Keywords

COVID-19 Waves; Elderly population; Loneliness; Social isolation; Social inclusion;

Introduction

The return of Covid-19 has created fear and anxiety across people in India as it come with unique symptoms like: shortness of breath, sore throat, dry cough, muscle ache and loss of smell. According to the Director General of Indian Council of Medical Research (ICMR) Mr, Balaram Bhargava and Co-Chairperson of Task Force for Covid-19 (NFT), there is not very high difference of mean average of Covid-19 patients (nearly 9,500) of first wave of pandemic (50.4) and second wave (48.9). Similarly, there is marginal increase in mortality rate in the second wave that is 9.7% and it was 9.6% in first wave. In the first wave the demand for oxygen was 41.1% and in second wave there is increase in the demand for oxygen which is 54.5% (www.thehindu.businessline.com, 19th April, 2021). The second wave of Covid is more dangerous and damaging than the first wave as on10th February the infection of daily cases were 11,000 and on 30th April it was 370,000. The Delhi High Court has called the second wave as “Tsunami”. The second wave has come with more infectious variants which has wreaked chaos with people and healthcare systems across India (Warrier). The World Health Organization (WHO), has made assessment on March 2020, that COVID-19 is a global pandemic as it has captured the entire world and created life risk and stress throughout the population. During the outbreak it is advisable by WHO to take care of mental health and psychological well-being of senior citizens (WHO, 18th March, 2020). According to the scientists of Staten Serum Institute of Denmark the elderly people above 65 of age are more prone to reinfection. The researchers have stated that there is 0.88% of chances of reinfection among the elderly people more than the age of 65 and they have suffered in both first and second wave of Covid. At the same time, it is very difficult to refrain from the virus as the mutants are varied with different Covid-19 strains. Therefore, after be vaccinated the elderly people should enhance social distancing. Most of the elderly adults face health issues like: Parkinson or Alzheimer which destroys memory and makes slow the mental function and nervous system. They continuously face decline in thinking, irritation, behavioural changes and fear which disrupt their ability to live independently. Even the environmental changes create health issues for them as they have low immunity. The elderly are more connected socially and enjoy gatherings as most of them are retired persons having enough time. The pandemic has put restrictions on social gathering and visit outside. Social isolation during COVID-19 pandemic affects both physical and mental condition of elder people. They suffer from poor sleep, anxiety, depression and physical weakness (Loyola and etal. 2020). These people have also faced economic uncertainty due to the pandemic. They are not only socially disrupted but also most of them are financially weak. Financial constraint, old age requirements and social isolation create panic situation across the ageing mass [1].

Review of Literature

Dutta (2021) has focused on the statements of senior members VK Paul, Balram Bhargava and Randeep Guleria of National Covid-19 taskforce who have stated in a press conference that 70% of patients of 40 years and above that are affected by both the waves of Covid-19. The second wave of Covid-19 may catch the younger mass, but it does not leave the elderly people. (Dutta). John1), has stated that in both the waves of Covid-19 the elderly people have suffered a lot. Banerjee, stated that COVID-19 has put the entire world in threat as it is directly related to the age and immune system [2]. The virus can be easily and quickly transmitted to low immunity and ageing people. To be protected from the virus the senior citizens are advised to maintain strict isolation and complete hygiene. According to Tripathy, the Corona virus has severely captured the entire globe since the beginning of 2020 and this pandemic has heavily affected the geriatric population. The lockdown, financial losses, reduction in standard of living, scarcity of infrastructure and high mortality rate have created emotional breakdown in people. The ageing group lives in fear and stress. The authors have remarked that public awareness towards health hygiene and environmental cleanness are necessary to protect elderly mass. Mukhtar, has made a study on impact of COVID-19 on mental health of geriatrics in a particular manner. The author has viewed that the older adults commonly face depression and anxiety, but due to rapid transmission of the pandemic and high mortality their mental health is affected severely. Banerjee, has stated that COVID-19 has strong psycho-social implications as it creates crucial health issues which hampers psychological stability and certain sections of society like: senior citizens live in risk [3,4].The ageing people are in chaos as the virus suddenly affects them and put their lives in danger. The author has suggested that the family members should take additional care of the elderly people and provide their complete support and concern. Bhatia and Sud have discussed on issues related to mental illness like: anxiety and depression of elderly people due to social isolation. Kashyaap, has focused on the wide spread misery which has been brought by the second wave of Covid-19 and suggested valuable strategies for the well-being of parents and grandparents. The author has also praised the consciousness of older adults as they are practicing Covid-appropriate behaviour like: social distancing, using of mask and sanitizers in their daily lives [5].

Methodology

This study is completely based on data collected from secondary sources such as: journals, review of articles, newspapers and internet. 

Objectives of the Study

To identify the basic issues associated with elderly people during COVID-19 breakdown.

To focus on the socio-psychological effects on the ageing group of population due to pandemic.

To suggest strategies to overcome the challenges.

Issues Faced by Elderly Population during COVID-19 Waves

The second wave of Covid is more dangerous and easily transmissible. On 11th June, 2020 approximately 10,000 people were infected by first wave of Covid-19 which was increased to 80,000 on 2nd September, 2020, whereas in second wave on 22nd February, 2021 the number of cases were 10,000 and within 30-40 days interval the number was raised to 80,000. The health experts have assumed the chances of heavy community spread because of increase in the number of suspects and advised for precautionary initiatives (Sinha). In the first wave of the pandemic nationwide lockdown has put the aging mass home arrest and to break the chain of infection during second wave several states like: Maharashtra, Andhra Pradesh, Utter Pradesh, Karnataka, Kerala, Goa, Odisha and many others are imposing curfews and lockdowns which also make all people including senior citizens closure to home. (Nahata). This unusual practice creates a feeling of loneliness, anxiety and isolation across elderly people and they do not get crowd and people around them. Even they do not use public transport, go for regular health check-up, morning exercises and yoga centre, worship places etc. which create worries among them. They feel themselves house arrest and sometimes neglected as the family members are busy in their own lives. At the same time, their aging immune system makes it very difficult to fight against Corona Virus and they are immediately affected by the disease. Their recoveries are complicated and very slow as most of them are suffering from different diseases related to heart, lungs, blood pressure, slow function of and allergies etc. which make their conditions more vulnerable (Sundararajan). Both the waves of Covid have brought sever challenges for elderly people. The Covid-19 restrictions and lockdown have forced them to maintain social isolation and bear a stressful life. Nearly 63% of elderly persons are suffering from depression and loneliness due to social isolation. The older people are afraid of the consequences of the pandemic which has long lasting impact on both physical and mental health. According to the report of Center for Disease Control and Prevention (CDC) older adults are more likely to suffer from Covid-19 as more than 80% of death cases are reported across the age group 65 and more. There is high risk of causalities with the senior citizens having the chronic lung diseases, asthma, cystic fibrosis, Chronic Obstructive Pulmonary Disease (COPD), acute diabetics, high blood pressure and other severe diseases. The presentation of following table can be explained the causalities in a better manner [6].

 

Socio-Psychological Condition of Elderly people

The COVID-19 pandemic has brought a large number of intricacies in human life and livelihood of the entire world and at the same time it has created a fear and anxiety in senior citizens. During the first wave of Covid-19 there has been nation-wide lock down to control the spread of the disease. At the same time using hygienic measures and social distancing have become the basic ways to secure lives as no vaccine against this disease has since been invented. The second wave has come with more powerful and energetic variant mutants which can be transmissible very quickly. As there is fear of community spread many states have declared curfews and lockdowns. The invention of vaccine is a strong weapon against the Covid-19, but there is the chances of reinfection of elderly people if they do not follow the Covid appropriate behaviour. The Covid-19 has increased mental health issues like: depression, anxiety with older adults. A study has been conducted by “Samvedana” during first wave of Covid that consists of respondents of forty years and above to identify the basis of impact of lockdown. According to the study 33% respondents having difficulties related to sleep, 83% to perform daily activities and household work and 86% participants have reported low mood and more strain comes from people working from home. Again 33% have reported on loss of well-being due to family conflict during lockdown. 22% older adults have spoken with mental health professionals and 63% respondents have communicated with friends and family to reduce their strain. However, in second strain 33% respondents of ageing population are in fear of the virus and stressful for the well-being of the family

Social isolation during COVID-19 pandemic affects both physical and mental condition of senior citizens. They are home arrest for which their daily lives are disrupted. The regular wandering, meeting with neighbours and face-to-face communication of elderly adults with their friends and associations are blocked completely. Life becomes stagnant for most of the ageing people as they even do not move outside to attain any religious ceremony or get-together. The changing life style and social distancing put lots of psychological pressure on them. They suffer from poor sleep, anxiety, depression and physical weakness (Loyola). According to the Dr. Rajesh Parekh who is the neuropsychiatric and head of the Jaslok Hospital Medical Centre the Covid-19 has brought large number of cases of stress- related problems, depression and anxiety. Most of the elderly people have a sense of isolation even in their families and the second wave of the pandemic has made them more isolated by making them home arrest [7].

According to the study of “NGO Age well Foundation” the Second Wave of COVID-19 has increased mental health disorder symptoms like: anxiety, heavy stress, depression, sleeplessness, fatigue and weakness in elderly people. On the basis of data collected by the organization this study has revealed that out of total respondents 82.4% people have faced anxiety, 62% depression, 55% weakness and fatigue, 52.2 loss of appetite and 70% of respondents have suffered from insomnia or poor quality of sleep due to return of COVID-19 and growing causalities. Himansu Rath, the founder of the organization has stated the senior citizens are also worried to get the bed and proper treatment in hospitals. Due to loneliness, home isolation particularly who are leaving or forced to live alone without family care and support and added with poor health status and low immune system have divested the life and mental health of senior citizens

On the basis of reports of NGOs about 25 million elderly people live alone in India and many of them are widow women. Due to the pandemic elderly people especially those live alone have been suffering from anxiety, depression and a sense of abandonment since Covid-19 disaster. According to Mr. Himansu Rath the Chairman of “Agewell Foundation” nearly 25 million of old adults live alone in India who are facing heavy mental issues during the pandemic whether it is the first wave or the second wave. Most of the people after their retirement have planned to live a comfortable life, but Corona has hit and brought heavy depression and anxiety for them. As the pandemic returns again they are worried for their children and grandchildren who are very young and living away from. There are some cases of interviews taken by reporters of “Economic Times” on 18th April, 2021 which can be explained below [8].

Rajesh Singh, 66 years old has been living in west Delhi with his wife, Sudha who is 61 years old states that the waves of Covid has stopped their lives, but they are trying not to stop. There is no body to talk, home isolation and not to meet any friends many times create stressful situations. According to Mrs. Sudha they afraid of to go to regular health check-ups. The couple is also worried for their children who are living abroad.

According to Sarin, an elderly adult who has been living independently for a pretty long period and she is in good relation with her neighbours and relatives for which she does not feel lonely. But the Covid waves have forced to live her alone with no physical communication for which she is suffering from anxiety.

Archana Sinha, 65, has been living alone since 2010 in Mayur Vihar, Delhi who has vaccinated, but still she is in fear of infection. She has in a good support of friends and neighbours which the waves of Covid has broken down and gradually the communication through phones has been reduced.

Older adults are basically connected with emotions and we-feeling. They have deep affection towards their community and groups from which they belong. The waves of Covid-19 have made them isolated and lonely by restricting them not to meet their group members physically. As a result the chain of group sharing-caring and concern have been broken down and the senior citizens move towards mental decline. The social disorder has put the ageing group in anxiety and depression and the status of their physical health is also being affected.

Strategies to Curb the Issues

The waves of Covid has adversely affected both the physic and psychology of elderly people. They have faced severe disruptions in their daily routines, and lack of adaptability with technology again has created complications in their lives. They are socially isolated and spend their times within four walls of their boundary. To make the elderly people free from fear and reduce their heavy stress there are certain strategies which can be explained in the following manner. These are Creating awareness, Obeying COVID guidelines, Vaccination acceptance, Internet adaptability and Distancing maintenance (COVID) [9].

Creation of awareness

It is very vital for the elderly people to be aware of the basic causes, sources and symptoms of the pandemic and take remedial actions on that basis. The older adults having immunocompromised health systems are facing high risk from the virus. They must be cautious of the Covid-19 symptoms like: fever, breathing difficulties, fatigue, cough and loss of smell and other difficulties. The right sources of information should be accessed which will help the aging group not to be biased and panic. The Covid awareness helps the elderly people to ensure healthcare facilities and protect themselves from the virus. The family concern will be helpful for the ageing group to create awareness regarding the Covid-19 and get rid of their anxiety. According to Dr. Jayashree Dasgupta, Clinical psychologist and the co-founder of “Samvedna Senior Care”, the great challenge for elderly people to deal with their psychological issues and to improve their mental awareness for more adaptive with changing circumstances. They can also practice physical exercise and meditation to enhance their immunity. Hence, creation of awareness regarding Covid-19, emotional support of family members and well-wishers act as the best strategy which helps the ageing population to overcome stress and fear [10].

Obeying COVID Guidelines Strictly

The Covid appropriate behaviours are very vital precautions for elderly persons during waves of Covid-19. They should wear double portative mask when visit outside and also clean that regularly. The ageing people should strictly avoid crowd and maintain social isolation. They also have to wash their hands with alcoholic soaps and hand wash and use pocket sanitizer. The Government interventions are playing very active role to take care of senior citizens. The elder people living alone are the worst sufferers in Covid-19 crisis. On the basis of the order of the Supreme Court it is the duty of all the states to provide necessary medicines, sanitizers and masks to all elderly people and to ensure that the eligible older mass should get their pension timely [12].

Vaccine Acceptance

Remaining away from rumour and biasness and accepting vaccine is the basic necessity of life which will protect the elderly people from Covid-19. According to the evaluation (January-March, 2021) under real-world conditions conducted in fourteen states at twenty four hospitals it is reported that the elderly people who have taken two doses of Covid-19 vaccine are less chance to be victimised. The risk is reduced about 94% of adults 65 age or more who have received both doses of Covid vaccine (Morbidity and Mortality Weekly Report, 28th April, 2021). The Government has also taken initiative like: door to door vaccine for this vulnerable group of citizens. The home care service providers are very helpful for elderly persons during waves of Covid-19. They are taking care of day-to-day activities of senior adults from ensuring vaccination to help them in emergencies. The balanced diet, good sleep, physical and mental exercise along with Covid appropriate behaviour should be maintained even after taking vaccine as the older adults have more chances of reinfection due to low immunity power

Internet Adaptability

Internet provides emotional support to elderly people who are away from their near and dearer. The senior citizens who are adaptive with e-technology can easily use Facebook, mails, what’s app etc. to be connected with their family, friends and relatives. They can also use videoconference, tele conference etc. to make face-to-face contact with social distancing with their well-wishers. At the same time attending the online wellness programs like: online health care facilities with the help of tele-counselling and tele-consultation will be helpful for the elderly people to reduce their stress level and depression. (Sundararajan). Social support through social media creates a sense of we-feeling among elderly mass and they can easily exchange their thoughts and free from mental stress. They can take the advantage of tele-medicine, set reminder for basic needs, stay safe at home by making e-transactions related to online-shopping, e-banking, gossiping, and entertainment etc. They should also avail the door step delivery services by using online transactions [13].

Distance Maintenance

It is very important that the elder people should always maintain minimum 6 feet distance from others while visit outside. It will protect them from attack of Coronavirus. Prior to go anywhere they should plan about the safety measures first and it will be better to avoid touching of any body by shaking hands or hugging. Maintaining physical distancing rule and avoiding social inclusion are very difficult, but these are the basic precautionary measures. It is also advisable for senior citizens not to meet any body and not to go outside if not urgent. They should also keep in mind not to touch their eyes, nose and mouth with unwashed hands [14].

Conclusion

The ageing people are the assets of society as they are the milestones of experiences of life. They are at their extreme stage of lifecycle where they need support and concern of the family members as well as the society. The waves of Covid-19 has brought the attention of the entire globe towards the elderly mass and it also demands enough care and respect for the senior citizens. This is the time when we should focus our concentration on older adults and protect them from the risk of Coronavirus. This study is trying to draw the attention of readers on elderly people who have spent their entire live for their family members and society. The issues they have faced and their socio-psychological conditions have been discussed in this article. A humble attempt has been made to provide some suggestions to curb the issues and make the life normal. The lockdown, shutdown and other restrictions are helpful to spend the time together with family members. The elder people may share their experiences of life and young mass can learn lessons from them. Similarly, the tech-savvy generation can update senior people with latest technology or use of internet, laptops, mobiles etc. and the gap of generation and communication will be bridged easily. Hence, the elderly people are the backbone of our lives as the family is incomplete without them. The pandemic has brought many causalities with the older adults and taught us the lesson to be concern for them and a little negligence must invite risk and they may leave us only to repent for the days to come. This is the duty of the family members to take proper care of older adults, spend more times with them and make them feel that they are socially isolated, but not lonely. The help age or old-care shelters should also give more stress on both physical and mental fitness of elderly people. Finally the older adults are free birds of the world and this phase of pandemic will over soon as they strictly follow the Covid-appropriate behaviour and they can again fly with their freedom.

References

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