For most Americans, social isolation is a foreign and scary situation that will hopefully end soon after Covid-19 subsides. For senior citizens, the heartbreaking reality of social isolation is anything but novel. As reported in 2016, according to the United States Census Bureau, about 1 in 5 adults age 65 to 74 live alone, and that figure doubles to approximately 40% among seniors 85 and older. 

Living alone does not necessarily equate to loneliness, however the probability does rise for older adults when compared to other age demographics. This can be attributed to a multitude of factors such as increased divorce and widow rates, limited access to the outside world due to disabilities and mobility restrictions, and cognitive impairment such as Alzheimer’s disease, just to name a few. 

Home CareFor older seniors, social continuity is often reliant on two main factors. One, having regular face-to-face contact with a handful of people, such as a spouse, relatives, children, and close friends. And two, maintaining some type of outside social group, for instance being a regular at a local restaurant, senior center, adult day care program, recreation center, or local meet-up groups.

The dilemma facing many seniors is that Covid-19 has stripped away the fabric of their social connections, leaving them without face-to-face or physical contact, absent of their external social groups. Not only is this a predicament for the seniors themselves, but also for the home care agencies caring for them. Home care agencies now need to provide emotional support in a different way as a result of extreme social isolation. Upon interviewing numerous home health agencies, here are several strategies being implemented to provide support for social isolated seniors. 

More Frequent Communication with Both Seniors and Their Families

Prior to Covid-19, standard protocol for most home care agencies went as follows:  enter a client’s home, provide supplemental companionship, care and services, leave upon completion.  For the most part, there was not an extra layer of communication, except for maybe a check-in phone call from time to time.  

“Due to COVID-19, we are now checking in with our clients and caregivers a few times a week to see how they are feeling and if they need anything,” says Debbie Robinson, Licensed Clinical Social Worker for Complete Homecare. “We have implemented an app called CareZone, enabling the caregivers and family members (near and far) to easily communicate on their cell phones. Caregivers log their notes on the app after each shift, allowing the family to read how the day is going, and then comment back, ask questions, and get immediate responses. The pandemic has created a situation where our clients are more alone than ever before. So it is important that we are there for them, not only to provide care, but also to be supportive in their mental and emotional health. And with a full-time social worker on staff, Complete Homecare is able to provide professional assistance for anyone who needs that extra attention.”         

But it’s not just the seniors who are now requiring emotional support. Because the caregivers are on the front line, and often are the only person entering a senior’s home due to coronavirus, many home care agencies are also providing emotional support for family members, as well.  There is a great deal of debate whether or not family members with outside contact and young children should have face-to-face contact with their elderly loved ones because coronavirus is most deadly to seniors. Even if a family member is asymptomatic, they can still pass on the virus to others, and therefore a lot of people are staying away from their elderly loved ones.  This is a double edge sword because it contributes to social isolation even more.  Home care agencies can be the bridge the gap of loneliness.

Multiple Points of Contact

One strategy that seems to be quite effective is having multiple points of contact regularly check in with clients in addition to the caregivers. Most seniors have already been in social isolation for several months, so really look forward to those visits.  While many friends check in regularly with one another, not everyone has that privilege.  Within a home care agency there usually is an administrator, numerous caregivers, marketing director, and sometimes even a social worker. When different personnel in the organization reach out to an individual client to see how they are doing it keeps interactions fresh and creates a more familial bond. A telephone call, even if only for a couple minutes, from a caring soul can go a long way! 

Setting Up Support Phone Lines

In our interview with Visiting Angels, one of the largest home care providers in the nation, they discussed implementation of a Teleconference Support-Line.  “Aside from our normal client check-ins we are offering several times per week in which our clients and/or their family members can call or tele-conference in,” stated Elaine Poker-Yount, Director of Care Management for one of the Arizona offices. “They can call in and speak to a support staff either individually or on a group call.  We also have a certified grief counselor weekly that facilitates discussion on change or anything else that may be of current concern to our families. These options provide an opportunity to either chat one-on-one in a more personal setting, or engage in a bigger group setting.  To support our caregivers who are in the homes, we have set weekly teleconference sessions here they can get their tank filled  with general support and counseling,  new ways to engage with clients and handle some of their emotional issues.”

Having a support line for emotional support services allows clients and family members to reach out at will, rather than the home care agency always being the initiator. Some people cope with social isolation more effectively than others, so welcoming clients to join in a set program allows for home care agencies to get a different view who may need more support than others.   

Utilizing Hospice Networks

What optional strategies can a home care agency implement if they simply do not have the bandwidth to take on additional mental health services during coronavirus?  With clients still in isolation and more than likely still requiring additional support, many agencies are currently overloaded and adding mental additional services is not an option. 

There is a very simple answer. Tap into your partners and even your local hospice networks! Hospice providers already have social workers and chaplains on staff. They already handle emotional support on an everyday basis. Depending on your area, their staff may also be strapped with extra care, but they may have supportive staff in the wings that can help.  Additionally, by tapping into referral networks you are creating a stronger foothold within the industry. 

A Paradigm Shift

I often wonder how Covid-19 is going to shape the senior healthcare industry moving forward. Among the many new protocols implemented during coronavirus, which are going to be temporary versus long-lasting? As stated above, social isolation is not a new phenomenon but now it’s different. In my opinion, additional mental health support will become a necessity for many of us as we live in the fall-out of significant social change.  Lingering effects of COVD-19 likely will haunt our routines well into the future.

Article written by Alex Milzer