Elderly face pandemic of loneliness

During the COVID-19 crisis, we’re battling three pandemics – a health pandemic, a financial pandemic, and an emotional pandemic. Nowhere is the pandemic of loneliness, anxiety, depression and despair more acutely felt than among the elderly.

So said Chabad House Director Rabbi David Masinter in a recent webinar titled, “Our Parents, our grandparents: the problems and the solutions”.

“Many of our seniors here have their kids and grandchildren in other provinces and places in the world,” said Masinter. “They’ve been very heavily affected by this.” Even those who live around the corner from their loved ones are often unable to be with one another for fear of infection.

Rabbi Ari Kievman, who runs the Chabad Seniors Programme in Johannesburg, has had to adjust his offerings to deal with the challenges brought by COVID-19. A panellist on the webinar, which was a collaboration between Chabad House Johannesburg and Central Shul Chabad (CSC) Melbourne, Kievman spoke of the spiritual void seniors often experience. “Perhaps it’s the soul crying out and asking for more meaning in its life,” he said. “Chabad cherishes elderly wisdom, and has a mission to promote lifelong learning opportunities.”

Before COVID-19, Chabad hosted daily shiurim, interactive lessons, and outings. “It’s important to keep seniors active, motivated, and animated,” said Kievman. “Yet, now we’re in a different era, one that we didn’t anticipate. Considering that we can’t offer these activities, we’re asking what we can do for the elderly to fill their time in a meaningful way. Personally, and with a team of volunteers, we at Chabad House have tried to reinvent ourselves in numerous ways. Whether dealing with seniors themselves, their families, nursing facilities, and retirement villages, we’ve tried to fill that spiritual void.”

Kievman and his team stay connected through daily online shiurim and phone calls to seniors, which serve as wellness check-ups. By delivering weekly Shabbos treats or full food parcels for those who need them, Chabad also ensures that it visit its seniors weekly, while following COVID-19 protocols.

“One of the benefits of having volunteers deliver the food is that personal interaction,” says Kievman. “We don’t want to just drop off the food, we want to interact with people and address any problems we observe.” This week, it’s adding activity booklets to its packages to keep seniors’ minds stimulated.

Dr Barrie Levin, a GP with a special interest in geriatrics, said it’s vital to raise awareness about the difficulties the elderly face, and unite to try and address these during the COVID-19 pandemic and beyond.

“I look at patients holistically, keeping track of their medications from different specialists, and their interactions and side effects. There are communication problems in our system which specifically affect the elderly.” While he believes in a multidisciplinary approach, Levin believes doctors, patients, and their families need to work together more effectively. “The psychosocial aspects of what the elderly experience are often neglected or not known,” he said. “I feel so strongly that as a community and as doctors and allied professionals, we’re failing the elderly.” This needs to be addressed, especially at this time.

“The elderly experience a loss of independence on various levels,” said Levin, “ranging from their car keys being taken away from them to losing the ability to walk and sometimes talk. I often get asked why the elderly are neglected. It’s because they can’t speak for themselves, and even if they can speak, they’ve lost their voice and ability to stand up for themselves, so they rely on others to do it for them.”

The psychosocial problems the elderly face have been worsened by COVID-19, he says. “They have to eat on their own in their rooms at retirement homes. Things they looked forward to like bridge games and shul visits have been stopped. A lot of my work at this time has been helping patients and their families navigate these difficulties as compassionately as possible.”

Dr Ryan Fuller, an old-age psychiatrist, echoed Levin’s sentiments, especially regarding the lack of cohesive care provided to the elderly. Yet, he said, one benefit of COVID-19 is that it’s forcing innovation regarding these issues. “These Zoom interactions weren’t allowed by the Health Professions Council of South Africa before, but now such regulations have been swept away,” he said. “We’re forced to talk to each other, learn more, and be kinder, which is crucial.”

“At the moment, we’re taking it day by day,” he said. “The COVID-19 crisis has really amplified problems. The elderly were vulnerable before, and now they’re even more vulnerable. The emotional impact on healthcare providers and on nurses is also profound. One nurse said to me, ‘There’s no textbook here. We have to figure it out as we go along, and the only way we do that is talk to each other and learn from each other.’”

Physical contact is also a challenge. “Before the pandemic, there were studies saying many of the elderly don’t have any physical contact for months, and that lack of tactile stimulation leads to further isolation on a physical and spiritual level,” Fuller said. “We’d ask nurses and carers to take blood pressure regularly, and hold hands where appropriate. Now you look like an alien in protective gear, and patients are already anxious.”

Yet, carers and medical professionals hold patients’ hands where the risk is manageable, obviously taking all COVID-19 precautions. “Sometimes people just need a hug, we need to be human,” said Fuller. “It’s important that we don’t lose that at this time. Netcare even has a compassionate policy where it allows families in protective clothing to see loved ones in hospital. There’s a perception that people die alone, and we’re working hard to ensure that doesn’t happen. It’s also important for carers to understand this isn’t just some geriatric, there’s a life and a history.”

Rabbi Yitzhok Riesenberg of CSC Melbourne said that South African expats living in Australia are anxious about not being able to travel to see their parents. “The children of the elderly are also adversely affected by the tyranny of distance,” he said. Among the suggestions made by experts is to ask nurses to facilitate video calls for seniors who aren’t computer or cell phone literate. Even if it’s just a telephone call, staying in touch and being proactive is vital. “We must ensure that the elderly have a voice, and we don’t forsake them,” said Fuller.