Venerable vulnerability or remarkable resilience? A prospective study of the impact of the first wave of the COVID-19 pandemic and quarantine measures on loneliness in Swedish older adults with home care

Abstract

ObjectivesTo examine the early impact of the pandemic and of quarantine measures targeting older adults introduced in March 2020 on loneliness among older adults in Sweden.Design Prospective pretest–posttest and controlled interrupted time series designs.SettingThe population of older adults receiving home care before and during the emergence of the first COVID-19 pandemic wave in Sweden in Spring 2020.ParticipantsRespondents (n=45 123, mean age 85.6 years, 67.6% women) came from two waves of a total population survey targeting all community-dwelling older adults receiving home care for older adults in Sweden in Spring 2019 and 2020.OutcomeSelf-reported loneliness.ResultsResults estimated 14% (95% CI: 10 to 19) higher loneliness in Spring 2020 compared with 2019, taking covariates into account. No impact of the quarantine measure was found (1% increase, 95% CI: −1 to 4).ConclusionsThe results illustrate the broader public health consequences of the COVID-19 pandemic for older adults, but also suggest a relative resilience among older adults in home care to quarantine measures, at least during the first months of the pandemic. Future studies should examine the long-term effects of sustained pandemic and social distancing measures on loneliness among older adults.

The association between leisure engagement and loneliness before and during the COVID-19 pandemic: A Nordic population-based study

“…On a population level, we observed similar levels of loneliness before and during the pandemic. This corroborates some findings [3,4] and contradicts others pointing to an increase in loneliness, particularly among those who were most at risk of social isolation and loneliness, including those receiving home care [18,19]. It is noteworthy that in the analysis of region as an explanatory factor in the likelihood of experiencing loneliness in 2021, Finland scored higher.…”

“…One reason might be related to the timing of our data collection, which began in the early phase of the third wave of the pandemic, and that social-distancing strategies were less strict in the mid-autumn of 2021. The timing of data collection during the pandemic related to the findings is an issue discussed by, for example, Gustafsson et al [19]. Further, it could be related to adaptation and new ways of performing different leisure activities [22], including small-group and online leisure events and outdoor social gatherings [25].…”

“…For example, Finland implemented lockdown in the spring of 2020, whereas Sweden remained relatively open and chose to rely more on voluntary adherence to recommendations. the authorities in both countries, however, emphasised the need to protect children, older adults over the age of 70 and the chronically ill. For example, all kinds of leisure activities, including social gatherings, in Swedish nursing homes were banned for older adults [18] and highly restricted for all other older adults, including physical and social distancing [19]. It has been shown that in areas with social isolation and restrictions, an increased sedentary lifestyle was reported among older adults whose level of physical activity decreased [20].…”

Intersectional inequalities in loneliness among older adults before and during the early phase of the COVID-19 pandemic: A total population survey in the Swedish eldercare setting

“…Analyses were performed separately for the 2019 (before the pandemic) and 2020 (during the pandemic) surveys, as well as collapsed for comparison of estimates between the years. Collapsing all observations within each year was chosen as previous studies on the same population have found no specific loneliness impact attributable to the introduction of restrictive policies among either home care recipients ( Gustafsson et al, 2022a ) or nursing home residents ( Gustafsson et al, 2022b ).…”

Compelled loneliness and necessitated social isolation: “It’s like being on the other side of a mirror, just looking in”

“…While there has recently been increased attention paid to loneliness within the sociology of health and illness (Achdut & Refaeli, 2020; Malli et al., 2022; Petersen et al., 2020), the field has tended to concentrate on bereavement, ageing and the effects of social restrictions following COVID‐19 (Gustafsson et al., 2022; Patulny & Bower, 2022). Lockdown research is driven by an exceptional social, medical and political event, rather than the everyday experiences of people living with contested chronic and disabling conditions.…”