The Experience of Homebound Older Adults During the COVID-19 Pandemic

Abstract

BACKGROUND: Homebound older adults have heightened risks for isolation and negative health consequences, but it is unclear how COVID-19 has impacted them. We examine social contact and mood symptoms among previously homebound older adults during the COVID-19 pandemic. DESIGN/SETTING: Cross-sectional analysis using data from the National Health and Aging Trends Study (NHATS), a nationally-representative longitudinal study of aging in the USA. PARTICIPANTS: A total of 3,112 community-dwelling older adults in 2019 who completed the COVID-19 survey in the summer/fall of 2020. MEASUREMENTS: Homebound status was defined via self-report as rarely/never leaving home or leaving the house with difficulty or help in the prior month. We measured limited social contact during COVID-19 (in-person, telephone, video or email contacts <once/week), as well as loneliness, anxiety, and depression. RESULTS: Among homebound older adults, 13.2% experienced limited social contact during COVID-19 vs. 6.5% of the non-homebound. Differences in social contact were greatest for contacts via email/text/social media: 54.9% of the homebound used this <once/week vs. 28.4% of the non-homebound. In adjusted analyses of those without limited social contact prior to the pandemic, the homebound had higher but not significantly different odds (OR 1.83; 95% CI 0.95-3.52) of limited social contact during COVID-19, with increased risk among the older individuals, those with dementia, and those in assisted living facilities. Of the homebound, 13.2% felt lonely every/ most days during the pandemic vs. 7.7% of nonhomebound older adults. Homebound and nonhomebound older adults reported similar rates of increased loneliness, anxiety, or depression during COVID-19. Fewer homebound older adults learned a new technology during the pandemic (16.3%) vs. nonhomebound older adults (30.4%). DISCUSSION: Isolation among homebound older adults increased during COVID-19, partially due to differences in technology use. We must ensure that homebound persons have the connection and care they need including new technologies for communication during and beyond COVID-19.

An Organizational Assessment of 34 Home Delivered Meals Programs that Engaged and Assisted Homebound Individuals With Obtaining the COVID-19 Vaccine During the Pandemic

“…While the risk can be lowered with vaccination, being homebound frequently limits access to this potentially life-saving intervention ( Dar et al, 2021 ). During the global public health emergency, barriers to vaccine access for this vulnerable group have included increased social isolation, loneliness, anxiety, and depression ( Ankuda et al, 2022 ; Sørbye et al, 2022 ).…”

Understanding the Impact of Social Engagement Activities, Health Protocol Maintenance, and Social Interaction on Depression During Covid-19 Pandemic Among Older Americans

“…Studies shown the majority of older adults are mostly dependent on their friends and family for various reasons and they are often in touch with them in person or virtually by phone call, text, e-mail, or video chat. However, with the advent of Covid-19, people spend less time interacting with older people (Freedman, Hu, & Kasper, 2021; Ankuda, Kotwal, Reckrey, Harrison, & Ornstein, 2022). Given that older adults were restricted to engage in social activities, strictly advised to maintain health compliances, and experienced limited physical social interaction.…”

“…People were discouraged from engaging in in-person communication and instead encouraged to adopt virtual interactions through phone calls, text or e-mail messages, and video-calling. Research also shows that homebound older adults felt limited social contact due to Covid-19 (Ankuda et al, 2022). It also reported that older people were mostly contacted through email, text, and social media during the pandemic.…”

“…It also reported that older people were mostly contacted through email, text, and social media during the pandemic. Importantly, one study revealed that older adults experienced an increased rate of loneliness and depression (Ankuda et al, 2022) during the pandemic situation because of a lack of communication activities. However, little is known about how older adults’ limited physical social interaction and dependency on virtual social interaction respectively affect their mental health during Covid-19 pandemic.…”

COVID‐19 pandemic experiences of older adults with dementia in community and residential care settings: Results from a US national survey

“…The first wave of the coronavirus disease 2019 (COVID‐19) pandemic brought sweeping changes to the lives of older adults. In the United States, high risk of severe COVID‐19 led many older adults to adopt behaviors to limit its spread, including staying at home; 1 reducing social contact with non‐resident family and friends; 2 and adopting related behavioral changes such as hand washing, masking, and physical distancing. 3 , 4 Other studies suggest increased reports of psychosocial distress among older adults during this time, 5 , 6 , 7 as well as declines in physical activity.…”