Mental health concerns and Measures to protect Elderly in Covid 19 – Outbreak

INTRODUCTION

Pneumonia clusters that occurred in Wuhan City, China in December 2019 contributed to the detection of Severe Acute Respiratory Corona Virus Syndrome2 (SARS-CoV-2)¹ . After a month it was declared as a “Public Health Emergencies of International Concern”.² Later on, on 11 March 2020 SARS-CoV-2 was declared as a pandemic by the World Health Organization (WHO).¹³ It has affected many people among many countries and geographical locations.^3,4 This COVID-19 epidemic has attracted growing nationwide attention⁵ . As on 16th June 2020, there are 78,90,687 confirmed cases with 43,3404 confirmed deaths are reported in 216 countries⁶ . On the same day, in India reported with 1,53,178 active cases with 9,900 deaths⁷ . Following this global health crisis, stringent public health safety interventions have been implemented on COVID-19 spread.⁸ Health authorities and governments Internationally, warn older people that they are at a higher risk of acquiring COVID-19 fatal disease.⁹

Problems of elderly during covid 19

Mortality of the SARS-CoV-2 pandemic has been striking in older adults.1 The Centers for Disease Control and Prevention ( CDC) of United States have reported that elderly constitutes 31% of COVID-19 infections, 45% of hospitalizations, 53% of admissions to the intensive care unit and 80% of deaths caused by this infection.¹ A relatively higher mortality among the elderly has been reported by the emerging data, which ranges from 3.6% to 14.8%⁴ . The elderly, who constitute 10% of India’s population, accounted for over 50% of the country’s Covid-19 deaths10. Further, they are at an increased risk of cardiovascular, autoimmune, neuro-cognitive and mental health problems.¹¹

Research studies have revealed that this virus causes worse outcomes and a higher mortality rate among older adults and those with comorbidities such as cardiovascular disease, diabetes, respiratory diseases, hypertension, and Chronic Kidney Disease (CKD)¹ . It has an intense effect on all aspects of society including physical and mental health¹². The elderly population is at a risk of developing mental health issues during the covid 19 outbreak³ . This reality has also been highlighted in the media and is urged to take more care for older people in general. All of this leads to an anxiety among the elderly, about the eminent death4 . Also it is very important to protect the mental health of the elderly as they vulnerable to stress due to exacerbated loneliness, morbidities like dementia, restrictions in lifestyle and feelings of worry¹¹.

For the older population the global recommendation is separation from society, staying at home for "a very long time"49 Social isolation is a serious public health concern and is known to increase chance of negative effects for mental health^4,13. Data available show that social disconnectivity raises the risk of depression and anxiety among elderly. It’s quite natural that an outbreak can cause anyone feel anxious or distressed³ . Elderly people face insurmountable psychological pressure that may lead to various psychological problems , such as anxiety, fear, depression, and Insomnia¹⁴. This may even have increase the risk of aggression and suicide¹⁴. The limited knowledge of the COVID-19 and the overwhelming news may lead to anxiety and fear among elderly¹⁴. Under the isolation measures, they also experience boredom, disappointment and irritability¹⁴.

Measures to be taken for protecting elderly people during Covid 19 pandemic:

Thus the measures should be undertaken by us to reduce the risk of negative psychological outcomes caused by the COVID-19 outbreak and to promote social stability. Some of the measures given by the World Health Organization, Ministry Of Health And Family Welfare and National Institute of Mental Health And Neuroscience are presented here in nutshell.

• Give emotional support through families networks and health professionals.

• inform them about the simple facts about what is going on

• Give clear information about how to reduce risk of infection

• Convey information in a clear, concise, respectful and patient way

• Repeat the information if required.

• Writing or pictures of information may be displayed

• Engage family members in providing information

• Encourage people to practice measures to prevent infection (e.g. hand washing, etc.).¹⁵

• Frequent handwashing. Regularly and thoroughly wash hands with soap and water for 40 secs or 70% alcohol based hand rub.¹⁶

• Help to maintain social distancing (Practice at least 1 metre distance between yourself and others, avoid going to crowded places etc)¹⁶

• Help to have access to required medications.¹⁵

• Have regular schedules and routines for the family (eg: cleaning, exercising, daily chores, painting ,singing, or other activities.)^15,17,18

• Encourage quality family time which reduce anxiety¹⁷

• Engage them with recreational activities with children like solving riddles, puzzles etc¹⁷

• If they are away from the loved one encourage them to connect to them over telephone or video calls^17,18

• Allow them to seek for information only through the credible sources (World helath organiasation /ministry of health and family welfare etc.)^17,3

• Encourage them to be physically active by doing simple exercises,yoga ,walkin indoors and meditation.^17,18

• Help them to limit alcohol and drug abuse¹⁸

• If required, ask for support from family members, friends or neighbours.¹⁸

CONCLUSION:

It is essential that we should understand and realize that all of us should take some essential steps to care for ourselves and our dependents. As the elderly people are found to be the most vulnerable to covid 19, this situation calls for an immediate attention to them by caring them during the outbreak. As the social isolation can have negative impacts on the elderly population, social support and information for mental and emotional wellbeing have to be made accessible to them. Another way of supporting older people during their current health crisis could involve regular meaningful telephone conversations, ensuring that mental, social and physical health needs are met. Thus ensure older citizens have access to the care and support they need during the COVID-19 outbreak. Owing to age, seniors may be frail but they're definitely not weak. Their durability can be impressive, if cared for properly.