Assessing the ongoing mental health of seniors as the COVID-19 pandemic moves into a second year is tough, mental health professionals say. As with other age groups, no one size fits all.

But some seniors and experts alike say they have seen some hopeful signs emerge despite the mental stresses created by the fear and separation caused by the pandemic.

A U.S. Census Bureau Household Pulse Survey published in late 2020 showed 29.3% of adults older than 65 reported depressive disorder or anxiety symptoms during the pandemic. Contrast that with the rate reported for adults aged 18 to 24 — 56.2%, almost double the rate for the seniors surveyed.

Some senior adults with emotional or cognitive issues have seen them worsen. Others are in counseling or getting help for the first time. But that’s counterbalanced by seniors who fight isolation by connecting on Zoom or Facetime, taking up hobbies, exercising outside or keeping cognitively sharp by reading, doing puzzles and playing games.

Still, seniors have faced a series of challenges since the world changed in March 2020.

“I think that [for some in] the 65-and-older community, being distanced at first was exciting, with all these technologies like Zoom and Facetime seeming fun,” said clinical health psychologist Dr. Rachel Feit, who works with patients having underlying medical issues connecting mind and body.

“But now there’s a general fatigue around ‘When am I going to be able to go take a pottery class in person?’ or ‘When am I going to be able to go to church and feel safe?’”

And many seniors who live in care homes have been denied in-person interaction for months while others haven’t been able to properly mourn the loss of loved ones.

“We have lived our lives for the past 40 years or so with the idea we can get to anyone by plane or car, but with COVID we have had so many families separated throughout the country that those yearly visits where grandma or grandpa come to stay for three months haven’t existed,” Feit said.

In her own case, she said, her husband’s parents live up north and have never seen their 1-year-old grandchild in person.

Senior Susie Rose of Woodstock said “trying to break out of this mental slump has been difficult. Certainly, I don’t have the concentration or focus I would normally have. I don’t have any patience with nonsense.”

Jennifer Sims of Mountain Park said her senior father is in an assisted living center. She said with COVID restrictions, she’s only been able to visit him in the last three months-and that through a window. No hugging allowed. She choked back tears as she described him, saying that frequently “he doesn’t know where he is or why he’s there.”

She’s worried about further decline because “they say for dementia and Alzheimer’s [disease] one of the best things to do is to keep your mind stimulated. I just can’t imagine just sitting in a room 24/7 for the past year waiting for the next meal to come.”

Those fears can seem well-founded. Licensed clinical social worker Kelly Morgan specializes in treating older adults and related how one of her partners has patients who have steadily declined while locked away from their families in independent care centers. They’ve wound up in nursing homes.

Mental health workers forecast that even after the worst of the pandemic subsides, they’ll be dealing with patients on after-effects.

Morgan tells the story of a client who was going out and doing things prior to the pandemic. Now she’s developed an almost paralyzing sense of fear of being able to again connect with people on the outside.

Others note those who have seen their loved ones pass away over the last year haven’t been able to grieve properly, without a traditional funeral and resultant close in-person connectivity with loved ones.

At the same time, as vaccination levels build and COVID cases level off or decline optimism seems to be building as well.

Psychologist Dr. Regina Koepp said a preponderance of older adults without life-altering illnesses or dementia seem to have zeroed in maintaining connections in a safe way and focusing on quality, not quantity of relationships.

East Cobb resident Tessa Sisson is one of those who said she’s maintaining well. “All my children live nearby and for a while we didn’t get to see each other and that was difficult,” she explained. “Things seem like they’ve eased up a bit for me and for them. Now we socialize, but with respect for distance.”

She said the increase in staying apart led her back into painting — she showed her work professionally when younger — and has convinced her to spend her time more wisely.
Another positive sign is a pandemic-enforced increased use of mental health-related telemedicine.

Morgan said Medicare and insurance companies have increasingly relaxed their restrictions on reimbursing for remote counseling or mental health treatment. She said previous telehealth was mostly to provide service to remote areas.

“Right now because of the pandemic it’s wide open,” she said, but she fears that insurance providers may beef up restrictions again as COVID caseloads drop.

And still others on the mental health front believe the pandemic has convinced some seniors who had been reluctant about therapy to seek help when they need it.

Mental health workers said the responses they are seeing make plain the importance of connecting with other people, however that’s accomplished.

Kirk Bryant Wellstar Neuropsychologist.

“I had a patient today who talked about their church having virtual services and that it’s just not the same,” said clinical psychologist Kirk Bryant. “I’d say that even though it’s not an ideal solution, people need to work on forging links.”

He said regularly scheduled phone calls might help. Maybe writing a letter or sending a gift could be what the doctor ordered. Without regular human connections, he said, not just emotional maladies could worsen, but there also is an increased risk of heart disease and stroke.

For those reluctant or confused by remote technology, Feit has straightforward advice.
You can start simply with better habits, she said. Always change out of the clothes that you slept in. Line out different day and night routines. She suggests journaling to put down what you are experiencing and how it makes you feel. And seek professional help if that feels appropriate.
“Stop being stubborn,” she said. “I would say to those people that nothing is ever going to be as good as [being together] in person. [But] there are so many other roadblocks that we have been faced with that are out of our control. Don’t add another one for yourself.”

Mark Woolsey

Mark Woolsey is a freelance writer based in Atlanta.