Kalpana Poon

The world is now in a dark situation of pandemic caused by COVID-19. COVID-19 is an acute respiratory illness caused by a novel coronavirus identified in Wuhan, China in December 2019. Among all age groups, older adults and the people with medical conditions such as cardiovascular disease, chronic vascular disease, chronic respiratory disease, diabetes and cancer are more vulnerable. Eight out of ten deaths reported in the U.S. have been in adults aged 65 years old or older. Even Nepali senior citizens are at higher risk of infection particularly among those who are left behind abandoned and in care homes without families, care takers and loved ones.
Many old age homes of Nepal, rehabilitation centres, Dharmasaala and kuti have been providing support and basic facilities to those with mental disability and some of who are of advanced age. In such areas of care, older adults are at a greater risk of infections due to living in close proximity to others within limited space. Related care homes, families, communities, specialised geriatrics team and government need to plan and implement long-term care facilities and integrated community support services for preventing the spread of COVID -19. Long-term care facilities should include restricting visitors, group activities, regularly check-ups by healthcare workers. Need of developing a care plan to take special precautions is vital during this crucial time even in our country.
Similarly, older adults living with family should be encouraged to follow new restrictions such as visiting temples, mingling with peers and other gatherings. It should be made mandatory for social distancing, wearing masks and self-quarantine. However, those restrictions might be complicated for the older adults. Older people with dementia or Alzheimer’s are more challenging for caregivers in this crisis. Those special group of older people might suffer shortness of breath while using the mask and more vulnerable to becoming severely ill with this virus. It also puts them in social isolation, psychological problem as well as emotional and resource crisis.
In such circumstances, one important way to lower this risk of our older adults catching COVID-19 is to practice physical distancing but not social isolation. It should be clear that social distancing is not social isolation or loneliness. We need to keep older adults safe, but we should also be very careful that social isolation can lead to adverse psychological conditions. Though faith communities are often a big part of older adults’ social lives but that is not possible due to lockdown.
How can it be done in a better way and what is needed to be encouraged? It is a deep reflective question to be debated among the concern bodies. Care homes can help them by accessing online services and outreaching for spiritual solace and support. Utilisation of advanced technology for staying connected with older adults can make them feel less lonely during the pandemic. Constructive side of traditional networking services such as encouraging in writing notes, reading books or sending cards can lift loved one’s spirits. We can give them homebound projects that match their hobbies. It may be organising old photos and the life stories they experienced and happy memories that inspire them to stay positive. It can be a good time for an elder to demonstrate cooking a favorite family recipe or to share favorite songs or classic movies with other family members in the household.
Beside these, unnecessary doctor visits should be postponed if an elderly is feeling well. If the doctors and health service providers can offer telemedicine it will be very helpful for older people living with chronic illnesses. Telemedicine enables doctors and patients to communicate over video, telephone or other means available rather than meet face-to-face. Non-essential travels particularly in public transports that expose them to crowds should be avoided.
Picking up an emergency contact and call forwarded to nurse helpline or urgent care facility is another resolution for main caregivers in the cases of seen symptoms or exposed to someone diagnosed with COVID-19. One shouldn’t try to become an expert as it is an unethical way of practicing COVID-19 is a new disease and we are learning more about it every day.
Donors and service providers should identify the real needs of older adults and marginalised groups rather than only favouring the afno manchhe (relatives and cronies). It is very sad that the distinction between the group ‘us’ and the rest as ‘them’ manifests itself in every walk of socio- economic, cultural and political life even at pandemic situation. The state and its citizens should work together for advocacy of social solidarity, work on refining public health strategy, national economic startup strategy and risk stratification that touch the whole concept of government policy and programmes.
Along with this, contributions of inter-disciplinary team such as medical practitioners, social workers, health care professionals, politicians, economists, integrated community activists, members of civil society, NGO-INGOs, development workers and policy makers are highly needed.
As we all work together to ensure the safety of the public, particularly the older adults and other individuals at higher risk of COVID-19, it is important to turn to trusted sources of information rather than the misleading ones. Following government advice, the older people need to minimise their risk of infection by staying home during the COVID-19 pandemic. Still, more investigation seems lacking where many older people and other vulnerable groups are suffering in the streets for a meal. So, the government and communities should provide additional support to the older people to avoid their fear, anxiety, and paranoia.

(The author is a Masters Level student of Sociology at Tribhuvan
University. kalpanapoon534@gmail.com)