Coping With Isolation and Other Stressors

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Barbara Coffey

By Barbara J. Coffey, M.D., M.S.
Professor and Chair, Department of Psychiatry and Behavioral Sciences
University of Miami Health System

 

The coronavirus crisis put everyone on high alert. We don’t just worry about getting sick or seeing friends or family members fall ill, we’re having to deal with new safety protocols, restricted freedoms and a heightened sense of isolation.

These concerns are especially acute for the elderly, who are at much greater risk from the virus.

I am hearing people ask how they can support their elderly relatives and friends during this time. One caregiver described how she’s caring for her 90-year-old mother at home. Her mother is healthy, but recently has become very emotional over minor things such as when the daughter helps her with meals or bathing. These are tasks the daughter did before the pandemic. The daughter is struggling with a big question:

How can I help my mother so she can get back to being a strong, happy woman, the way she was before the coronavirus pandemic?

I am a child psychiatrist by training, but I can tell you that there are many similarities between geriatric psychiatry and child psychiatry. For this caregiver, the first order of business is to make sure her mother has not been exposed to COVID-19 and does not have the virus. In the elderly, the virus can present in different ways, apart from the classic shortness of breath, fever and cough.

Secondly, as I would advise parents of children, it’s important to provide a basic understanding of what is going on right now, but don’t overburden vulnerable people with too much information. Set aside time to discuss the topic in a straightforward and thoughtful manner. Answer questions, but don’t overwhelm them with excess information they haven’t asked for. This is important whether you’re dealing with an elderly person or a child.


[Seniors] also have the benefit of wisdom, or what some people call the long view. They have lived through other trying times, and may have the perspective to say, “This too shall pass.”

It may also be that her mother is feeling isolated from the rest of her family and friends, and being excluded from visits to minimize her risk of exposure. In this situation, I encourage caregivers to help the elderly person stay in touch with others. That’s very important, for the elderly and for children.

And it’s especially important if your elderly relative is in a senior care facility and you can’t visit them in person. If that’s the case, keep the lines of communication open and consistent. Schedule a FaceTime or Zoom call or phone call on a regular basis. The elderly love to receive mail. A simple card or short note makes them feel connected to the outside world. If you have a child at home, have them draw a picture to include with your note. If the facility allows you to speak to your relative through a window, take advantage of it. Check on your relative’s emotional and physical state of health by speaking to the facility staff at regular intervals.

Do men and women cope differently with isolation?

It depends on the individual. Women often tend to have very strong social networks of friends. Some men, on the other hand, have their spouses and may not have as large a network. It’s important to recognize that there are differences in the way people respond to isolation and to accept people where they are.

From a health standpoint, we do know that COVID-19 affects men more than women. It’s not known if that’s because of an immune system response or something else, but it may have an impact on how people deal with the emotional aspects of COVID-19. Men may think, “Should I worry about getting this virus a lot more than my wife has to?”

The elderly must be especially careful about being exposed to the virus. This requires more self-isolation and a disruption to their routine. However, they also have the benefit of wisdom or what some people call the long view. They have lived through other trying times, and may have the perspective to say, “This too shall pass.” In the meantime, realize that, like the rest of us or perhaps even more so, they require extra support and understanding.

 


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