COVID-19’s Hidden Toll: Shrinking worlds

For many older adults, the question now is how they recover from a pandemic that made their lives dimmer and lonely.

Soon the regulars at the senior centers in Rappahannock and Fauquier counties will be able to come in four days a week again. They won’t need to wear masks or social-distance around the tables, which will make conversation a whole lot easier for those with hearing problems. They’ll be able to eat their lunches off plates instead of from pre-packed plastic containers.

It will be like old times. 

But not everything will be as it was before the pandemic. Some of the seniors will be changed.

Darcy Canton, supervisor of the Rappahannock Senior Center, noticed this when her regulars started returning after months of isolation. “For many people, it’s been a very, very difficult time. Life was heavy for them,” she said. “They already had a lot on their plates with aging and health issues. I saw the light dim in their eyes.”

Rachel Pierce has seen much of the same at the Senior Center in Warrenton, where she is administrator. “I feel like the pandemic has changed a lot of them,” she said.

“By them being home so long, they’ve become very comfortable just staying home. They’re not being social. They’re not being mobile. Mentally, physically, emotionally, they’ve declined. It’s so hard to see that.”

Home alone

From the beginning, it was clear that COVID-19 was going to take a terrible toll on older adults, particularly those struggling with chronic health conditions. Of the 600,000 people who have died, 80 percent were 65 or older. 

But when it came to mental health, experts expressed more concern about the impact on children and teenagers isolated from their friends and forced to “attend” school through a computer screen at home. The thinking was that older adults, with more life experience,  would not be as disoriented by the constraints and disruptions brought by COVID-19.

Through the early months of the pandemic, researchers found that largely to be the case. A survey by the Centers for Disease Control and Prevention a year ago determined that participants 65 or older reported “significantly lower percentages of anxiety disorder, depressive disorder or trauma- or stress-related disorder than participants in younger age groups.”

But as the pandemic wore on into late fall and winter, and they faced a holiday season in isolation, followed by a big spike in COVID cases in January, many seniors felt disheartened. 

“When people are home alone day after day after day, they begin to lose hope,” said Kathi Walker, support coordinator and long-term-care ombudsman for Rappahannock-Rapidan Community Services (RRCS). “When you lose hope, your world becomes smaller and everything around starts to shut down.”

She said the need to talk to another person likely made seniors more vulnerable to phone scammers, and she worked with some to help them protect themselves from being duped.  

“You hear a nice friendly voice on the phone, and you want to chat,” Walker said.  

Before she retired recently, Kathryn Treanor was member services coordinator for Rapp at Home, a nonprofit serving older adults in Rappahannock. Her volunteers checked in on people through weekly calls. Over time, a number of those seniors seemed less sure of themselves and more dependent.  

“Some of our members who normally could manage through challenging situations called us more often,” she said. “These were problems that ordinarily they could have handled easily. It became more and more a debilitating situation.” 

Physical costs of loneliness

The smothering weight of loneliness also can have consequences for an aging person’s physical health. Research has found that people who describe themselves as lonely are more likely to have trouble sleeping, and are at a higher risk of heart disease, stroke and obesity. They may have more difficulty fighting infections, too, because danger signals activated in the brain can affect production of white blood cells. 

Social isolation similarly has been linked to a 50 percent increase in the risk of dementia, and lack of human interaction can accelerate the decline of those already suffering from it. Last year, in fact, there were at least 42,000 more deaths in the United States related to dementia compared with the average of the five previous years, according to the CDC. 

Overall, research suggests that chronic loneliness increases the risk of mortality by as much as 45 percent.

The pandemic jeopardized the health of older adults in more basic ways, too. At a time in their lives when many need it most, health care was put on hold. In-person visits to doctors and dentists didn’t happen. Some skipped cancer-treatment follow-up appointments. Elective surgeries, such as knee or hip replacements, were postponed, raising the likelihood of prolonged pain and limited mobility for many months.

Physicians tried to compensate with phone check-ins or online conversations, but the former precluded a visual appraisal and the latter wasn’t an effective option for seniors with limited technology skills or broadband access.

“Most everything went digital overnight,” noted Rachel Pierce, “and a lot of seniors did not have the technology to make that shift.” She explored buying iPads for senior center members, but said the cost was prohibitive. 

The senior centers reopened on a limited basis last July, and when members started showing up again, it was clear that many had not been physically active. Kathi Walker pointed out that some people who were moving with little trouble the last time she saw them had begun using walkers or other mobility devices.

“Exercise is part of the program at the senior centers, but it was so obvious people haven’t been exercising,” said Poppy Foddrell, support coordinator for Aging Services at RRCS. “It’s been hard to get some back in the swing. 

“For people used to being social, the isolation has been really hard for them to manage,” she said. “It brought up mental health things that they didn’t know they had. Like fear.”

That was particularly true at the Rappahannock Senior Center after one of its regulars died of COVID-19 last summer in an outbreak at the Massanova Pentecostal Church in Castleton. 

“That freaked everybody out,” said Darcy Canton. “A lot of people decided they were going to lock themselves in their houses.”

Nursing home scourge

The past year has been especially traumatic for residents of long-term-care facilities and their families. Almost four out of every 10 Virginians who died of COVID lived in nursing homes or other long-term-care facilities. Last September, there was a serious outbreak at the Brookside Rehab and Nursing Center in Warrenton: 103 cases were diagnosed; 20 people died. 

For Ellen Phipps, executive director of the nonprofit Aging Together, the COVID scourge in the nation’s nursing homes, while tragic, was also revealing. “The pandemic really shined a light on how poorly long-term-care facilities are managed, how understaffed they are, and how poorly equipped they were to provide infection control and hygiene,” she said. 

Family members, not permitted inside to visit, could provide neither company nor the personal care needed to compensate for insufficient staffs.

“What’s become clearer is how much care family members actually provide in these situations,” said Walker, who works with families with loved ones in long-term care.  “It’s emotional support, physical support, the whole gamut. But they weren’t there.

”People were desperately lonely, but for long periods of time, they were locked in their rooms,” she added. “You had people who were in the early stages of dementia and they couldn’t understand why they had to stay in their rooms.”

For those who have cared for loved ones in their homes, the challenges have been different but no less draining. In many cases, either outside help wasn’t available or family caregivers didn’t want to risk having someone come into their houses. So they handled everything themselves, often radically limiting their own trips outside the house for fear of bringing COVID home.

“One thing that keeps caregivers going is getting a break,” Phipps said. “But now a lot of these people are really burning out because they’ve been doing this by themselves for a long time.”

Danny Wilson would agree. The Rappahannock resident has been leading a caregivers support group for years. His group had to move to Zoom, which took some getting used to. Some people dropped out. But eventually, Wilson noticed a change in those who stuck with the virtual sessions.

“They began to share more,” he said. “Within the group, people are more compassionate towards each other. Is that because of the pandemic or because they’re online? I don’t know for sure. But they are more open with each other.”

Wilson has seen older folks who have shut down, and thinks they will have a hard time rebounding to where they were a year ago. He has also seen seniors who have been able to keep their balance during an earth-shaking pandemic. 

“They realized that this is awful, but they’ve figured out that this is what we have, so how are we going to deal with it,” Wilson said. 

Poppy Foddrell also has seen positive signs. “A lot of people were able to see through fresh eyes that they were stronger than they thought.”

By Randy Rieland — For Foothills Forum

Where to get help

Helplines

24/7 Crisis Hotline:For help with mental health and substance use disorders; 540-825-5656

National Suicide Prevention Hotline: 800-273-8255.

Substance Abuse Hotline: 800-662-HELP (4357) 

Peer2Peer Regional Warmline: Not a crisis line, but callers connect with peers with experience in mental health and substance use issues. 833-626-1490. 

Agencies and services

AARP Virginia: Information on health, wealth, retirement, lifestyle and more. https://states.aarp.org/virginia/

Aging Together: Regional nonprofit that offers advice and programs on older-adult issues. https://www.agingtogether.org/

Alzheimer’s Association: www.alz.org

Area Agency on Aging,Rappahannock-Rapidan Community Services: Information on home-delivered meals, long-term care and Medicare. www.rrcsb.org

Caregiver Support Group: Open to anyone providing direct or long-distance care to someone with a physical or mental health condition. Contact Danny Wilson for more information. [email protected]

Department of Social Services:Provides support services to older adults and responds to reports of elder neglect and abuse. Fauquier County: 540-422-8400;  Rappahannock County: 540-675-3313. 

FAMS (Foothills Area Mobility Systems): Call center that arranges transportation. www.fams.org

Fauquier Community Food Bank & Thrift Store:  

www.fauquierfoodbank.org

Mental Health Association of Fauquier County: Nonprofit that provides information on mental health and addiction resources and treatment for Fauquier and Rappahannock residents. https://www.fauquier-mha.org/  540-341-8732.  

Rappahannock County Food Pantry:  

www.rappahannockpantry.org

Rapp at Home: Member organization that supports neighbor-to-neighbor assistance to sustain an independent lifestyle for those over 50. www.rappathome.net

Rappahannock Benevolent Fund: Provides financial and support services in a confidential manner to Rappahannock residents. www.rappbenfund.org/

Rappahannock-Rapidan Community Services Senior Centers: Provide daytime support, meals, social activities and transportation for adults 60 or older. Fauquier Senior Center: 540-347-7729. Rappahannock Senior Center: 540-987-3638. 

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