Since this coronavirus pandemic has started, the community that my workplace services have been facing an increasing problem with mental health. Being told to stay inside and distance ourselves from individuals and loved ones who we were once able to have physical contact without the fear of becoming sick, has changed the way society thinks and the mental strength of some individuals. The individuals I have noticed that have been heavily impacted by the isolation includes older adults, 65 and older, who are experiencing loneliness during the country lockdown and isolation measures.
To have a better understanding for older adults, we must know that some of these individuals are already experiencing some sort of isolation whether it is by widowhood of a spouse, and mobility or transportation complications that creates a challenge for social activities with their community. According to Armitage and Nellums (2020), depression and anxiety have increased in older adults which is associated with the quarantine in the United Kingdom (Armitage and Nellums, 2020).
The article written by Cornwell and Waite (2009) researched what aspects of isolation causes the most damage for health in older adults (Cornell and Waite, 2009).
They used population-based data from different resources such as the National Social Life, while combining measures of social isolation into scales evaluating social disconnectedness and perceived isolation (Cornell and Waite, 2009). The researchers examined the point where both social disconnect and perceived isolation have a connection with the physical and mental health among the older population (Cornell and Waite, 2009). The study resulted that both categories are independent to one another and related to lowered physical health (Cornell and Waite, 2009). However, disconnectedness and mental health may work together in a strong relationship (Cornell and Waite, 2009). The article was concluded stating that health researchers should consider both social disconnectedness and perceived isolation at the same time in their future experiments (Cornell and Waite, 2009).
Interventions that could help improve the mental health decline in older adults during the public isolation measures includes, providing social support networks through online technologies and frequent telephone contact (Armitage and Nellums, 2020). Disparities in access or literacy do need to be taken into consideration when dealing with technology (Armitage and Nellums, 2020). Most older adults may not know how to use modern technology which could cause stress and further anxiety and depression but having constant connections through video chats or phone calls could help lower the feeling of being lonely.
Another intervention includes orchestrating group get togethers in the community with no more than 5 individuals in different locations to do activities and produces an opportunity to communicate with others. Different facilities could host these activities and make sure to follow the CDC guideline of being 6 feet apart from each other and wearing masks. The individuals who wants to participate could have their temperatures taken before entering the facility and be provided with masks and gloves depending on the activity that is planned. This would help the older adults who were going to adult daycares before the lock down and provide a sense of normality in their life,
The final intervention could be to have one person, whether it is a family member or volunteer, visit the individual once a week and either help them with errands such as grocery shopping. This would allow a constant face and short amount of contacts that could be guaranteed. This scheduled visit could help the older adult look forward to a friendly face and have someone check up on them to make sure that they are still healthy and do not need any medical help.
To evaluate the effectiveness of these interventions the community or the hospital could have a survey be administered to the older adults aged 65 and older to assess their feelings before and after the implementation of the interventions. The surveys could be the simple phq-9 questionnaires that assess for depression by asking questions of how the individual has been feeling over the past 2 weeks and rate how often the feeling has occurred. Then the results could be sent to the community health department or community nurse who is assigned this project and be scored. The score can be averaged and evaluated to see if the interventions decreased the scores that were collected beforehand.
These interventions could be assessed every 3 -6 months to make sure the interventions have a chance to be implemented and tested with enough time to see some results. The calls could be tallied to see how often a phone call or video call was made in the timeframe. The facilities that hold the small group gatherings can keep a record of how many people participates in the groups and use rating cards at the end of the activities to evaluate the mood of the group. Finally, the one on one visitations could be assessed by interviewing both the older adult and volunteer to see the overall helpfulness the service provides and if it should be increased or discontinued.
In conclusion, advocacy could be used for the patients that nurses take care of one on one, but also can be extended to the community that we service. Being an advocate helps support individuals and makes sure that the patient’s rights are being upheld and the care being provided is appropriate and effective. This helps improve the overall health in patients, their families, and the community.