Social Preparedness in Response to Spatial Distancing Measures for Aged Care During COVID-19

To the Editor:

As cases and deaths from the novel coronavirus (COVID-19) continue to rise exponentially, many countries are employing increasingly tight lock-down and emergency procedures, including the rapid implementation of spatial distancing measures. However, as we progress to more aggressive spatial distancing processes, the coronavirus fallout threatens to cause a social crisis for already disadvantaged populations, such as older individuals who are managing chronic illnesses and those who are in receipt of aged care services.

Long-term effects of prolonged spatial distancing will likely affect this cohort, who may already be and are particularly vulnerable to social isolation, and have detrimental effects on their physical and mental health.¹ This necessitates comprehensive strategies to address the social impact of these changes.

We provide solutions toward integrating traditional and new social support structures to manage the evolving pandemic in addressing the social needs of older individuals and highlight how governments can manage and evaluate social preparedness for aged care. An investment now will contribute to longer-term social benefits after spatial distancing requirements are over.

Tackling Digital Engagement

Research and resources now need to be placed on developing and adopting technology-based options to connect people in different places using both synchronous and asynchronous forms of communication.² Population-based survey research supports the view that older adults are increasingly adopting and using technology in their lives.^{3 , 4} However, despite two-thirds of US seniors owning smartphones and more than 80% being Internet or social media users, adults older than 80 years barely use technology-based communications,⁵ and those in residential care have even more limited use.⁶

Call to Action for Governments to Be Digitally Inclusive

To tackle the pandemic and bring forth the next era of digital inclusion, governments should apply a Digital Education Revolution to support e-connections within aged care. In 2008, laptops were provided to all Australian public high school students.⁷ In 2020, supplying tablets to individual residents, rapidly employing high-speed broadband in facilities, and providing supportive information and communication technology infrastructures and digital proficiency for both staff and residents are now essential.

Residents will have varying needs and responses to technology depending on their previous technology use and adoption history, cognitive and functional status, and reliance on visitors and group activities. Initial studies have shown great benefits, with residents successfully overcoming loneliness, but effectiveness is limited by staff troubleshooting skills. Increasing staffing levels with tech personnel will assist with the digital adoption process as aged care personnel will all be stressed by the challenges of a prolonged response to COVID-19.

A Trialing Time for Aged Care

These times are now demanding care workers to both balance residents' social needs against personal risks and develop alternative, age-friendly digital environments for residents to maintain social contact with their families, other residents, and staff while being spatially distant.

Providers can take immediate action by familiarizing residents with existing, recognizable, and free video chat platforms (eg, FaceTime) to engage in meaningful social exchange with family, as well as prioritizing engagement between residents. In the long run, providers can recruit community members to assist with traditional phone check-ins to at-risk individuals and introduce residents to apps that increase individual personal well-being, physical activity, brain health, and personal interests. Websites now host free “virtual” galleries of international museums and physical activity classes, which will be particularly useful in tackling physical deconditioning, a condition likely to occur.

More original ideas will surface as we embrace these changes. It is pertinent that this information be widely distributed so improvements and adoptions can be made globally. Sharing positive experiences in the affected communities is also key to connecting with one another, which can also support individual recovery and resilience in the long term. Research should also focus on evaluating the effectiveness of different technologies and policies used to inform future pandemics.

Supportive Role of Telemedicine

Telemedicine has been a critical part of communication during this pandemic, with patients being increasingly screened over the phone. Further use of telemedicine to specifically prevent or limit adverse health and mental impacts of social isolation in residents will be invaluable, especially for those with chronic conditions who ordinarily have frequent healthcare visits.

Conclusion

To become a stronger, more resilient society both during and after the outbreak, we must focus on rebuilding central social foundations for vulnerable individuals in an innovative way. Once this viral crisis is over, our hope is that we do not forget the lessons learned about the value of creating and sustaining meaningful relationships with our oldest members of the public.