Isolation has had negative impact on people living with cognitive impairment
By Deborah Jeanne Sergeant
Social isolation during the pandemic has brought a myriad of changes, from the inconsequential to the lifechanging.
For people with Alzheimer’s disease or another form of dementia, isolation can have lasting negative effects.
“It’s a really complicated situation,” said Lauren Ashburn, licensed master social worker and director of education and training for the Alzheimer’s Association, Western New York chapter in Amherst. “Not only do they already have impaired cognitive ability, but quarantining adds staying in their home. They may be confused. They may have difficulty in understanding what COVID is as a whole and remembering to follow their instructions.”
Although most healthy people can go places even during quarantine, most people with Alzheimer’s or another form of dementia are likely elderly or have health issues that put them at higher risk. Many have both age and comorbidities against them.
“Being isolated can lead to decrease in cognitive ability,” Ashburn said.
For those at a more advanced stage of the disease, it may be difficult to understand why their schedule has been disrupted, relatives aren’t coming to visit or they can’t go places they would like to go.
“People living with Alzheimer’s live best with a routine and this is a complete routine disruption,” Ashburn said. “When disrupted, there’s more wandering, confusion and disorientation. Their cognitive abilities may lessen due to not having that socialization.”
It’s also challenging for those with hearing impairment to understand caregivers who are wearing masks as their voices sound muffled and their lips and expressions are concealed.
If the person with dementia would have normally gone to a day program, but have been at home with a caregiver trying to work from home full time, the caregiver is in a position of trying to juggle both responsibilities.
Limiting interaction with people outside the household has also limited the possibilities for respite care, such as a caregiver helping out or taking the person to an adult day program. This can lead to caregiver burnout and less stimulation for the patients.
“The caregiver is increasingly isolated and more stressed because they have to take care of their loved one all the time,” Ashburn said. “There’s no respite services. They may have less outside assistance which adds to the already high levels of caregiver strain.”
For those who live in a nursing home or assisted living, their family cannot visit, they’re entirely dependent upon staff for socialization. Ashburn said some individuals may feel confused about why no one visits anymore.
“They have to find alternate ways to communicate,” she said. “Some of the offices for aging have been able to fund tablets for families.”
Some families have visited by sitting outside their loved one’s room to have lunch and chat.
Physician Anafidelia Tavares, who holds a Masterof Public Health degree, is the state-wide research liaison for the Alzheimer’s Association.
She said that discussing neurological issues over the phone is difficult. In addition to its regular assistance, the organization’s 24-hour helpline (800-272-3900) has been offering families support in navigating telehealth, such as ideas on what to ask doctors over the phone and ways to discuss their own or their loved one’s mental health.
“We’ve been working with health systems with how they might respond with their loved one’s COVID risk,” Tavares added.
The association is also helping people who have never used telehealth with tasks like logging onto Zoom or engaging in conference calls.
“For the caregivers who are struggling in the pandemic, we are here for them,” Tavarez said. “Alzheimer’s disease doesn’t have to be a lonely journey. We have all these free, virtual services. Our helpline is available with well-trained staff and social workers to respond to whatever your needs are. We have emotional support groups and they share strategies that work for them.”
She encourages caregivers to establish a new routine during the pandemic to help create a safe sense of normalcy for their loved one.