The COVID pandemic in the U.S. has just passed its two-year milestone, and there are signs in most American communities that normalcy – or something like it – is slowly returning. Mask mandates are being lifted, concerts are being held once again, and crowds seem to be returning to clubs and restaurants. While health experts remain cautious, there is a sense of optimism that, after the tragedy of almost one million American COVID deaths, the worst may be behind us.
But sadly, there’s one group of people for whom the so-called “return to normal” may prove impossible. In this recent article from NextAvenue, freelance writer Randi Mazzella explains that seniors living with dementia were hit harder by the pandemic than most other groups, even if they never contracted the virus. For those with cognitive decline, the past two years of social isolation, deferred medical treatment, and forced neglect may in the end prove disastrous, and the damage irreversible.
Seniors With Dementia Can’t Manage the Return to “Normal”
It’s accurate to say that everyone has been impacted by the COVID pandemic in some way, some much more dramatically than others. As mask rules are relaxed, vaccines and boosters are widely adopted, and pre-pandemic routines return, it can be tempting to think that everything is returning to some kind of normal. But Mazzella warns that “for older adults with dementia, a return to the old normal may be harder to manage due to a decline in cognitive health.”
Sadly, the links between COVID-19 and accelerated cognitive decline are backed up by emerging research, as reported at the Alzheimer’s Association International Conference (AAIC) 2021. Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association, says, “This new data points to disturbing trends showing COVID-19 infections leading to lasting cognitive impairment and even Alzheimer’s symptoms.”
Prolonged Social Isolation Accelerates Cognitive Decline
Think back to March 2020, when social distancing and lockdowns were first implemented. Do you remember how everyone thought they would be temporary? Unfortunately, we all did. “Instead,” Mazzella remarks, “the pandemic has continued to impact daily life and disrupt routines for over two years.”
Over the course of the pandemic, younger people were not warned to isolate on quite the same levels as older adults. Therefore, older adults experienced a different intensity of isolation than others. “They couldn’t see family and friends in person or participate in social activities,” Mazzella writes. “Assisted living facility residents were cut off due to restricted outside visitation and faced sporadic total lockdowns confining them to their rooms.”
Humans are social creatures, and isolation is tough on even the healthiest among us. But for those in cognitive decline, being alone is even more harmful. Sociologist Laura Gitlin of Drexel College says, “The research shows that the extended social isolation due to COVID-19 has been linked to worsening cognitive ability as well as an increase in mental health issues including loneliness and depression.”
Technology Offered a Hollow Promise for Seniors
This isn’t to say that younger people weren’t affected at all by isolation, but the landscape looks very different for generations raised comfortably with technology. Younger adults could utilize texts, email, video messaging, and social media to easily keep in touch with family and friends. But for many seniors, tech is simply not as accessible or intuitive. Gitlin says, “If you weren’t tech-savvy or you relied on public libraries or community centers for your access to computers, you had minimal options for human connection” during the lockdown.
But even when the cases began to decline and the world started to open up again in stages, older adults still experienced different challenges from their younger counterparts.
“New variants made even vaccinated people worry that it wasn’t safe to gather,” Mazzella writes. “Those willing to take the risk found that programs they relied on before the pandemic were no longer available.”
Staffing shortages and other issues plagued certain programs for older adults. Gitlin explains, “Some senior centers were unable to reopen due to lost funding or not having enough staff anymore to run their senior programs,” leaving many seniors unable to access companionship in the ways they were used to. Many otherwise healthy seniors quit volunteering due to fear of contagion. This only compounded their isolation.
Many With Dementia Faced Delays in Routine Medical Care
One of the most important aspects of diagnosing and treating cognitive delays is recognizing the signs as soon as possible. This was also complicated by the pandemic, which saw many families avoiding contact with their elderly relatives out of a desire to keep them safe. Unfortunately, that meant that many early signs and symptoms of developing dementia went unnoticed, and therefore untreated.
Gitlin says, “Families juggling remote work issues and childcare may have been overwhelmed and not picking up on changes in behavior or realized the extent of cognitive decline.”
Sadly, once the signs were noticed, the types of treatment available were not nearly as expansive, since the act of going to a doctor or dementia specialist could include dangerous exposure to the virus.
COVID Restrictions Often Tinged with Ageism
Drexel College’s Gitlin calls much of the global reaction to the pandemic “worldwide ageism […] widely expressed.” In his article, Mazzella explains, “Even as some restrictions were lifted (such as allowing partners to be present at the birth of a child), for older adults, many hospitals continued to prohibit visitors and doctors’ offices were reluctant to allow them to have someone accompany them on doctor’s appointments. Without supportive caregivers present, information may have fallen through the cracks.”
This is to say nothing of the communication struggles inherent in wearing masks and standing six feet away from someone. “Especially for people suffering from age-related hearing loss, not being able to read lips or stand close can make them feel more isolated and more vulnerable,” Gitlin says.
Patients with dementia may also struggle to understand the reasons behind the rules. Mazzella writes that they “may not comprehend that the pandemic impacted the entire world. They may think mask rules are just for them or not understand why loved ones aren’t visiting in person. This may add to their feelings of confusion and loneliness.”
Helping a Loved One with Dementia
Mazzella urges that as “normal life” resumes, “this is a good time to pay close attention to what might be going on with an older loved one.” She provides seven steps. We’ve summarized them here, but highly recommend visiting the original article for her full thoughts.
- Schedule ALL appointments. Doctor’s offices have established a much better handle on keeping patients safe, so there’s no reason to put off getting all of your essential check-ups done.
- Stay fit and active. We’ve written on this blog before about the link between physical activity and brain health. Good nutrition goes a long way, too!
- Exercise your brain, too. Mazzella lists jigsaw puzzles, crosswords, word searches, strategy games, reading, audiobooks, and learning a new skill as great ways to give your brain a much-needed daily workout.
- Socialize (wisely). Even though the rules are slowly lifting, exercise caution, but find ways to safely meet with others. Balance the risk and reward by choosing when to mask up, when to meet outdoors, etc. But do find connection.
- Build tech savviness. This is a good time to help the older adults in your life learn to use the tech that can help them connect with others, play brain-exercising games, or take online classes.
- Fight the stigma. The older adults in your life may find it difficult to ask for help if they’re experiencing cognitive decline. You can make it easier and non-confrontational by saying things like, “I’m going to the store. Do you need anything?”
- Seek support for YOU. Caregivers need support, too. Reach out to family, friends, and other caregivers for help and encouragement. The Alzheimer’s Association has plenty of free resources for people with dementia and their caregivers.
The pandemic may have caused a frightening upswing in cognitive decline, but help is available. Look for the signs, follow the steps above, and know that no matter how much isolation you’ve experienced in the past two years, you’re not alone.
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(originally reported at www.nextavenue.org)