Re-Engagement After Prolonged Isolation

Isolation has been a long-standing issue for many older adults whose physical health has declined and support needs have increased. Sadly, in many instances it has been normalised as an expected part of ageing, along with the assumption that depression too is just part of getting old.

However, while it may be common, there is much we can do to minimise the impact and improve outcomes for the elders in our care. In this article we explore the latest research on the impact of isolation in late life, particularly related to COVID-19, and offer practical strategies on how to gently reintroduce opportunities for better engagement and increased social connections in late life.

The Problem

Many individuals who experience isolation may subsequently experience loneliness and be at risk of developing mental health conditions. They are not as active, engaged and well as they once were and may not be able to participate in activities as readily as before. From jumping in the car or going for a walk, to organising a holiday with friends or family, life is different. Their support needs have increased and their losses may be multiple, including loss of independence, loss of value, loss of role and loss of meaning. Older adults may feel reluctant to ask for help unless it is essential, as they fear inconveniencing others or interrupting their schedule.  

It is not uncommon to hear:

‘I am not meaningfully participating or contributing towards my community.’

or

‘What is the point of going on?’

In day-to-day interactions, many of us have noticed our clients are not as keen to leave the comfort of their chairs, rooms and accommodation. Fear of the unknown environment and a new reality can set in and impact the confidence and self-esteem of our elders. For some, it can be a sudden change, perhaps due to a fall or other health setback, while for others, a quieter lifestyle has always been the preference. For many, the impact of COVID-19 has led to increased disengagement over the last two years, and in many ways this has been normalised. This is not okay and we need to work together to fix it. 

Statistics and Research

Isolation and loneliness in late life has drawn attention of many clinicians and researchers over the last decade. For researchers, it has been difficult to capture disengagement, as the uptake on various programs has varied and has been severely impacted by the pandemic. How do we measure something if we do not know how many people are impacted by isolation? It has been easier to capture this information in residential care settings where we can track how often people leave their rooms, engage in activities or leave the facility for recreational purposes. We know from residential settings that up to 1 in 2 residents have symptoms of depression (AIHW, 2019).

In community-based settings, client engagement from programs and services has significantly reduced. The uptake of support has been low, with some clients expressing fear of contracting COVID-19 if they allow a service provider to enter their home. Many service providers have continued to deliver welfare checks over the phone, however, after a few phone calls several have reported difficulty in initiating new conversations and keeping the talk going, as clients report not having much to discuss as they are confined to their homes and not experiencing positive emotions.

According to Kryzazanik et al. (2021), older adults from residential care settings account for up to 65% of all COVID-19 related deaths in Australia. The reduction in face-to-face contact with loved ones, social activities, outings and interaction with other residents within the facility due to COVID-19 safety measures has led to an increase in loneliness (41%) and anxiety (33%) in older people in residential aged care facilities (Brydon et al., 2022). Further, increased community and media scrutiny has been observed where outbreaks occur, with finger pointing and certain individuals being labelled as ‘patient zero’.

So, where should we tune our attention and efforts to turn things around? 

1. Create opportunities which encourage gentle participation and calm experiences: Sharing interests and hobbies may be more appropriate in smaller groups than big loud musical concerts. Quantity is not always better than quality, do not underestimate the power of short bursts of meaningful interactions. 
2. Allow elders to share the impact of grief and loss:Encourage discussion around the events of the last two years and how it has impacted them. Being able to relate to those around us can improve the sense of belonging and understanding. 
3. Focus on the strengths of older people: Ask elders how they overcome other challenges in their lives before? How can they use these strengths now? This is what I teach in my workshops. 
4. Engage in reminiscence:This is a powerful practice – even a 5-minute activity can have profound effects on the wellbeing and mood of an older person.
5. Encourage time in nature: Sunshine (and even rain!) can be calming and beneficial to our wellbeing. Make time for elders to get outdoors as often as possible.
6. Be mindful and present in service delivery: Pause, be present, and allow moments of meaningful engagement throughout the day.
7. Be kind and gentle on yourself: Working during COVID-19 times has been difficult not just for clients but also for caregivers. Sometimes you can feel you have so much of yourself to give, but being just present in the moment may be all the client needs.

In our practical, industry-endorsed workshop ‘Enhancing Emotional Wellbeing in Late Life’ we share strategies that you can implement immediately to increase engagement in the elders in your care. Get in touch with our team via [email protected] to find out more today.

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