According to the Public Health Agency's directive, the elderly should avoid spending time with relatives and friends unless absolutely necessary. How should those affected by the directive adjust their thinking in order to make the best of the situation?

“Firstly, it is important to point out that people over 70 are not a homogeneous group. We have 70-year-olds who are still working and participating in the Vasaloppet ski race, and we have 60-year-olds who are in early retirement and have multiple illnesses. It is important to have confidence in people's ability to handle crisis situations!” emphasises Lisa Ekstam, Associate Professor of Occupational Therapy in the research group Participation, Aging and Everyday Life, at the interdisciplinary research environment CASE at Lund University.

“Negative views of the abilities of older people also create greater dependence and stronger feelings of loneliness among the elderly,” explains Lisa Ekstam. Among other things, her research work has included a commission from the City of Helsingborg aimed at increasing understanding about loneliness and the importance of activities among residents of the city's nursing homes.

Even before the coronavirus crisis, 65 percent of Swedish nursing home residents suffered from frequent or occasional feelings of loneliness (The National Board of Health and Welfare's survey “What do the Elderly Think About Eldercare?” The National Board of Health and Welfare, 2019). Social isolation and loneliness can also trigger other forms of loneliness, such as existential loneliness – loneliness that is intertwined with anxiety and feelings of futility.

Fragile elderly people with multiple illnesses and people with cognitive impairment or mental illness may be in particular need of help in a situation like this one, in which our ability to live with uncertainty is being tested. It is these individuals who suffer most from the loss of their personal support network.

“It’s important to be on the lookout for signs of mental stress and psychiatric conditions, such as anxiety, aggressive behaviour, and isolation. In this situation, it is important to implement efforts that make it possible to maintain everyday routines and a balance of activities.”

What should relatives keep in mind right now, when it is impossible to spend time with older friends and family members?

• Talk to each other about your needs. It is important to just be there for each other and listen, and you can ‘visit’ each other over the phone. Maybe talk about any worries you have about the coronavirus. Or just take a break from the newsfeeds and chat about everyday things, to shift the focus from coronavirus to something else.
• According to the Swedish Internet Foundation’s 2019 report “Swedes and the Internet”, 84 percent of people aged 66 and older use the internet. Find out what opportunities the nursing home offers for digital meetings, such as Skype or other online meetings where you can see and hear each other. That way you can meet for a coffee, have dinner, and watch TV together.
• If you don’t like digital meetings, perhaps you can sit down and write an good old-fashioned letter or postcard to your loved one.
• Offer help – with shopping, for example. Many creative solutions and suggestions emerge in a situation like this, such as supermarkets offering special times when older people can shop while no one else is there.

What can healthcare professionals do to alleviate anxiety and loneliness among the elderly?

• The way the staff treat the elderly people in their care is important – that they have time to sit down and answer any questions and concerns. Worries can spread easily among the residents or staff, so it’s also important that the staff feel safe and have time for the residents.
• Staff continuity is important, but also a challenge due to increased sick leave.
• Maintain everyday routines, as far as possible.
• Offer meaningful activities, not just random ones. Ask the elderly what they want to do. Outdoor walks is one of the most common activities in which nursing home residents have expressed an interest. Take advantage of digital resources. In social media, virtual tours of museums and live streams of operas and other concerts are being made available.