It is
important clinicians pay close attention to the mental health of all patients,
but particularly the elderly, with the restrictions being imposed to curb the
spread of COVID-19.

Physical
distancing during this public health crisis is essential in preventing the
spread but it can come at a high cost to seniors’ mental health and well-being,
resulting in loneliness, anxiety, depression,
and cognitive problems.

“Everyone
in the healthcare system is now under siege. We’re at war with this virus, and
we need to approach it like that while making sure we attend to the mental
health needs of our older patients,” co-president of the American
Association for Geriatric Psychiatry (AAGP) Brent Forester, MD, told Medscape
Medical News.

“Research
has demonstrated that social connectedness and engagement with other people are
important to promote successful aging; but that’s being directly
challenged” by physical distancing policies, he said.

Against
this somewhat bleak background, experts note there is a wide variety of
high- and low-tech strategies to help seniors stay socially connected and
mentally healthy.

Forester,
who is also vice-chair of the Council on Geriatric Psychiatry for the American
Psychiatric Association and chief of the Division of Geriatric Psychiatry at
McLean Hospital, notes that after the recent announcement in the
US that Medicare will now reimburse for all telehealth services, his outpatient
clinic is becoming entirely virtual.

Maintaining
seniors’ connection to their healthcare providers using the telephone or video
telehealth platforms is critical and “may be the most important thing we
do as mental health professionals,” said Forester.

Ipsit
Vahia, MD, medical director of geriatric psychiatry outpatient programs and
medical director at the Institute for Technology and Psychiatry at McLean
Hospital, agrees and said the accelerated shift to telemedicine because of
COVID-19 will have a lasting legacy.

“After
this crisis passes, I predict that we’ll see a permanent shift in care models
that incorporate telemedicine to a greater extent,” he told Medscape
Medical News.

In
addition to setting up online connections to their healthcare providers, there
are other strategies to help older patients maintain social contact. These
include greater use of computers or tablets to stay connected to family, loved
ones, and friends through video chats and playing online games.

“Seeing
each other’s faces, hearing their voices, and sharing the experience that we’re
going through can be therapeutic for everybody,” Forester said.

Vahia also
recommended picking up the phone, whether it’s to use smartphone apps or just
“old school” talking with others.

AAGP
past-president Iqbal “Ike” Ahmed, MD, clinical professor of
psychiatry at the Uniformed Services University of Health Sciences and of
psychiatry and geriatric medicine at the University of Hawaii, Honolulu, said
it is important to stay in touch with older people now more than ever.

“Even
older people who are cognitively healthy are at risk, because cognitive
reserves are down. Tele–hook-ups are important for contact and to make sure
[the elderly] are doing well,” Ahmed added.

SOURCE: https://www.medscape.com/viewarticle/927519#vp_2