Problems of the Aged during Corona Outbreak In India

Relevance: Sociology: Problems of Ageing & G.S paper I: Society and Social Issues: &G.S paper II: Health: Governance

Why in news?

The elderly are especially vulnerable in the global pandemic and health officials and governments are increasingly calling for extreme measures to safeguard them. Across the globe, many cities have all but shut down as officials issue dire warnings for younger people – who can carry the virus without knowing it – to avoid their parents and grandparents. But this growing isolation of the elderly has spawned its own crisis, as families try to balance the need to care for loved ones with directives to stay away, shifting the burden to overstretched governments and medical facilities.

SOCIAL PERSPECTIVE

Introduction

Loneliness and isolation, or social isolation, are often discussed together and even used interchangeably. While they are related, they are distinct concepts.

Loneliness can be understood as an individual’s personal, subjective sense of lacking desired affection, closeness, and social interaction with others. Although loneliness has a social aspect, it is also defined by an individual’s subjective emotional state.

Loneliness is more dependent on the quality than the number of relationships.

Social isolation refers to a lack of contact with family or friends, community involvement, or access to services.

It is possible to be lonely but not to be socially isolated – research shows that older people in large households and care homes are more likely to report loneliness. It is also quite possible to be socially isolated but not lonely. Some people who live on their own or in remote places may not feel or report loneliness.

Persistent loneliness can have profound impacts on physical and mental health, and quality of life. For example, loneliness can be as harmful for our health as smoking 15 cigarettes a day, 30 and people with a high degree of loneliness are twice as likely to develop Alzheimer’s as people with a low degree of loneliness.

These issues are discussed in more detail in the ‘Impacts of loneliness’ section below. In our recent studies we have found that the three top concerns of older people were: bodily pain, loneliness and memory loss.

Why do we get lonely?

Research on twin and non-twin siblings suggests that loneliness is approximately 50 per cent inherited and 50 per cent environmental.

This means that a person’s response to environmental triggers is only partly due to their social situation, and is also partly due to inherited factors. This helps to explain why some people are happy to be alone, and others are not (but other environmental factors such as upbringing also play a role).

However, the fact that loneliness is not 100 per cent heritable means that it can be affected by changes to environmental conditions (such as interventions to reduce loneliness). It is thought that loneliness is an adaptive indicator (self-defence mechanism), like pain or hunger, which signals that something is wrong and prompts the person experiencing it to correct the problem.

The impact of loneliness on older people

As noted above, existing health conditions or impairments can lead to a curtailment of independence and can limit social roles, resulting in feelings of loneliness.

Conversely, chronic feelings of loneliness can result in deterioration of health and well-being, and a shorter lifespan.

Feeling lonely has been shown to increase blood pressure and risk of cardiovascular diseases, elevate cortisol and stress levels which weakens the immune system, impair sleep quality (which causes memory problems) leading to negative effects on metabolic, neural and hormonal regulations, and heighten feelings of depression, anxiety, and increase vulnerability.

Self-perceived loneliness doubles the risk of developing Alzheimer’s disease. There is evidence that loneliness and social isolation are associated with reduced cognitive function, while socially engaged older people experience less cognitive decline and are less prone to dementia.

It is thought that cognitive health is facilitated directly through enhanced brain stimulation, and indirectly through lowered stress reactions,  improved coping mechanisms, and healthy behaviours.

Having weak social connections also carries a health risk: those with strong social connections have a 50 per cent increased likelihood of survival after an average follow-up time of 7½ years.

On the other hand, nursing home residents who report feeling emotionally lonely die sooner than those who are not. It has been found that loneliness often relates to feelings of ‘anger, sadness, depression, worthlessness, resentment, emptiness, vulnerability and pessimism’.

Studies have also found that loneliness leads to poor lifestyle behaviours; for example, alcohol has been shown to be used by people in order to alleviate a sense of a meaningless life, depression, anxiety and loneliness.

Studies have also found a link with drug abuse and bulimia and loneliness.

Lonely adults are more likely to be overweight and smoke, and are less likely to exercise. There is a proven link between loneliness, depression and suicide.

But loneliness does not just directly affect health and well-being; it can also become a vicious circle: research has shown that lonely people are more likely to view social encounters with more cynicism and mistrust, rate others and themselves more negatively, and expect others to reject them.

In addition, lonely people tend to adopt behaviours that increase their likelihood of rejection.

These beliefs and behaviours are referred to as ‘maladaptive social cognition’.

Main causes of loneliness

• Retirement: although you may have looked forward to retirement, you might find you miss day-to-day contact with work colleagues, plus the routine of getting ready and going out to work. It’s very different being on your own seven days a week, rather than just at weekends.
• Bereavement: chronic loneliness can set in after the loss of a partner. Similar feelings of loneliness can arise if your partner has to move to a care home and you’re left alone at home.
• Lack of friends and companions: you may have reached a stage in life where friends have passed away, no longer live in the same area or have health issues or restricted mobility that stops them from getting out and about.
• Poor physical health: ill health or loss of mobility can make it more difficult to socialise.
• Location: you may not live near family and friends, particularly if you need to live in a residential care home where choices of location might be limited. Modern life means that families are often more ‘geographically scattered’ – living further apart due to jobs or family break ups.
• Lack of transport: you may have reached a stage where you are no longer able to drive for health reasons, or no longer own a car. If you live in a rural area, public transport might be limited. Not being able to leave the house as often as you’d like reduces your opportunities for social contact and can lead to feelings of social isolation.
• Financial difficulties: in addition to causing stress, financial problems can also limit travel and opportunities for socialising. It may be worth checking whether you’re entitled to any additional benefits.

Sometimes loneliness can occur without any of the above reasons. It may alternatively be caused by certain medical conditions, such as degenerative brain conditions like dementia. Depression can also be both a cause and a consequence of loneliness.

INDIAN GOVERNMENT

Stating that the course of COVID-19 tends to be more severe in the case of the elderly population, resulting in higher mortality, the Union Health Ministry has issued a health advisory, listing some “dos” and “don’ts” for reducing the transmission of the virus among the aged section.

The advisory said globally, COVID-19 has impacted several lives and is steadily increasing its reach.

While the Indian government has taken stringent actions to contain the spread of COVID-19, including a nationwide lockdown, it is also critical for each one of us to follow the protocols and take necessary measures and precautions to break the chain of transmission of the disease, it added.