How the Elderly Can Manage the Mental Health Impacts of the COVID-19 Crisis

By Noel McDermott

The current situation around the coronavirus is worrying for many people and in particular for the elderly who are receiving messages that they find extremely alarming—primarily that they are at enhanced risk from the virus. You’d be forgiven for thinking the virus is a death sentence in older people when it is not. The fear and anxiety it has created is, however, in itself a major potential mental health problem.

Elders are susceptible to mental health issues and reporting of mental health difficulties can be significantly underreported as well. At this time, there is a significant risk of the worsening of these conditions and the development of them in people who previously didn't display symptoms. The types of issues we might see are anxiety, depression, cognitive decline in dementia conditions, and increase in alcohol abuse.

Anxiety Attacks in Older People Becoming “Contagious”
This type of anxiety can lead to anxiety attacks, which can include shortness of breath, chest pains and fear of heart failure, racing thoughts and uncontrollable thoughts of disaster, bladder problems, sleeplessness, rapid mood shifts, increased sweating, muscle aches, and fatigue; as you can see, some of these symptoms look similar to the symptoms of COVID-19. This can obviously lead to a vicious cycle of increased anxiety then increased symptoms then increased anxiety. Anxiety like this is “contagious”; we pick up on anxiety in others, and it amplifies our own if we have it, or it will make us feel anxious if we don’t have any to start with. In this sense, getting some social distance might be helpful!

Understanding Anxiety
One of the biggest ways to combat this type of response is to understand it thoroughly so you can reassure yourself, “Oh, I’m experiencing anxiety,” rather than any of the doom-laden thoughts your mind may give you to explain the symptoms otherwise; knowledge here is power.

Follow the Daily Government Briefings
As a major source of anxiety is going to be the 24-hour news cycle tending to focus on disaster, or even worse the “experts” on social media, it might be a good idea to limit your contact with these outlets, and when you do check in, ensure you have chosen your information sources wisely, ie, government sources, the World Health Organization, the National Health Service (NHS), or your country’s equivalent health service. In the United Kingdom, watch the briefings the government are doing every evening at 4:30 pm.

How to Manage the Mental Health Impacts of Self-Isolation for Yourself With Key Behaviors and Activities

• Establish structure and routine: The loss of structure and routine is already identified as a major mental health issue for older people and this can be worsened at this time. If you are moving to being “self-isolated” to protect yourself from infection, then it’s important to establish a new routine as fast as possible. The first thing on your mental health shopping list is a weekly planner; ensure you have a routine about bed and waking times, food, “work” activity, social connections via phone or computer, catching up on news, and getting outside to exercise.

• Remain cognitively active: For those with dementia, cognitive exercise is particularly beneficial. Ensure a good supply of board games and word games, investigate online support groups for dementia sufferers, and get engaged in cooking, gardening, housework, playing music, etc.

• Exercise: Stay active; the social distancing measures still allow you to go outside, just be careful about contact with others. Go for regular walks. Do home gym sessions using books as weights. Use the good old army calisthenics. Practice your yoga—if you don't do it yet, now is a very good time to learn. Many personal trainers are offering online sessions right now.

• Cognitive behavioral therapy (CBT): Learn CBT techniques online to improve your mental health toolkit. Many online resources exist. In the United Kingdom, a good resource to start with is the NHS website. You could also order Mind Over Mood, which is a comprehensive self-help resource for CBT.

• Practice meditation: Ensure you meditate regularly, and if you don’t do mindfulness yet, then now is the time to learn. There are a lot of apps available to learn, one of which is Headspace. Or do a search on YouTube; there are many free, very helpful resources for you.

• Stop or manage drinking: Alcohol is not going to help. Alcohol abuse in elders is a significant problem and abuse of alcohol significantly contributes to mental health problems.

Get Help From Your Community
The above steps will help with depression symptoms and anxiety. Another crucial step towards wellbeing is how elders can become resources to each other. You will know the other elders in your local community, so reach out to each other. Set up telephone contacts with each other. If you haven’t already, learn how to use Zoom and Skype to meet online. Have contact that is safe socially, observing infection control. Arrange to meet in the local park to form walking groups. Empowerment and self-efficacy are profoundly powerful tools in times when we feel so disempowered.

— Noel McDermott (www.noelmcdermott.net) is a psychotherapist and international speaker with over 25 years’ experience in health, social care, and education. An impactful workshop leader, he delivers bespoke training on a range of social care, clinical and human rights ethics and issues across multiple sectors. He is the founder and CEO of three organizations: Psychotherapy and Consultancy Ltd, Sober Help Ltd, and Mental Health Works Ltd. McDermott’s company offers at-home mental health care and will source, identify, and coordinate personalized care teams for the individual.