2020 will be remembered as the year in which we were called upon to face a pandemic for the first time in a century, the pandemic caused by the rapid spread of the SARS-CoV-2 or COVID 19 virus, as it has become sadly known in the media. In most of the countries involved, one of the most effective restrictive measures implemented was quarantine: a lockdown that kept the vast majority of the population in their homes – in strict social isolation – especially in some countries such as Italy and Spain. The elderly population is obviously the most affected, with a peak mortality rate in Italy – at least based on the currently available data – estimated at around 7.2%, which is incredibly high compared to 2.3% reported in China. According to a report by Il Sole 24 Ore, inspired by a detailed survey by the Echo di Bergamo (a local newspaper from one of the most affected areas), mortality is similar in the two countries up to the age group 60-69 years (about 3.5%), while the data start to diverge as age increases in Italy: respectively 12.8% and 8% in the age group 70-79 years and 20.2% and 14.8% in the over 80 class.
But what effect has this isolation had – and will it have – on their general well-being? While considering the imminent loosening of social containment measures, the over-65s should still be required to pay more attention, possibly still preferring to stay at home until the emergency is completely over.
Isolation and well-being: a delicate but fundamental balance, which needs to be thoroughly investigated, given the typical fragility of the ageing process.
The effects of pre- and post-emergency isolation mainly involve two areas:
The physiological area, from dietary-food changes to those concerning mobility and physical activity.
The psychological area, linked to emotional stress and loneliness, which may lead feelings of panic and depression.
According to data provided by ISTAT (the Italian National Institute of Statistics), in Italy the over-65s exceed 13 million: an huge number, which reminds us of one of the most interesting peculiarities of this country – second for longevity only to Japan – and which turns out to be a real “hidden resource”.
Establishing a virtuous circle of optimal habits to stay healthy is more than desirable, and should not be interrupted even during total or partial isolation.
Sports activity is essential to slow physical decay: the SIOT (Italian Society of Orthopaedics and Traumatology) advises not to give up light physical activities even within the walls of the home, such as free body gymnastics, Tai-Chi and Pilates, disciplines that strengthen coordination and harmonious movement, tonicity and elasticity, and of course the mood, given the massive release of endorphins.
Nutrition also remains a key element of daily well-being: it is necessary not to include drastic changes in one’s diet, such as the arbitrary elimination of certain foods.
On the other hand, it is well known that the metabolism of the elderly is different: the ever decreasing energy expenditure and the reduced digestion and absorption of vitamins and minerals, as well as the decrease in taste and smell, often leads to “altered” consumption, which may lead to a lack of appetite or a poor and messy diet. Let’s not forget hydration: according to AIRC Foundation for Cancer Research, drinking 8 glasses of liquid a day (2 litres for women, 2.5 for men) would be ideal, even when one does not feel thirsty.
Active ageing is a path now consolidated and characterized by various components, all useful to promote a gradual transition to senility, with all that it entails. There are various factors to be monitored, from socio-cultural participation to physical and mental activity and access to health services. According to the World Health Organization, this is “a process of optimizing opportunities related to health, participation and safety, in order to improve the quality of life of older people“.
Logically, in a historical period such as the one we are experiencing, there are many obstacles that this model encounters on its way, going to undermine the general well-being of many individuals, often forced to face their problems in solitude. In a joint note, the seniors’ association and some voluntary ones – specifically Auser, Anteas, Ada – stressed the possible onset of very serious consequences due to prolonged isolation.
According to a document promulgated by the Italian Ministry of Health on mental health and psycho-social support, the elderly (and not only them) will have to face delicate situations in which they will feel more anxious, angry, agitated or depressed. The importance of staying in touch with friends and family is of paramount importance, as is the need for specialist support. The problem is often that many of them don’t have easy access to technological devices, which is one of the most effective ways to keep long-distance relationships active today.
This type of concern can only affect family members: not being able to personally ensure how our loved ones are doing is a source of anxiety and emotional stress. We are only at the beginning, but the technological and digital revolution in remote assistance – or RPM, Remote Patient Monitoring – could be of great help, as the extreme case of the current epidemic is highlighting.
On the Italian front, Mario Cardano, Professor of Health Sociology at the University of Turin, points out that one of the reasons why the RSA model failed in this emergency was the almost impossible structural isolation of sick patients, where most of the staff did not have adequate expertise in infectious diseases. Structured home care would have been simpler and – perhaps – more effective.
According to a recent survey conducted by Cambia Health, 64% of American caregivers use a digital device as a care aid. As shown by CES 2020, a great interest is developing not only in health-related technologies but also, for example, in personalisation algorithms such as Kibi, which can create an ad hoc mapping of the needs of the person being cared for. Remaining updated on the habits of loved ones (alimentation, motility and others) even at a distance, would relieve the strain on them and us.
Today more than ever it is necessary to invest in home automation – Smart Homes, to be precise – and the active reduction of social isolation, also thanks to the potential offered by these new classes of devices.
Hoping that the situation will work out for the best, we look to the future with more conviction and awareness than before: after all, the best cure is prevention, and using every means and knowledge to stay healthy is one of the most effective solutions at our disposal.