Easier Said Than Done: Social Distancing and Quarantine Coping Strategies for Older Adults

As COVID-19 sweeps the nation, public health professionals seek to contain its spread by calling for quarantine and social distancing. Quarantine is intended to prevent the spread of infection from people who are known to or suspected of having an infection to those who don’t. Quarantine has been used for centuries in ports of arrival to prevent people, animals, and goods from circulating infection in a new community. Social distancing is a relatively new concept, built on the principle that close contact with people who are infected accelerates the spread of infection.

These concepts make empiric sense, and they’ve proven to be useful in containing the spread of certain diseases. But in practice, they can be extremely difficult to abide by. In the case of COVID-19, quarantine means you don’t leave home for at least 14 days. But what happens if you share your home with others; live alone and don’t have enough supplies to last that long; eat in a communal dining area; and/or rely on a visiting caregiver to help with daily activities, as many older adults do?

Recently, I was staffing a local call center for COVID-19-related concerns and questions, and I spoke with a woman in her 80s who had been quarantined because of potential exposure. This woman’s home was an assisted living facility that offered no nursing services and limited caregiver support. She had no one to grocery shop for her, minimal food supplies and food preparation equipment, and no family nearby. Her social interaction was limited to shared meals provided by the facility and strolling around the center. Suddenly, those small but important contacts were eliminated. I worried about the consequences of being alone for so long and the fear that might develop. We talked about notifying the facility manager, her doctor, friends, and family of her situation so that she could be supported. She didn’t have a computer or cell phone, so she planned to stay in touch with others using a landline telephone and identifying a trusted person in case she needed help urgently.

I also spoke with an older man who lived with his daughter and her family. Because of his age and chronic conditions, he knew he was at particular risk if one of them became infected with COVID-19. In truth, it is almost impossible to maintain 6 feet of distance from those with whom we share a home. For one thing, few of us live in homes that are big enough to facilitate such a berth, and with schools and offices closed, many homes have more people in them at all times. For another thing, humans are social animals, and we generally benefit from proximity to and physical contact with each other.

But now, it is critical that young people who live with older adults follow social distancing rules so they don’t transmit the virus to them. Here are some suggestions for supporting older adults through this trying and unfamiliar time:

• Think about who in your life has a higher risk of serious complications should they acquire COVID-19. Practice social distancing to protect them and, if indicated, follow quarantine guidance to protect yourself, too.
• Help older adults in your life think about how they would manage if they are quarantined. Do they have enough food, medication, and supplies to last for two weeks? Would they enlist a caregiver, or would the risk of an outsider outweigh the benefits of his/her help? How might they avoid the depression that often occurs when direct human contact suddenly stops? What activities could help to fill the void? How could you help? Buying groceries, leaving prepared meals, securing medications and supplies, and making regular phone calls are wonderful gifts.

Until recently, few of us thought about how we would manage if we couldn’t go outside. COVID-19 has ushered in a new reality.  It is time to think of ourselves as part of a broader community. Those of us who are healthy can use our time and mobility to help our vulnerable neighbors remain in their homes safely. The bonus is that thinking about and caring for others also helps us cope during this challenging period.

Resources to guide older adults. 

• • The CDC has a special section for the needs and questions of older adults.
  • The Massachusetts Senior Care Coalition has a site with multiple resources for citizens and professionals caring for older adults during this pandemic.
  • In NH, people can call 211 or go to a website for information and assistance.
  • In Maine, the Tri-state Collaborative on Aging created a webpage devoted to sharing resources for both older Mainers and for aging services providers.

Written by Margaret Franckhauser, Director of Aging Services, U.S. Health Services