Alice Herb, 88, a fearless New Yorker, has a habit of walking for miles in Manhattan. But after this year of being locked inside, trying to avoid covid-19, she has noticed a big difference in how she feels.
“Physically, I’m not in good shape,” she told me. “The other day I took the metro for the first time and was out of breath going up two flights of stairs to the street. It’s just not me.
Emotionally, Herb, a retired lawyer and journalist, is unusually reluctant to resume her activities even though she is fully vaccinated. “You ask yourself: what if something happens? Maybe I shouldn’t be doing this. It may be dangerous, ”she said.
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Millions of older Americans also struggle with physical, emotional, and cognitive challenges after a year of being locked inside, stopping their usual activities, and seeing few, if any, people.
If they don’t address the issues that arose during the pandemic – muscle weakness, poor nutrition, disturbed sleep, anxiety, social isolation and more – these older people face the prospect of poorer health and greater health. increased fragility, warn experts.
What should people do to overcome challenges like this? Several experts shared their advice:
Reconnect with your doctor. Large numbers of older adults have delayed medical care for fear of covid. Now that most older people have been vaccinated, they should schedule visits with primary care doctors and preventive care exams, such as mammograms, dental cleanings, eye exams and hearing checks, said Dr. Robert MacArthur, Chief Medical Officer of the Commonwealth Care Alliance in Massachusetts. .
Have your functioning assessed. Primary care visits should include a basic assessment of the physical functioning of elderly patients, according to Dr. Jonathan Bean, an expert in geriatric rehabilitation and director of the New England Geriatric Research, Education and Clinical Center at the Veterans Affairs Boston Healthcare System.
At a minimum, doctors should ask, “Do you have difficulty walking a quarter mile or climbing stairs?” Have you changed the way you do ordinary tasks such as dressing? Bean suggested.
Get a referral to therapy. If you have trouble getting around or doing things you used to do, see a physiotherapist or occupational therapist.
A physiotherapist can work with you on strength, balance, range of motion, and endurance. An occupational therapist can help you change the way you perform various tasks, assess the safety of your home, and identify needed improvements, such as installing a second handrail on a staircase.
Do not wait for your doctor to take the initiative; too often this does not happen. “Speak up and say: Please can you write me a recommendation? I think a qualified assessment would be helpful, ”said James Nussbaum, clinical and research director at ProHealth & Fitness in New York City, a therapy provider.
Start slowly and build steadily. Be realistic about your current abilities. “In my experience, seniors can’t wait to get out of their homes and do what they did a year ago. And guess what. After being inactive for over a year, they can’t, ”said Dr. John Batsis, associate professor of geriatrics at the University of North Carolina-Chapel Hill.
“I’m a fan of the low start, go slow,” Batsis continued. “Be honest with yourself about what you feel able to do and what you are afraid to do. Identify your limits. It will likely take some time and some adjustments along the way. “
Nina DePaola, vice president of post-acute services at Northwell Health, New York’s largest healthcare system, warned that getting back into shape may take time. “Your pace. Listen to your body. Don’t do anything that causes discomfort or pain. Introduce yourself to new surroundings in a thoughtful and measured way,” she said.
Be physically active. Regularly engaging in some physical activity – a walk in the park, chair exercises at home, video fitness programs – is the top recommendation of experts. the Go4Life program, sponsored by the National Institute on Aging, is a valuable resource for those just starting out and you can find videos of some examples of exercise routines on Youtube. The YMCA put exercise course online, as are many senior centers. For veterans, the AV has Gerofit, a virtual group exercise program it is worth the detour.
Bienvenido Manzano, 70, of Boston, who retired from the Coast Guard after 24 years and suffers from severe lower back pain, attends Gerofit classes three times a week. “This program strengthens your muscles and involves all parts of your body, and it’s a big help,” he told me.
Have realistic expectations. If you’re afraid to start, try some activity and see what it feels like. Then try a little more and see if it works for you. “This type of repeated exposure is a good way to deal with residual fear and reluctance,” said Rachel Botkin, physiotherapist in Columbus, Ohio.
“Understand that this has been a time of psychological trauma for many people and that it has had an impact on our behavior,” said Dr. Thomas Cudjoe, geriatrician and assistant professor at Johns Hopkins Medicine in Baltimore. “We’re not going to go back to a pre-pandemic activity and engagement like turning on a light switch. We have to respect people’s limits. “
Eat well. Make sure you eat a well-balanced diet that includes a good amount of protein. Adequate protein intake is even more important for older people during times of stress or when they are sedentary and not getting much activity, noted a recent study on aging health during covid-19. For more information, check out my column on how much protein seniors should eat.
Restore routines. “Having a day-long structure that involves social interactions, whether virtual or in person, and a variety of activities, including time outdoors in good weather, is important for seniors,” said Dr. Lauren Beth Gerlach, Geriatric Psychiatrist and Assistant Professor of Psychiatry at the University of Michigan.
The routines are especially true for older people with cognitive disabilities, who tend to do best when their days have a reliable structure and they know what to expect, she noted.
End-of-day routines are also helpful in dealing with sleep issues, which have become more common during the pandemic. According to a University of Michigan survey, administered in January, 19% of adults aged 50 to 80 report sleeping less well than before the pandemic.
Reconnect socially. Mental health problems also worsened for a segment of older adults, according to the University of Michigan survey: 19% said they felt more sadness or depression, while 28% said they were more anxious or worried.
Social isolation and loneliness can contribute to this and it’s a good idea to start “building social support” and seeing other people in person if older people are vaccinated, Gerlach said.
Families have an important role to play in re-engaging their loved ones with the world around them, Batsis suggested. “You’ve had about 15 months of face-to-face interactions – do it now by visiting more often. Make the effort. “
Laura Collins, 58, has spent a lot of time last month with her mother, Jane Collins, 92, since restrictions on visits to Jane’s retirement home in Black Mountain, North Carolina eased and both women were vaccinated. Over the past year, Jane’s dementia has progressed rapidly and she has become depressed, often sobbing with Laura on the phone.
“She loves going out and it’s been wonderful,” said Laura. “Her mood changes immediately when she leaves the building: she’s just happy, almost childish, like a kid going out for ice cream.” And, in fact, that’s what we do – go out for ice cream.
We look forward to hearing from readers about the questions you would like answered, the issues you have encountered with your care, and the advice you need to deal with the healthcare system. Visit khn.org/columnists to submit your inquiries or advice.