In May, President Biden declared the end of the national COVID-19 emergency. However, the pandemic’s ripples continue to disproportionately affect older adults with each surge, accounting for nearly 90% of related fatalities in 2023.
The fear generated by the virus has driven a significant shift in care setting preferences. We’ve seen a noticeable shift from congregate settings like adult day centers and nursing homes to home-based care across many states. For example, adult day care centers are grappling with sustainability challenges due to low census. The number of residents living in nursing facilities decreased by 13%, from 1.33 million in July 2019 to approximately 1.16 million in July 2022. This is a substantial reduction in occupancy during the pandemic period.
The growing reliance on home care is further illustrated by a median revenue increase of $52,192 in the home care industry over the past year. Also, there’s been an increase in home-based meal programs like Meals on Wheels that are serving 57% more meals and 44% more seniors since the pandemic onset. Although this migration toward home care aligns with the wishes of 80% of Americans who want to age in place, avoiding congregate settings due to COVID-19 safety concerns only exacerbates the grave issue of persistent social isolation and loneliness.
The risk of social isolation at home among older adults
Older adults benefit when they age in settings that offer them the support and services they need at any given time. For many, a primary benefit of congregate settings is the opportunity for friendships and productive engagement — which are essential in thwarting physical and cognitive decline. However, with a shift towards home care, the challenge of social isolation and loneliness becomes prominent. According to an AARP report in 2018, nearly 1 in 5 community-dwelling Americans 65 and older are socially isolated.
During the COVID-19 pandemic, more than half of adults aged 50 and older living in the community say they were experiencing social isolation. The National Institute on Aging underscores the association between social isolation and elevated risks of numerous health issues, including cognitive decline, frailty, multiple chronic conditions, dementia and mortality. Hence, focusing on enhancing social engagement in home and community settings is imperative to combat the negative ramifications of social isolation and foster a holistically supportive environment for older adults.
Benefits of technology-based interventions
Technology-based interventions herald promise in bridging the emotional chasm exacerbated by the pandemic. Virtual platforms like CareMobi, a smartphone app, facilitate communication between primary care providers and adult day care centers, improving well-being and reducing social disconnection of older adults. Community-driven initiatives like Toronto’s Friendly Neighbour Hotline further foster support networks and alleviate social isolation by mobilizing volunteers to assist with essential deliveries. Yet, inadequate funding has jeopardized some of these programs. For instance, California’s Temporary Alternative Services program for Adult Day Centers to operate remotely ended due to a lack of funding.
As seasonal COVID-19 resurgences loom, a triad of robust preventive measures that allow for safe interactions, technological innovation and community-driven interventions are vital to alleviate the pervasive social isolation and loneliness among our older adults. Evaluating the effectiveness of these interventions through rigorous research will inform policy adjustments, nurturing a safer and more inclusive aging experience.
The post-pandemic era invites a reevaluation of societal support structures for older adults. With empathy, innovation and community engagement, we can traverse the emotional landscape of the post-pandemic world together, cultivating a more inclusive and supportive society.
Xiang Qi, PhD, RN, is a research scientist at NYU Rory Meyers College of Nursing. His program of research, affiliated with the Hartford Institute for Geriatric Nursing, focuses on social determinants of healthy aging and longevity, dental public health, and Asian immigrant health disparities.