Ageing in the pandemic: 'My comfort and security had been pulled out from under me'
Mary O’Brien participates in dance classes on Zoom and exercise sessions in the gym: ‘Of course, these are great for the old body but an unintended consequence is that they’re good for my soul too.’ Picture: Garry O'Neill
The Covid-19 pandemic has taken from us all. It has stolen some of life’s most precious milestones. At its cruellest, it has taken our loved ones and removed all the usual supports for the grieving process.
But, while we have all lost something, there can be no doubt that older people, and those most vulnerable in our society, have borne the brunt of this virus.
In terms of morbidity and mortality, Covid-19 disproportionately affects older people, particularly those with underlying conditions and, in Ireland, almost 80% of deaths attributable to the virus have occurred in those aged 75 and above. Half of deaths occurred in nursing homes.
This is the first part of Nicole Glennon's series in which she asks older people how they have fared during the pandemic. Click on Ageing in the pandemic to read the second part.
Between July and November of last year, one in 20 Irish adults aged 60 and over had lost a family member or friend due to Covid-19.
In order to protect older people and the most vulnerable, healthcare professionals and government officials sought to introduce policies with the sole aim of preventing premature deaths due to a deadly virus. But, as we approach the second anniversary of the first case of Covid-19 being recorded in the Republic (on February 29, 2020), we need to face up to the fact that some of the policies introduced to curb the spread of Covid-19 in social settings, residential settings, and in family homes, have caused irrevocable and lingering damage that may well outlast the threat of the virus.
It remains to be seen whether, ultimately, the policies themselves may contribute to premature deaths among the population we sought to protect.
“The idea that we’re all equal — older people realised that’s not true during Covid,” says Seán Moynihan, chief executive of Alone.
“Some older people entered the pandemic very resilient; volunteering, contributing, active retirement, running businesses, running social clubs,” he says.
All of a sudden, those things were taken away, and people who had never considered themselves vulnerable or old “felt a little bit more vulnerable and older”.
Those who went into the pandemic already prone to loneliness or poor mental or physical health have suffered the most, he says: “But everybody across the spectrum of older people has been affected.
Of particular concern to Alone, a charity that supports older people to age at home, is the declining levels of physical activity amongst older people during the pandemic. Research from The Irish Longitudinal Study on Ageing (Tilda) found that almost 70% of people over the age of 70 reported exercising less frequently or not at all while cocooning.
Healthcare professionals — including GPs, geriatricians, and nurses — are already seeing the consequences of this decline in movement, with many reporting high levels of deconditioning, where inactivity can lead to a loss of muscle tone.
“People who were pre-frail, maybe that’s been accelerated because they couldn’t do their exercises or couldn’t go swimming or couldn’t do their normal things,” Mr Moynihan says.
The message that Alone repeatedly gives to older people is “get up, get dressed, get moving”, but this was hard for some, especially during periods of cocooning.
“We all know as a society we can be too sedentary and keeping active, good nutrition, friends, family — this is what keeps us all healthy. Ultimately, older people were denied that opportunity for quite a long time. That has been detrimental to both their physical and mental health.”
Mary O’Brien, who is in her mid 70s, had a remarkably busy life prior to March 2020. That all came to a “screeching halt” when then Taoiseach Leo Varadkar addressed the nation on March 12 that year.
“I need to speak to you about coronavirus,” he said, as he announced the first in a wave of restrictions that — 22 months later — still have not been entirely lifted.
“I know that some of this is coming as a real shock and it is going to involve big changes in the way we live our lives. I know that I am asking people to make enormous sacrifices.”
In the week that followed, one such enormous sacrifice was introduced — cocooning. Mary, who lives on her own in Greystones, Co Wicklow, said at that point, “panic” set in.
“I don’t think Leo Varadkar understood what he was asking… So many of us live alone, with no family near and friends of a similar age. The rug — my comfort and security — had been pulled out from under me.”
Like many of the older people the spoke to, despite cocooning being advice rather than a legal requirement, Mary says it never crossed her mind that she could disobey the guidance.
“It never even dawned on me,” she says now. During this time, Mary tried to stay busy. Despite taking early retirement some years ago, she still compiles the daily Simplex crossword for and, “for the first time in 36 years — I was ahead of deadline,” she jokes.
An hour of dance with Loreto and Robert of the Dance Theatre of Ireland also “saved my sanity,” she says: “It was the only activity during the worst days of Covid that was both enjoyable and good for me, unlike all the chocolates and cream cakes that I consumed.”
Almost two years later, she’s still participating in the dancing class over Zoom, but she’s also back in the gym for the Super Seniors exercise classes at least twice a week.
“Of course, these are great for the old body but an unintended consequence is that they’re good for my soul too. I’ve made some great pals and we always go for coffee and a chat afterwards.”
The most lasting effect of the pandemic for Mary, and for many people approaching their twilight years, is that she was forced to face her own mortality.
“Before the pandemic, I never acknowledged my age. I wasn’t old, I had years and years,” she said. “Now, I’ve been told so many times that I am old. That’s difficult to deal with sometimes.
“It’s hard to accept that my time here is limited... There’s so much more I want to do. I want to stay around.”
Manus O’Donnell, who is in his early 80s, feels the Covid-19 pandemic has had a detrimental impact on older people’s sense of self, their independence and their wellbeing.
Manus says he and many of his friends contributed to their Donegal community through volunteering and other outlets before the pandemic, he says:
As a cancer survivor, he is also concerned about physical health issues that have been put on the long finger.
“Everything has been centred around Covid, cancer clinics, indeed all clinics, have been downgraded and people were afraid to attend hospitals out of fear of getting Covid.
“I had cancer myself and was attending a clinic in Scotland for treatment. It’s coming up to two years now where I haven’t been able to attend my clinic. I am in remission, but it’s still a problem.”
Living through Covid-19 has made him extra aware of the beauty of “the simple things” and made him acutely aware of things he had taken for granted, he said.
“What I missed most was hugs from my grandchildren.”
Manus said the vaccine was a ray of hope for him and his wife.
“I felt very vulnerable before I got the vaccine, and it gave me a sense of confidence. It was very liberating for me.”
Lucia Gannon, a Tipperary GP, has seen this impact on both physical and mental health in her practice. Dr Gannon says she has seen a rise in older people speaking about depression in recent months.
She has also prescribed more antidepressants to older people since the onset of the pandemic:
“When patients come in [now], there’s often a lot of physical things that they’ve been meaning to show you or tell you about, the mental health often comes at the end of a long consultation and it might not even have been acknowledged by them until they come in.”
Dr Gannon, a GP in Killenaule Surgery in Co Tipperary, says when her elderly patients started returning to her practice she noticed some people had gotten “very frail very quickly”. Others showed various degrees of cognitive decline which had advanced quicker than what would be considered the norm in such a short period of time.
“I think it’s a mixture of a little bit of depression too, because of a lack of stimulation and a lack of contact, and just a lack of being able to care for people as much as being able to feel cared for,” she says.
“A lot of grandparents, in particular, have really missed their grandchildren, particularly healthy grandparents who would have been looking after grandchildren after school, where they would have come in and maybe had their tea and did their homework there before the mum or dad collects them, and that was all taken away from them.
“That was a big source of stimulation and a purpose in life that was just taken away.”
Dr Gannon also notes that older patients were not presenting with the typical chest infections or throat infections, but many had bigger ailments or chronic pain that they had put off addressing for some time.
“Even now, older patients are fearful of being sent to hospital.”
As a GP, Dr Gannon says her advice to older people who are struggling is to try to stay connected with a small bubble of people — if you are concerned about your mental health, your doctor’s door is always open.
“Loneliness in a pandemic is understandable,” Dr Gannon says, “but if you are feeling a loss of sense of purpose, that there’s no enjoyment in your day, nothing to look forward to, your future looks bleak, and that’s not the way you usually are, then it is time to get help.
“And there is help available,” she emphasises.
Rose Tobin, a volunteer with Seniorline for close to five years, has seen first-hand the loneliness, fear, and isolation that Covid and the resulting restrictions have had on Ireland’s older population over the past 22 months.
Seniorline, Ireland’s only national dedicated peer-to-peer telephone service for older people, has seen a huge increase of calls since the onset of the Covid-19 pandemic. In 2019, the service received around 10,000 calls.
However, in 2020, this nearly doubled to some 18,000 calls. In 2021, the service received in excess of 18,700 calls.
Ms Tobin says that many of the callers were people who may not have access to the internet or may not be confident using it — making them “doubly isolated”. “For most of us, Zoom kept us going,” she says.
“But for a lot of the older people, certainly those who would have been ringing us regularly, they weren’t really connecting online at all.” In Ms Tobin’s experience, many older people’s experience of the second wave and the winter lockdown of 2020 was even more difficult than the original lockdown in March that year.
“There were some people really feeling, ‘will this ever end?’ Now that we’re freer, it’s easy to forget how confined people were."
“I mean the 2km, the 5km… that kind of confinement people found very, very hard. For people who were used to having the ICA, the cards, the bridge, whatever it was, they really missed that. And, you know, chatting to people on the streets, sitting in a cafe, meeting people.”
When case numbers begin to climb, anxiety and fear increase, she says, and there is a sense of “are we ever getting out of this?”
During periods when case numbers have been particularly high, every call is intense: “People are wondering if they will ever get back to normal," she says.
“The nervousness isn’t just about going out and maybe getting Covid... It’s about connecting with people again.
“It’s a muscle, and if you haven’t exercised it for a bit, people can get out of the habit, especially if you’re a bit shy or socially awkward.”
Ms Tobin says her experience volunteering with Seniorline has made her more aware of being friendly and kind to strangers, especially older people who may be on their own. “Somebody said to me once that they would go out and nobody would even say hello to them. It was a big thing if somebody just said hello and talked about the weather or something very simple.”
Now, when she is out herself, she says she is very aware of older people who may be on their own and the importance of a simple smile and a “hello”.
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