Author: Dr. Pragnya Rao
MBBS Recipient of Research fellowship from Indian Academy of Sciences, Published Author Actively involved in Mental Health Advocacy, Medical Research, debates and panel discussions surrounding mental health. Writes poetry and tries stand-up comedy when free.
Care for senior citizens during coronavirus lockdown
The novel coronavirus pandemic has ushered in stringent measures including lockdown and closure of all non-essential services in the country. Healthcare workers including doctors, nurses and paramedics are fighting the battle at the forefront every day, risking their lives in a bid to save others. With numerous open letters and appeals coming from healthcare professionals, politicians and celebrities, the relevance of this request only gets bigger day by day- stay at home, practice social distancing seriously.
“Caregiving will never be one-size-fits-all.” ― Nancy L. Kriseman
It is well established that people over 60 years of age, that is, our senior citizens are at a higher risk of developing a severe coronavirus infection that may need hospitalization, and mortality is significantly higher for this age group. However, apart from just these risks, it is extremely important to give special attention to their diet, mental health, and needs, which stands doubled if they have any co-existing health problems like diabetes, hypertension, stroke amongst others. You can do your part in this collective battle against the coronavirus, by taking special precautionary measures and extending the utmost care for the elderly.
1. Social distancing in the fight against coronavirus for senior citizens:
It is important to keep individuals over the age of 60 informed about how social distancing can immensely help in preventing the spread of the virus as well as in reducing the burden on healthcare services.
a) Tell your elders to stay at home. If there is a need for groceries or essential medicines, get it for them. If you know of any older people living in the neighborhood, extend help and drop whatever they need at their doors.
b) Ask them to not visit houses of other relatives. If they are somewhere else alone, video call them and speak with them to keep them motivated.
c) If you live with older people, keep a distance of at least a meter from them- do so politely, explain the situation and the importance of such an act.
2. Hand and respiratory hygiene practices for the elderly:
a) Provide them with information on precautionary measures such as hand and respiratory hygiene, as they might not be active on social media or their access to such vital information is limited. Explain the importance of disinfection of common touchpoints such as doorknobs, taps, and handles.
b) Handwashing for a good 20 seconds with soap and water is important- help them understand it, put up charts with instructions or pictures if necessary near the washbasins. Regular handwashing as well as avoiding touching of mouth, eyes and other parts of the face must be explained well.
c) Teach them to cough or sneeze into their elbow or a disposable tissue. They are at-risk, so make sure they have masks and hand sanitizers. If you have hoarded more than required, now is the time to step up and donate some to the elderly and at-risk persons.
d) Make sure they know how to dispose of masks and used tissues- in a closed bin.
2. Diet and exercises for the elderly:
A diet pattern with minimum regular exercises can ensure fitness and optimum health during social distancing, especially when a walk in the public park is definitely not recommended
a) Foods that can help improve immunity- The following types of food can help boost immunity and are considered to be healthy:
Fruits and vegetables:
- Green leafy vegetables like spinach, palak, cabbage
- Carrots, beets, brinjal
- Citrus fruits like oranges, sweet lime
- Fresh berries
- Guava, papaya, kiwi, watermelon
Nuts & Grains
- Sunflower seeds, pumpkin seeds
- Whole grains
- Walnuts and almonds (soaked overnight)
Others:
- Green tea
- Ginger, onion, garlic, lemon and turmeric
- Coconut water
- Milk, buttermilk
It is important that these foods are incorporated into the daily diet.
b) Foods that need to be avoided- Sour and spicy foods need to be avoided as they can contribute to gastric troubles. It is best to avoid oily food as well as parcelled food items while practicing social distancing. Refrigerated food, cold juices need to be avoided as much as possible.
c) Adequate hydration and other precautions- It is important to drink at least 4 litres of water per day (unless there are restrictions due to kidney disease) to maintain proper bodily functions. Smoking and alcohol should be strictly avoided.
d) Physical exercises: Minimal physical exercises like walking around in the house, using a treadmill at home if there are no bone or joint pains as well yoga can help break the monotony of staying at home. Respiratory exercises like deep breathing and pranayama, as well as the use of respiratory exercisers in patients with asthma and breathing problems, is recommended.
4. Management of existing health conditions:
All non-essential follow-ups and check-ups at the hospital need to be avoided. However, it is important that any existing comorbidities are managed at home. Make sure you have gotten prescription medicines for at least 3-4 weeks so that they do not have to step out to refill.
a) Diabetes: Insulin and oral hypoglycemic drugs need to be stored properly and must be provided to them on time and regularly for maintenance of blood glucose levels. You can buy blood sugar test trips for home glucose monitoring in advance. Symptoms like excessive sweating, tiredness, and dizziness must be looked out for identifying hypoglycemia. For any doubts, you can always consult a diabetologist online or call your doctor.
b) Hypertension and heart disease: BP medications, blood thinner and other medicines for the heart such as statins need to be taken regularly. BP must be checked once a week to ensure that a senior citizen’s health is optimum. Symptoms like headaches and chest pain need to be watched out for.
c) Epilepsy, stroke, Parkinsons, and other neurological conditions: Medications must not be skipped and adequate care has to be taken. If there is a senior citizen who uses a wheelchair or has paralysis, special attention needs to be given to hygiene. It is better to have a home nurse rather than having regular visits to the hospital.
d) Osteoarthritis and bone health: Senior citizens must take their vitamin and calcium supplementations regularly for their bone health. Excessive exercise can be avoided but they can surely walk around the house with support.
e) Respiratory illnesses like asthma, chronic obstructive pulmonary disease: Maintaining respiratory hygiene, regular medication including home oxygen supplementation, nebulizations, chest physiotherapy as well as usage of respiratory exercises must be in place. Any severe breathing difficulty or fever must be looked out for as these patients can be more susceptible to develop pneumonia even if it is not necessarily caused by coronavirus. Consult doctors online on MFine if you have even the slightest doubt that something might be wrong.
f) Cancer and other immunity-related conditions: Senior citizens with such conditions need to be isolated physically since they can be extremely vulnerable to contracting a severe coronavirus infection if they are not practicing social distancing. Regular intake of chemotherapy medications, as well as hand washing practices, are necessary.
If there are any queries regarding medications, management of health conditions and symptoms you may be worried about, you can consult on MFine with specialists who can help you. However, if there is any critical reason where a hospital visit is absolutely necessary, make sure you inform the hospital or your doctor beforehand so that they are adequately prepared to handle an emergency.
5. Mental health of the elderly
How to talk to them about the pandemic:
Depression is prevalent in about 30% of the elderly population in India (over 60 years of age). Other mental health disorders like anxiety are also common.
- Speak to the senior citizens, check on them on a regular basis- be it your grandparents or other people in your apartment. Help them with their needs. Social distancing definitely means that you must avoid physical contact with anyone unless there is an absolute requirement. However, you can always speak with them and comfort them.
- Keep them informed, give them updates- be their window to the world especially when they are in need of protection during such testing times
- If they have already pre-existing mental health issues, make sure they are taking their medicines regularly. Do not neglect them, reason with them with facts to alleviate any panic
Senior citizens are important pillars of the society- they are our links to history and our windows to a plethora of vivid life experiences. It is our duty to step up and protect them since none of us are alone in this. Together, we can flatten the disease curve and conquer the challenges of the ongoing pandemic.
Also Read: Why Are Senior Citizens At a Greater Risk of Coronavirus
