The lockdown to prevent the spread of coronavirus has put an end to the already limited social life of thousands of elderly people who live alone. No more morning constitutionals, chats with the neighbours, playing cards with friends or daily trips to the shops.
For them, this situation makes them feel especially isolated. This is one of the most vulnerable groups in this health crisis, because as well as the risk of catching Covid-19 they have to spend all their time indoors. With no visitors other than those which are strictly necessary, this also increases their sense of being alone.
This, too, poses its own risks for their health. On one hand it can affect their state of mind, making them feel low in spirits and sad; on the other, as they are the most vulnerable section of society, they can have a more negative perception of the situation, which makes them feel even more afraid and anxious.
The measures decreed by the government to stop Covid-19 spreading do allow people to go and help elderly, dependent people, but many relatives and carers are not sure of what this entails and how to balance the need to visit these people with the risk of spreading the disease to them.
Jesús Vargas, who is the secretary of the Andalusian Geriatrics and Gerontology Society, recommends limiting visits to elderly people as much as possible and being very strict about the hygiene measures and protocols set down by the Ministry of Health.
"We need to reduce contact with elderly people as much as possible; that's why they have to be in isolation. However, if contact is essential, it should be for as short a time as possible and under the most hygienic conditions," he says.
In the case of people who have to look after elderly parents, Vargas warns that the most important thing to bear in mind is that the person who goes to their home needs to be the one who is safest.
"Someone with symptoms of an acute respiratory infection should not go, even if it is just catarrh. If the person who visits has no symptoms, because the incubation period for the virus is 15 days, they should still keep at least a metre and a half or two metres away from the elderly person and, as soon as they enter their homes, they should wash their hands and arms up to the elbow and also their face, because we all touch our faces constantly with our hands. If they have a mask to put on, that's good, but the priority is to wash their hands," he explains.
Although it doesn't always have to be the same person who visits, Jesús Vargas points out that there is more risk if two or three people go, because they have more outside contacts and the possibility that they are incubating the infection while showing no symptoms is much higher.
How to deliver their shopping
As long as the elderly person is able to look after themself at home, experts advise leaving their shopping outside their door and not going in. However, there is also an emotional aspect to this.
"Elderly people who are more independent or who live with their partner can relieve the feeling of isolation by speaking to their children on the phone every day, but if they live alone then the presence of somebody, even at a distance if their son or daughter has come in to check on them, is very important to keep their fear at bay and make the situation seem more normal," says Jesús Vargas.
The situation is very different for elderly people who are dependent on others, needing help with basic tasks such as showering, eating or getting dressed, where physical contact is unavoidable. In these cases those who look after them, whether they are their children or carers (live-in or home helps), should stay indoors as much as they possibly can.
"In those cases then yes, they do need to wear a mask and gloves, but that can give a feeling of false security. If they put gloves on and wear them to do everything, within 10 minutes that form of protection is no longer effective. That's why hand hygiene is safest. You should always put gloves on clean hands and for specific purposes. For example, if you are going to change an incontinence pad, use gloves. When you have finished then throw them away and wash your hands again before putting new gloves on to do the next task," says Vargas.
Solitude and social isolation are the biggest problems caused by restricted visits, but another problem is the excessive information to which elderly people who live alone are exposed because they are continually seeing news about the pandemic. Jesús Vargas says they should fill their time with reading and hobbies or, if they do access audiovisual content, it should be entertainment and not exclusively news.
He also warns of the emotional aspect of this situation, not only for elderly people but also their families. "They have to decontaminate psychologically and in fact that advice applies to everybody," he says. He says a balance has to be found between the necessary isolation and the wellbeing of elderly people. "That is why communication, either by phone or videocall, if possible, is essential two or three times a day to break the routine of solitude and fear," he says.