As the world continues to struggle with COVID-19, many are likewise struggling with the emotional and mental impact that comes with the uncertainty of the pandemic. Seniors, who are in the high-risk group for getting the virus, may be some of the most afraid. 

We reached out to Julie Smirl, Assistant Professor in the Online Counseling program at Bradley University, for some ways that nurses can best help seniors during this trying time. 

We’re experiencing something unlike anything any of us have ever gone through, and that’s obviously stressful, which weakens the immune system. What are the most important things that nurses can do right now to help protect the mental health of seniors during this scary time?  

One important key element to improving mental health as a professional engaging with their clientele is using intentional active listening skills. In working with the senior population for many years, the feedback I have received from my clientele has been that they appreciated a professional taking time to listen to their story, sharing words of encouragement, and the act of human touch on decreasing one’s stress level.   

RNs at this time have a unique opportunity to engage with their patients providing reassurance and human toucheven though protective gloves and masks are used, you can still engage in a kind word or touch on their shoulder, etc.since family members cannot be present during this pandemic. Facing a grave illness and fears about one’s mortality, anxiety and depressive levels will increase. These simple daily practices of encouragement and touch can improve overall mental health symptoms when you come into contact with each of your patients. Keep in mind, some of the patients you are working with may have experienced other traumatizing events in their lives in the past, and this pandemic will trigger many detrimental responses that subsequently will impact their overall health and wellness. 

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What kinds of things can they say to seniors whom they come in contact with to help reduce their stress?  

When talking with seniors, reassuring them that their responses are normal during these uncertain times is first and foremost. Sharing your own fears can assist in normalizing their feelings. Asking them how you can help them decrease their worriesas each person is different in wanting to know about their prognosis for example or having an opportunity to make final plans, if necessarywill help a person feel they have more control over their current health dilemma.  

What additional actions can they take?  

If they ask for other assistance make these available such as Pastoral Care departments, or legal assistance, financial aid, etc. can all lead to decreasing one’s stress levels knowing their COVID symptoms may impact their mortality rates and their families both physically, emotionally, and financially. 

If nurses work in nursing homes/rehab centers—and seniors are potentially with someone who have been exposed—how can they help to keep seniors’ spirits up? What actions can they take?  

Provide ways seniors can still participate, perhaps virtually, in activities can boost spirits. Provide activities that they can do in their room with their roommates. Find ways family and friends can connect through a window to their room, or technology/phones, etc. that they may not have personally will assist with social engagement. There are many games you can participate in keeping social distancing requirements in place.   

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What precautions should be in place to prevent the elderly from feeling lonely or isolated right now?   

Having access to technology such as computers, smart phones, etc. is helpful so that they can connect with family and friends since they cannot leave the facility, and visitors cannot come to see them. Encourage them to call someone daily. Turn off the TV if they are focusing on the news all daywhich can keep their anxiety and depression levels high. They can check once or twice a day to receive the news.  Sitting out on their patio keeping social distancing guidelines and wearing masks, can still provide a boost to their moods and distract intrusive thoughts.     

Suppose nurses do home health care. What can they do to make their senior patients feel better?   

Similar to being in a hospital, residential, or home settings, encourage them to connect daily with a friend or family member to create connections with others. We are social beings by nature and being isolated can increase anxious and depressive moods in anyone.   

 What are some things that nurses should never be doing in these kinds of situations?   

 It is not helpful to tell someone who is scared or hurting, that they should not feel that way. This invalidates their feelings about what is occurring both internally and externally in response to stimuli. Feelings are important as they provide a label for our perception of what is occurring in our lives from our worldview and also lets other people know what our perspective is on what we are experiencing. Taking time to understand your patient’s cultural background can also provide helpful information on how to approach your clients without incurring more harm to their mental health by acting contrary to their cultural belief system.        

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Inclusion, Part 2: Changing the Culture

 What else should readers know? 

Taking time with each patient who is an older adult can have a very positive impact. Often, they are afraid and cannot hear or see well. Iprofessional caregivers are hasty in their movement during the provision of procedures they are performing, not taking time to explain each step they are taking, then anxiety levels will increase. Fear or flight/fight responses will have a negative effect on patients’ ability to build up their immune system and will potentially deplete one’s ability to recover.    

Michele Wojciechowski
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