Lockdown from the eyes of the aged

Lockdown has been really scary and stressful for all of us but the extent of its effects has been different for each one of us. It has been particularly difficult for some segments of the societies, especially the lower-income groups, disabled people, and the elderly.

The elderly have been hit not only because of the economic pressure and the inability to work but also because of the socially distancing norms, especially considering that they are most vulnerable to the situation due to the high risk catching category they fall in.

Age and ageism are major vulnerabilities to the 2019 coronavirus disease (COVID-19). Although the number of cases and deaths is growing worldwide, the elderly are vulnerable to the infection’s physiological and psychosocial consequences. The mental well-being of this fragile population is sadly ignored, as the emphasis on management is primarily geared towards precautionary steps and looking for a biological remedy. In addition to being vulnerable to alienation, loneliness, tension, sorrow, depression, and anxiety during the lockout, seniors are often victims of ageism-induced stigma, bigotry, and violence. Elder abuse has been especially troubling during the current pandemic in any manner. There is a higher risk, especially for those who remain alone, those with a sensory or cognitive disability, and those who are institutionalized.

According to a new report, the coronavirus lockdown affected the livelihoods of 65 percent of the elderly and they either had no jobs or suffered a severe loss in their salaries during the time.

On the occasion of World Elder Abuse Awareness Day on Monday,’ The Elder Story: Ground Reality during Covid 19′ was published. It was conducted by HelpAge India, which surveyed 5,099 elderly people across 17 states and four territories of the Union.

• It found that 67 percent of that 65 percent elderly whose livelihoods were affected were in the age group of 60-69 years, a substantial 28 percent in the ‘old-old category (70-79 years) and five percent in the ‘oldest-old age group (80 plus).

Also, there is unfair discrimination in the selective extension of lockdown on some classes, in this case, the aged. It is suggested that a more proportionate approach to the risks raised is the selective isolation of the elderly than continuing a full lockdown. The aim of the lockdown is to reduce COVID-19 deaths and to avoid overwhelming the healthcare system. If they contract COVID-19, the elderly face a considerably greater risk of being seriously unwell and dying. This not only means that the elderly benefit more by not catching the virus, but that they pose the greatest risk to society because the elderly are more likely to put considerable pressure on scarce resources for intensive care. This is because everyone must endure the same deprivation of rights for the elderly to experience the advantage of not contracting COVID-19, even if everyone else does not experience the same benefit and does not face the same risk of overwhelming the healthcare system.

Selective isolation of the elderly may be argued as rational prejudice since it is a fair way of attaining a valid target. The valid purpose of selective isolation, like the current full lockout, is to reduce the number of deaths caused by COVID-19 and the social damage that this would bring.

A survey conducted by the Agewell Foundation showed that when engaging with older people, volunteers discovered that the majority of older people were frustrated because of this new phenomenon. When speaking over the phone, they shared a sense of anticipation, resentment, anxiety, and even anger.

• It was found during the survey that 54 percent of elderly respondents stayed with their younger family members (children/grandchildren/other family members, etc.), while 33 percent lived with their respective spouse and 13 percent of respondents lived all alone during the time of lockdown.
• 45% of respondents who remained with their children/grandchildren and other family members at home admitted that lockdown helped bridge the divide between generations. 55 percent, however, do not agree with the view that life has helped to bridge the intergenerational gaps during the lockdown phase.
• 52 percent of elderly respondents reported during the lockdown period that their interpersonal relationship with family members, particularly their own children, has further deteriorated due to hardly any contact, conflict of personal ego, interests, and attitudes.
• The prevalence of new information technology gadgets is the most responsible factor for their broken interpersonal relationships, according to 23 percent of respondents, since most younger individuals are occupied with their mobile phones or computers.
• 59% of the elderly living with their other family members, said that even within their family members, they still feel psychological loneliness/isolation. The key reasons for this condition were negligence by younger members of the family, hostile relationships, racist conduct towards elderly people, increasing levels of anger, etc.
• 65 percent of older people complained that they have lost their freedom, self-esteem, and even integrity to some degree because of the lockdown situation, as they have to rely on others for their basic needs.
• Nearly every second elderly person (51 percent of respondents) believed that their human rights are at risk during the time of the lockout, as they are (mentally or physically) mistreated/harassed/shouted/misbehaved/threatened/tortured/neglected/isolated/marginalized.

The psychosocial vulnerability may give rise to depressive disorders, insomnia, and chronic stress, especially at times of lockdown and quarantine: isolation, anxiety, and uncertainty. It can be important and persistent to grieve and regret because of loss or distance from their loved ones. If the stress is prolonged, they are also at higher risk for posttraumatic stress syndrome. Alarmingly, in the elderly population, suicide risk is often two to three times higher and is frequently under-reported. During the current pandemic, a national mental health study in China found that one-third of those over 60 years old suffered from grief, depression, anxiety, and insomnia.

Many senior citizens may not be able to keep in contact with their loved ones through social networking (WhatsApp, Facebook, etc and video conferencing methods recommended worldwide during the COVID-19 crisis for social communication due to different reasons such as lack of familiarity, cognitive or sensory deficits, and difficulties in adjusting to a new activity. In particular, when they choose to digitally communicate with their families, older adults living alone do not have the requisite assistance. This can lead to resentment and helplessness. While digital links seem to be a rational alternative, previous studies have shown that elderly people prefer personal contact and treatment rather than virtual interactions. Staying physically “segregated” contributes to their depression and social alienation during the current pandemic situation.

References

Bureau, E. (2020, April 24). Elderly worst affected during lockdown: Agewell Foundation survey. Retrieved December 05, 2020, from https://www.expresshealthcare.in/news/elderly-worst-affected-during-lockdown-agewell-foundation-survey/419307/

Pti. (2020, June 15). Lockdown impacted livelihood of 65 per cent elderly: Study. Retrieved December 05, 2020, from https://economictimes.indiatimes.com/news/economy/indicators/lockdown-impacted-livelihood-of-65-per-cent-elderly-study/articleshow/76382969.cms

Savulescu J, Cameron J. Why lockdown of the elderly is not ageist and why levelling down equality is wrong. Journal of Medical Ethics 2020;46:717-721.

Banerjee, D., D’Cruz, M. M., & Sathyanarayana, T. R. (2020). Coronavirus disease 2019 and the elderly: Focus … – jgmh.org. Retrieved December 5, 2020, from https://www.jgmh.org/article.asp?issn=2348-9995;year=2020;volume=7;issue=1;spage=4;epage=10;aulast=Banerjee