key: cord-0969799-e0vqn7t5
authors: Mackolil, Julia; Mackolil, Joby
title: Why is the mental health of geriatric population at a higher risk during the COVID-19 pandemic?
date: 2020-09-01
journal: Asian J Psychiatr
DOI: 10.1016/j.ajp.2020.102401
sha: e078b681ba4e32759b79e9db6c1c0a7ebd1d5bad
doc_id: 969799
cord_uid: e0vqn7t5

nan

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adults but also make them highly dependent. There is also a regression in economic status owing to retirement or inability to work. In addition, older adults often have to deal with the emotional toll associated with the death of their spouse or peers. Further, the opportunities to seek help are limited due to problems related to immobility. These stressors are topped by the increase in elder abuse during the pandemic. Studies show that elder abuse has increased by ten times during this pandemic which includes physical, verbal and emotional harm; financial exploitation and neglectful behaviour with low dignity (World Health Organization, 2020).

These can have severe psychological effects which often go unattended.

The need to socialise during these adverse times is often met through online media.

Online platforms are used to stay connected and to avail services and products without being in direct contact with others. However, the older adults belong to the age group that is neither skilled nor comfortable with using technology and online platforms. This places them at a disadvantage as their social needs are not met. In addition, they are at a higher chance for illinformation and fake news as they might lack the skills required to check for authenticity of the news. This could lead to issues related to health anxiety, fear and loss of hope. They are not able to avail any of the services that is now offered online including religious/spiritual services, medical assistance, home-delivery services and virtual therapy sessions. This further affects their immunity and quality of life as they are forced to live with limited access to services and necessities. With these increased vulnerabilities, they are at a higher risk for panic and anxiety.

For older adults who live alone, the arrival of family members and visits of dear ones are a major source of social interaction and joy. The social distancing measures due to COVID-19 require people to confine in their homes with limited contact to the outside world.

This leads to social isolation among older adults and an intensified worry about the safety of their loved ones. Social isolation can have detrimental effects on the geriatric population including cognitive decline (Wilson et.al, 2007) , reduced physical wellbeing and higher mortality. Studies have shown that health risks due to isolation equate to that of smoking and obesity (Holt-Lunstad, Smith & Layton, 2010) . Social isolation and loneliness are specifically damaging in the geriatric population due their increased dependence on others. They depend on servants or other family member for their day-to-day functioning including medication, J o u r n a l P r e -p r o o f dietary needs and housekeeping. The containment laws have adversely affected older adults as servants have stopped providing service and relatives are no longer visiting them. The irony is that, the social distancing measure introduced to ensure protection of older adults has led to a reduction in their overall quality of life and increased the likelihood of depression. In addition, some older adults might not be able to comprehend instructions regarding selfhygiene, respiratory etiquette and safe distancing leading to hostility, neglect and isolation.

This can push older adults into loneliness, worry and depressive thoughts of being a burden.

The first step towards mitigating the problem is creating awareness about these vulnerabilities and providing timely interventions. Ensuring that older adults receive authentic information about the pandemic, helping them stay connected with family members (over the phone) and providing necessary psychological assistance can help to curb problems related to ageism and anxiety. In addition, mental health professionals should prioritize contacting older adults with disabilities as they might not get the opportunity to seek help.

Providing updated directories of helplines and equipping the geriatric population with selfhelp and stress management skills can help to reduce elder abuse. Further, avoiding unhelpful coping strategies like overthinking and substance abuse can ensure psychological wellbeing during this pandemic.

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Addressing violence against children, women and older people during the COVID-19 pandemic: key actions (No. WHO/2019-nCoV/Violence_actions/2020.1). World Health Organization