1. Hale, Deborah MSN, RN, ACNS-BC
  2. Marshall, Katherine DNP, NP, PMHCNS-BC, CNE

Article Content

Older adults are at greater risk for morbidity and mortality issues related to COVID-19 (Bailey et al. 2021). As a result, isolation and protective measures have been implemented to help mitigate the virus spread among older adult populations. Some of these measures include physical distancing, face masks, stay-at-home policies, and restrictions on social gatherings (Lebrasseur et al., 2021). Although meant to be protective, these strategies come with a cost. Loneliness, anxiety, depression, decreased mental health wellness, sleeplessness, age discrimination, excessive worrying, decreased physical activity, and lower healthcare utilization are some of the issues older adults face due to COVID-19 mitigation strategies (Richter & Heidinger, 2021).


Mental health evaluations are always important when assessing older patients, and even more so in the time of COVID-19. Concerns of anxiety, depression, lack of sleep, excessive worrying (from fear of contracting the virus or of a loved one becoming ill), and feelings of loneliness are topics to address. Consider also that older adults may feel even more isolated because they may not be adept at utilizing online resources for up-to-date information and social interaction (Lebrasseur et al., 2021).


You can help alleviate mental health concerns by conducting appropriate assessments of mental health and developing a treatment plan with the healthcare team. Some intervention may include medication initiation or change; helping the patient connect with loved ones via social media or phone; encouraging safe interactions with others as able; brainstorming ideas specific to the patient to keep mentally busy (e.g., puzzles, word games, letter writing); exercising as able; and counseling services if appropriate.


In addition to mental health concerns, the physical well-being of patients is an important consideration. Isolation increases sedentary behavior and increases the risk of decline in mobility, balance, activities of daily living performance, and overall quality of life (Bailey et al., 2021). Advise physical activity such as walking in their home, marching in place, or chair exercises. Consider therapy services to encourage optimal functioning and prevent decline.


Lastly, with COVID-19 prevention strategies comes the risk that older adults will not seek healthcare services as they once did. Home care clinicians can play an important role in bridging the gap between the patient and primary care provider, by facilitating a connection to healthcare providers and encouraging the patient to seek out appropriate services as needed.


Clearly, COVID-19 has serious consequences for older adults. In addition to the risks of contracting COVID-19, the mitigation strategies to protect patients from COVID-19 can also cause harm to mental and physical health. Be on alert for mental and physical decline and help the care team develop appropriate strategies to reduce risks. Educate patients on the importance of seeking out healthcare services. Helping mitigate unintended consequences from COVID-19 prevention measures is an important role of the home healthcare team.




Bailey L., Ward M., DiCosimo A., Baunta S., Cunningham C., Romero-Ortuno R., Kenny R. A., Purcell R., Lannon R., McCarroll K., Nee R., Robinson D., Lavan A., Briggs R. (2021). Physical and mental health of older people while cocooning during the COVID-19 pandemic. QJM: An International Journal of Medicine, 114(9), 648-653. [Context Link]


Lebrasseur A., Fortin-Bedard N., Lettre J., Raymond E., Bussieres E. L., Lapierre N., Faieta J., Vincent C., Duchesne L., Ouellet M. C., Gagnon E., Tourigny A., Lamontagne M. E., Routhier F. (2021). Impact of the COVID-19 pandemic on older adults: Rapid review. JMIR Aging, 4(2), e26474. [Context Link]


Richter L., Heidinger T. (2021). Hitting close to home: The effect of COVID-19 illness in the social environment on psychological burden in older adults. Frontiers in Psychology, 12, 737787. [Context Link]