Older adults suffer disproportionately from the 4:29 pandemic
(CNN) – 88-year-old Alice Herb, a fearless New Yorker, is used to walking miles around Manhattan. But after this year of being locked up at home, trying to avoid covid-19, she has noticed a huge difference in how she feels.
“Physically, I’m out of shape,” he says. “I took the subway for the first time the other day and was out of breath going up two flights of stairs to the street. That is not like me.
From an emotional point of view, Herb, a retired lawyer and journalist, is unusually hesitant to resume her activities, despite being fully vaccinated. “You wonder, what if something happens? Maybe I shouldn’t do that, maybe it’s dangerous,” he said.
Millions of older Americans are similarly struggling with physical, emotional and cognitive challenges after a year of being locked up at home, stopping their usual activities, and seeing few or no people.
If they do not address the problems that have arisen during the pandemic, such as muscle weakness, poor diet, interrupted sleep, anxiety, social isolation and others, these older adults face the prospect of worse health and greater fragility, experts warn.
What should people do to meet these kinds of challenges? Several experts shared their advice:
Reconnect with your doctor. A large number of older adults have delayed medical care for fear of COVID-19. Now that most seniors have been vaccinated, they should schedule visits with their primary care physicians and for preventive care checkups, such as mammograms, dental cleanings, eye exams and hearing screenings, said Dr. Robert MacArthur, medical director of the Commonwealth Care Alliance of Massachusetts.
Ask to have your performance evaluated. Primary care visits should include a basic assessment of the physical functioning of elderly patients, according to Dr. Jonathan Bean, an expert in geriatric rehabilitation and director of the New England Geriatric Clinical, Educational and Research Center at the New England Health System. Boston Veterans Affairs.
At a minimum, clinicians should ask, “Do you have difficulty walking half a kilometer or climbing a flight of stairs?” Has the way you do ordinary tasks, like dressing, changed? ”Bean suggested.
Ask for a referral to physical therapy. If you have trouble moving around or doing things you used to do, ask for a referral to a physical or occupational therapist.
A physical therapist can help you improve strength, balance, range of motion, and endurance. An occupational therapist can help you change the way you perform various tasks, assess the safety of your home, and identify necessary improvements, such as installing a second railing on a staircase.
Don’t wait for your doctor to take the initiative; normally not. Speak up and say: Please can you refer me to a doctor? I think a qualified evaluation would be helpful, “says James Nussbaum, clinical and research director for ProHealth & Fitness of New York, a therapy provider.
Start slowly and build up the intensity. Be realistic about your current capabilities. “In my experience, older adults are eager to get out of the house and do what they did a year ago. And guess what? After being inactive for more than a year, they can’t, ”said Dr. John Batsis, associate professor of geriatrics at the University of North Carolina-Chapel Hill.
“I am in favor of starting small, going slowly,” Batsis continued. Be honest with yourself about what you feel capable of doing and what you are afraid to do. Identify your limitations. It will probably take some time and you will have to make some adjustments along the way.
Nina DePaola, vice president of post-hospital patient services for Northwell Health, New York’s largest health care system, cautioned that getting back into shape can take time. “Be patient. Listen to your body. Do not do anything that causes discomfort or pain. Try to introduce yourself to new environments in a thoughtful and measured way, “he said.
Be physically active. Experts recommend doing some kind of physical activity regularly (a walk in the park, chair exercises at home, video fitness programs). The Go4Life program, sponsored by the National Institute on Aging, is a valuable resource for beginners, and videos of some sample exercise routines can be found on YouTube. The YMCA has put exercise classes online, as have many senior centers. For veterans, the Veterans Administration has Gerofit, a virtual group exercise program worth checking out.
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Welcome Manzano, 70, of Boston, who retired from the Coast Guard after 24 years and has severe back pain, attends Gerofit classes three times a week. “This program strengthens the muscles and involves all parts of the body, and it is a great help,” he said.
Keep your expectations realistic. If you’re afraid to get started, try a little activity and see how you feel. Then try some more and see if you feel good. “This type of repeated exposure is a good way to deal with residual fear and indecision,” said Rachel Botkin, a physical therapist in Columbus, Ohio.
“You have to understand that this has been a time of psychological trauma for many people, and that it has impacted the way we behave,” said Dr. Thomas Cudjoe, a geriatrician and adjunct professor at Johns Hopkins Medicine in Baltimore. “We are not going back to pre-pandemic activity and participation, as if we were flipping a light switch. We have to respect what the limits of the people are.
Eat well. Make sure you eat a balanced diet that includes a good amount of protein. Adequate protein intake is even more important for older adults in times of stress or when they are sedentary and not very active, noted a recent study on healthy aging during COVID-19.
Reestablish routines. “Having an up-to-date structure that involves social interactions, whether virtual or in person, and various activities, including some time outside in good weather, is important for older adults,” said Dr. Lauren Beth Gerlach, Geriatric psychiatrist and assistant professor of psychiatry at the University of Michigan.
Routines are especially important for older people with cognitive impairment, who tend to do better when their days are reliably structured and they know what to expect, he said.
Routines at the end of the day are also helpful in addressing sleep problems, which have become more common during the pandemic. According to a survey by the University of Michigan, conducted in January, 19% of adults between the ages of 50 and 80 say they sleep worse than before the pandemic.
Reconnect socially. Mental health problems have also worsened for a segment of older adults, according to the University of Michigan survey: 19% reported experiencing more sadness or depression, while 28% reported being more anxious or worried.
Physical isolation and loneliness may be contributing, and it’s a good idea to start “reinforcing social support” and seeing others in person if they are vaccinated, Gerlach said.
Families play an important role in reconnecting loved ones to the world around them, Batsis suggested. “They have had 15 months or so of few face-to-face interactions. Make up for it now by visiting more often. Make the effort.
Laura Collins, 58, has spent a lot of time this past month with her mother, Jane Collins, 92, since visiting restrictions were relaxed at Jane’s Black Mountain, North Carolina nursing home and both women were vaccinated. In the last year, Jane’s dementia progressed rapidly and she became depressed, crying often with Laura on the phone.
“He loves to go outside and that has been wonderful,” says Laura. “Her mood changes immediately when she leaves the building: she is happy, almost like a child going out for ice cream. And in fact, that’s what we do, go out for ice cream.
–Kaiser Health News is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the top three operational programs of the Kaiser Family Foundation. KFF is a non-profit organization that provides health information to the nation.