Covid-19 Pandemia Impact On Mental Health Of Older Adults And Possible Treatment Options.

AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY(2021)

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摘要
Introduction During COVID-19 pandemia being in a “golden age” group, having chronic health conditions make people more susceptible to the virus. The need to socially distance creates the sense of isolation, affects older adults routines, mass transportation, and some “non-essential” social services. Those factors in addition to the uncertainty and fear COVID-19 creates, and the potential for older adults to be more vulnerable to the virus and higher mortality rates among older adults may exacerbate depression and anxiety for which effective and safe treatment interventions are required. The goal of this retrospective chart review is to evaluate the impact of COVID pandemia on mental health and responce to treatment of the patients 65 years old and above attending virtual partial hospitalization program. Methods Retrospective randomly selected chart review of 40 patients ages 65-84 year old who attended 3-4 week virtual partial hospitalization program since April 1, 2020 till October 30, 2020. The group composition: 16 males and 24 females; Caucasian – 32, Hispanic – 2, African American – 6; married – 12, widowed/divorced/single – 28. Results All of the patients identified COVID-19 pandemia as a major precipitating factor for exacerbation of their mood disorder (major depression, bipolar depression, dysthymia) and anxiety disorder (generalized anxiety disorder, panic disorder, anxiety disorder NOS). The patients identified the following factors that made significant negative impact: social isolation – 32 patients (80%), disruption of daily routine – 36 patients (90%), grief over the loss relatives and peers due to COVID-19 – 12 patients (30%), fear of the possibility of contracting COVID-19 – 18 patients (45%), decrease in social and PCA services in part because the fear of contacting the virus – 14 patients (35%), inability to see their health care providers in person – 12 patients (30%), challenges utilizing platforms for virtual appointments – 24 patients (60%). Utilization of virtual partial hospitalization services was higher among females – 24 (60%) than males – 16 (40%), higher among Caucasian – 32 (80%) than Hispanic – 2 (5%) and African American – 6 (15%), higher among widowed/divorced/single – 28 (70%) than among married – 12 (30%). 90% of patients (36) admitted that the virtual partial hospitalization program was very helpful to them in big part because of group and individual therapy. By the end of the program all the patients felt comfortable utilizing platforms for virtual interactions. All the patients admitted anticipatory anxiety about leaving the program. 18 patients (45%) expressed the desire to keep in touch with other patients who they met in the program after graduation and possibly establish the group for further meetings. 22 patients (55%) expressed the desire to join support groups (mostly virtual) in the community through NAMI and other organizations. 3 patients (7.5%) adopted the pet (cat) from the pet shelter which they enjoyed. Conclusions Based on results of this chart review COVID-19 pandemia has a negative impact on mental health of older adults. The major factors that produce impact are: social isolation, disruption of daily routine, grief over the loss of the loved ones due to COVID-19, fear of contracting COVID-19, decrease in social and PCA service support in part due to the fear of contracting the virus, challenges with connecting with others through the virtual world. One of the valuable treatment options for the affected older adults is virtual partial hospitalization that offers group and individual therapy, decreases social isolation, promotes networking, teaches patients to use various platforms for virtual interactions. As Hispanic and African American patients tend to utilize virtual partial hospitalization services less outreach efforts are desirable. Pet adoption seems to be an effective and safe way of overcoming social isolation for older adults. Larger sample studies to further study this subject are warranted. Funding No funding.
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