When it Comes to COVID-19 and Social Contact, it Pays to Weigh the Risks and Benefits
A senior citizen who lives alone had become depressed. Her family said she seemed confused when they spoke to her on the phone. Should she allow visitors into her home to help her, or was the risk of contagion too great?
An elderly couple was being urged to attend the wedding of a dear family member, and they very much wanted to be there. Should they go?
These and similar questions are being debated daily by older adults, who are among the groups most at risk for severe illness from COVID-19. “When stay-at-home recommendations began, many assumed that there would be a clear end date and kept a stiff upper lip as they are socially isolated,” says Jessica Israel, MD, Senior Vice President of Geriatrics and Palliative Care for RWJBarnabas Health and a member of RWJBarnabas Health Medical Group.
However, as questions about transmission and treatment persist, it’s become clear that life will not be going back to “normal” anytime soon—and prolonged isolation has health risks as well.
“Today, older adults need to evaluate the risk of having an interaction vs. the risk of not having it,” says Dr. Israel. “And we all need to be open to the fact that there’s no one-size-fits-all answer for everybody.”
Three Questions
To weigh out the pluses and minuses of social interaction, Dr. Israel advises, ask yourself three questions:
1. “What are the risks of what I’m thinking about doing?”
Will people be masked, will there be the ability to wash or sanitize hands, and will commonly touch surfaces be sanitized? Will the event be indoors or outdoors?
2. “How am I feeling emotionally?”
Are you emotionally OK, or is staying inside affecting your ability to live your life successfully? For example, do you have a hard time getting motivated to get out of bed to begin your day? Have you lost interest in talking to people on the phone or in doing things you could enjoy, such as sitting outside?
3.“How am I feeling physically?”
Is your health good, or do you have trouble with normal activities, such as walking from room to room? Have you been putting off care for a health condition?
Based on these considerations, Dr. Israel advised the family of the depressed older woman that she should have visitors. “It was becoming an unsafe situation, and when it comes to depression, you can’t solve everything with medication,” she says. “The family had been trying to protect her by staying away, but she needed to see them in person, with all appropriate safety measures taken, of course.”
As for the elderly couple who were invited to the wedding, Dr. Israel asked them whether all guests would be masked and practice social distancing. The answer was no. “I had to tell them that I thought it would be too unsafe for them. They actually felt relieved,” she says.
“People come to me all the time and say, ‘Can I go to the hairdresser? Can I go to a restaurant that has outdoor seating?’” says Dr. Israel. “I tell them there may not be a great answer. No activity is without any risk at all, so you have to consider what you can do to mitigate that risk.”
The one activity that’s definitely off-limits, for now, is hugging grandchildren, says Dr. Israel. “We’re still learning, but it looks like young people spread the virus very easily, even if they show no symptoms at all,” she says. “I hate to say it, but hugging grandkids should be on hold for a while longer.”
To learn more about health care for seniors at RWJBarnabas Health, visit www.rwjbh.org/seniorhealth.