ABSTRACT
Background: Cocooning, i.e. staying at home and reducing interaction with others, was a key part of the strategy to protect older people during the COVID-19 pandemic. Unfortunately, there are concerns this has had a negative impact on the physical and mental wellbeing of those who have been isolated. Methods: We completed a survey of 150 patients (55% female, mean age 79.8 years, averageClinical Frailty Scale 4.8) attending ambulatory medical services in a large university hospital. Questions were focused on: access to healthcare services, mental health, physical health, and attitudes to COVID-19 restrictions. Results: Almost 40% reported that their mental health was 'worse' or 'much worse' while cocooning, while over 40% reported a decline in their physical health. Over 57% had a scheduled healthcare-related visit cancelled while cocooning, most frequently hospital outpatient appointments. Worryingly, almost 1/6 reported not seeking medical attention for an illness that they would usually. Of these, half did not as they were worried about catching COVID and 46% did not as this service was not currently available to them. Conclusion: The COVID-19 pandemic and lack of access to essential services, both medical and social, has had a devastating impact on older people. This is evident in both the acute presentations to hospital and the longer-term impact it has had on health and function. It is important that in the future clear policies are in place to enable older people to access care when they need it.
ABSTRACT
BACKGROUND: Cocooning or shielding, i.e. staying at home and reducing face-to-face interaction with other people, was an important part of the response to the COVID-19 pandemic for older people. However, concerns exist regarding the long-term adverse effects cocooning may have on their physical and mental health. AIM: To examine health trajectories and healthcare utilization while cocooning in a cohort of community-dwelling people aged ≥70 years. DESIGN: Survey of 150 patients (55% female, mean age 80 years and mean Clinical Frailty Scale Score 4.8) attending ambulatory medical services in a large urban university hospital. METHODS: The survey covered four broad themes: access to healthcare services, mental health, physical health and attitudes to COVID-19 restrictions. Survey data were presented descriptively. RESULTS: Almost 40% (59/150) reported that their mental health was 'worse' or 'much worse' while cocooning, while over 40% (63/150) reported a decline in their physical health. Almost 70% (104/150) reported exercising less frequently or not exercising at all. Over 57% (86/150) of participants reported loneliness with 1 in 8 (19/150) reporting that they were lonely 'very often'. Half of participants (75/150) reported a decline in their quality of life. Over 60% (91/150) agreed with government advice for those ≥70 years but over 40% (61/150) reported that they disliked the term 'cocooning'. CONCLUSIONS: Given the likelihood of further restrictions in coming months, clear policies and advice for older people around strategies to maintain social engagement, manage loneliness and continue physical activity and access timely medical care and rehabilitation services should be a priority.