The Effects of the COVID-19 Pandemic on the Lived Experience of Diverse Older Adults Living Alone With Cognitive Impairment

Abstract

Background and Objectives Even before the COVID-19 pandemic, older adults with cognitive impairment living alone (an estimated 4.3 million individuals in the United States) were at high risk for negative health outcomes. There is an urgent need to learn how this population is managing during the pandemic. Research Design and Methods This is a qualitative study of 24 adults aged 55 and older living alone with cognitive impairment from diverse racial/ethnic backgrounds. Participants’ lived experiences during the pandemic were elicited via 59 ethnographic interviews conducted over the phone either in English, Spanish, or Cantonese. Using a qualitative content analysis approach, interview transcripts were analyzed to identify codes and themes. Results Qualitative analysis of transcripts revealed 5 themes: (a) fear generated by the pandemic, (b) distress stemming from feeling extremely isolated, (c) belief in misinformation, (d) strategies for coping during the pandemic, and (e) the importance of access to essential services. Discussion and Implications This pandemic put a spotlight on the precarity and unmet needs of older adults living alone with cognitive impairment. Findings underscore the need to expand access to home care aides and mental health services for this population.

SARS-CoV-2 Susceptibility and COVID-19 Mortality Among Older Adults With Cognitive Impairment: Cross-Sectional Analysis From Hospital Records in a Diverse US Metropolitan Area

“…The observed, increased risk of SARS-CoV-2 infection among the population with cognitive impairment may, in part, be attributed to a general lack of cognitive awareness or physical capacity to adhere to public health guidance about prevention measures (9). Prior studies have highlighted experiences of older adults with cognitive impairment during the COVID-19 pandemic with an emphasis on the high prevalence of sense of distress and precarity as they attempted to adapt to pandemic-related restrictions (e.g., sheltering-in-place) (16,17). Furthermore, patients relying on managed care or social support may have difficulty adapting to social distancing requirements or visitation restrictions.…”

“…Understanding this risk is particularly relevant to the cognitively impaired population we identified, in which >50% had a self-reported marital status of single, separated, divorced, or widowed. It has been widely recommended that individuals diagnosed with cognitive impairment receive tailored care, and this guidance is particularly important during public health crises-such as pandemics or extreme weather disasters-when access to home care providers or aides may be limited (16). The COVID-19 pandemic brought about a substantial rise in utilization of telehealth services (24), and this shift in care delivery presented an additionally unique challenge and opportunity for the care of the cognitively impaired population (25,26).…”

Purpose in Life, Loneliness, and Protective Health Behaviors During the COVID-19 Pandemic

“…On the one hand, recent studies highlight remarkable resilience among older populations, such that older compared to younger adults during the COVID-19 pandemic reported lower levels of stress ( Birditt et al, 2021 ; Knepple Carney et al, 2021 ; Nelson & Bergeman, 2021 ) and loneliness ( Losada-Baltar et al, 2021 ; Minahan et al, 2021 ; Polenick et al, 2021 ). On the other hand, evidence generally points to increased age-related vulnerability for loneliness, from research conducted both prior ( Pinquart & Sorensen, 2001 ) and during ( Luchetti et al, 2020 ; Portacolone et al, 2021 ) the COVID-19 pandemic.…”

A Siege on Positive Ageing: Experiences of identity threat and coping among Older Adults during COVID-19 pandemic

“…Research has begun to document older adults' experiences of living through the pandemic and its impact on their health and wellbeing (Heid et al, 2020;Lópezet al, 2020;Portacolone et al, 2021). Gonçalves et al (2021) discussed the repercussions of social isolation, pointing to the deprivations and negative affect experienced by older adults in different countries as the result of increasing social isolation during COVID-19.…”