of the Lonely Old)”. Many of the older people, who are in the risk group of getting infected with Covid-19, are already spending most of their time alone, and during the isolation due to Covid-10, they are even more isolated from contact and inspiration from “real” people. Even without a life-threatening pandemic, we have an increasing number of older people, and research shows, that people become more lonely with age. Hence, the focus on the social relations is extremely important, since well-being has a great importance for the general health.

There is a focus on loneliness both in the municipalities (primary care) and at GPs

The foundation “Fonden Ensomme Gamles Værn” indicates possible interventions in a news article It is widely understood that loneliness can have serious health-related consequences, but the GPs rarely have access to means of mitigation. The municipalities are creating overview of activities and the opportunity for “human interaction” within a municipal and volunteer framework. Furthermore, healthcare professionals, social workers and doctors have access and knowledge about these activities that can help older people feeling less lonely.

In a report from the State Institute of Public Health, SDU; Loneliness and Weak Social Relationships among the Older People, it is stated that it is of great importance for the individual’s life situation and health to enter into meaningful social relationships and communities. Extensive research has shown that weak social relationships have a negative impact on the individual’s health and well-being, and the lack of social activity can also cause or increase the feeling of loneliness. Prolonged loneliness increases the risk of poor mental health, a variety of illnesses and premature death, the report states.

How do you mitigate loneliness?

In Denmark, there is an abundance of offers with respect to training, activities and social interaction taking place in municipal centers, volunteer organisations and associations/ clubs. However, the latest’s report shows that the offers has difficulties engaging the older people, who are socially isolated, and often has a physical handicap, and lost their will of life. The spreading of loneliness has also reached the nursing homes, even though the elderly live close to each other, and there are employees around them.

In 2015 a guidebook was released, aiming at providing inspiration to actions for prevention of loneliness amongst older people. The guidelines are indicating how to identify the lonely old, and provide a tools to, mitigate their loneliness. 

More people volunteering as visitors

In year 2020 there exist quite a few digital and non-digital offers for lonely older people. The mitigation of loneliness is given special attention.  The municipalities are encouraging people who are reaching retirement age to engage in voluntary work. The DaneAge association in collaboration with the insurance company Codan, have launched a large campaign to recruit voluntary visitors, for lonely older people, says the director of DaneAge association, Bjarne Hastrup to a magazine.  The arrangement of volunteer visitors for older people who lack human interaction has during the corona crisis been transferred to telephone conversations.

Get a virtual friend

The platform is a digital community platform, cooperating with one-third of the Danish municipalities, and being used by 285,000 citizens in the age between 15-95 years old. To reduce the loneliness, makes it is possible to find friends with the same interests. It could be someone to take a walk or a run with,  a pen pal or simply just someone to talk to. Together with Red Cross, in regard to Covid-19, has launched a digital visitor service www.snaksammen.dkOn this webpage it is possible to get digital visits from volunteer visitors, who can meet online through a secure system. This way it is possible to reduce the feeling of being alone, even though they might be alone. The service “SnakSammen” is developed by and Red Cross in cooperation with the municipality of Faaborg-Midtfyn. During the corona-situation “SnakSammen” has been made temporary accessible countrywide incorporation with the Nodea-foundation and TDC NET.

Visits from the municipality online

Many municipalities have also introduced virtual visits to older people. Often it is a virtual late morning visit by a healthcare professional – to say good morning, and make sure the citizens has woken up, had their breakfast and gotten their coffee. Some communication platforms are also allowing relatives and volunteers to communicate with older people, Life-ManagerVita-Com and Viewcare etc. These communication platforms have become extremely important during the Covid-19 pandemic, and are right now being widely implemented in the Danish municipalities.

Professor Bent Greve, University of Roskilde is pointing out that contact with others, using welfare technology, and the many forms of it-contact can reduce the loneliness amongst older people. Even though it is not like being in the same room, it is still better than not having any contact at all. It has become a necessity during a time where many older people are isolated, due to health risks. The corona crisis is also highlighting the need, for a more systematic preparedness in the coming years.

Social relations without the usage of IT

But what about those, who does not have access to, or knows how to use to digital media? New research from the Danish Agency for Digitisation shows that almost 400,000 Danes are exempt from having digital mail, of which 74% – which is almost 300,000 persons– are more than 65 years old. Christine Swane points out that many older digital users depend on the support of a relative to use digital services. These people are really isolated during the Corona crisis. However, Bent Greve is of the opinion, that this figure will decline as the next generation of older people already is users of  digital devices.

Join a bike ride

Cycling without age is an association offering a concept to be used at ex. nursing homes. The concept has a digital booking platform and rickshaw-bikes. A person from the community can volunteer as a pilot, and drive the older people on a bike-trip. The digital platform is indicating the specific time where the pilot is available. Employees at the nursing home will then match two older people and make sure they are ready at a specific time, where the pilot is available. The two older citizens sit next to each other, shoulder against shoulder, and talk about the things they pass during the ride. Due to Covid-19, the association is recommending that all the bike trips are suspended, until the situation goes back to normal.

Activities are great, but it does not remove the vacuum

An evaluation of projects in the program “Strengthened efforts to combat loneliness among older people who receive a lot of home-care” point out several learning points.
Among them:

  • That loneliness mitigating activities have been a positive event during the day, which the older people have been content to participate in;
  • The new activities and the attention towards the older peoples well-being increases happiness in the older person life;
  • However, the activities have not created any new long term and deep social relations;
  • The activities cannot fill the void that the elderly are experiencing in their everyday life.

Mitigation of loneliness amongst the older people during the Covid-19 isolation

In this perspective, it is important to remember that  during the long-term isolation, due to Covid-19, it must be expected:

  1. The amount of lonely older people will increase.
  2. The group of older people who already were lonely, will be even more lonely and more socially distanced
  3. The loneliness of older people is a large health risk

Even though it is not documented, that loneliness during temporary situations like this, will increase sickness and death rates, – as much as long  term loneliness – it is still important to put a focus on the means we already have. We should be able to carry out more of the above-mentioned activities and services to decrease loneliness among older people. Both during this period, where they are isolated due to Covid-19, but also afterward, says Karen Lindegaard.

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