Well-Being in a Post-COVID World

When you think about the residents you care for in your skilled nursing facility, what does it means for them to be “well?”

During the pandemic, that answer was clear – freedom from the illness that seemed to stop the world from turning – at any cost. With its disproportionately severe effects on older adults, skilled nursing facility staff went above and beyond to protect their residents from contracting the highly contagious virus, implementing strict personal protective equipment protocols and social distancing requirements even as you knew doing so would potentially result in other consequences like loneliness, isolation and delayed preventative care. And we now know that research has shown many of those consequences did, in fact, come to pass.

But as we continue to emerge from the pandemic, now is our chance to re-think what wellness means for our skilled nursing facility residents. Taking good care of them no longer means just wearing a mask and giving them access to the COVID vaccine.[1] It means making sure they’re receiving regular checkups and screenings, addressing mental health issues, and helping them build resilience so they can better face adversity – whether that’s a worldwide pandemic or a future personal challenge.

Mental Health Consequences of the Pandemic

During the pandemic, nearly half of older adults surveyed indicated that COVID-19 had a negative impact on their mental health, and almost a quarter reported experiencing anxiety or depression – just 11% of older adults had reported the same in 2018.[2]

In a more recent survey conducted by AARP, half of adults over the age of 50 reported experiencing anxiety, and a third reported feeling depressed.[3] In another study, nearly 65% of older adults reported having trouble falling asleep or staying asleep recently – more than twice the rate reported in a similar survey conducted in 2017.[4]

However, as the pandemic progressed, the same study showed that fewer respondents reported feeling isolated than they did in its early months. And by late January 2021, as the vaccine was beginning to roll out to seniors, more than 80% rated their current mental health as good as or better than it was 20 years prior.[5]

The Pandemic, Preventative Care and Restarting Your Routine

The pandemic forced more than 40% of patients surveyed to delay critical medical care, according to a study published in the Journal of the American Medical Association.[6] This is likely true for your residents as well since access to skilled nursing facilities was understandably limited to protect them from contracting COVID-19. But now that restrictions have loosened, it’s time to reschedule those appointments for routine checkups and screenings.

We know more now than ever about how important routine health maintenance, including regular dental checkups and hearing and vision screenings, is to maintaining good overall health and wellness. For example, there is a direct connection between oral health and systemic health,[7] and good oral health can prevent or reduce the impact of chronic conditions like diabetes and cardiovascular disease – so regular dental checkups are essential for your residents. Studies also indicate that over a 10-year period, untreated hearing loss increases a senior’s risk of suffering from dementia by 50%, their risk of experiencing depression by 40%, and their risk of falling by 30%.[8] Yet, with early diagnosis by a trained specialist and treatment with assistive devices like hearing aids, seniors can decrease their risk of facing many of these debilitating health problems.[9] We also know patients with vision impairments report experiencing symptoms of depression more than twice as often as patients with non-impaired vision, and they’re also at greater risk of suffering from cognitive decline, loss of independence, falls, and early mortality.[10] But with proper screening and diagnosis, 80% of vision loss issues are preventable or treatable.[11]

Building Resilience

While the pandemic has certainly resulted in difficult consequences for skilled nursing facility residents, experts believe older adults who exhibit characteristics of resilience may have weathered the storm better than their peers – and are more ready to take on any similar future challenges.[12]

Resilience is one’s ability to adapt in a positive manner to life tasks while experiencing stress or living through adverse situations.[13] Researchers who’ve studied resilience in older adults have identified mental, social, and physical factors that are characteristic of high levels of resilience in older adults. Specifically, optimism, community involvement, independence in performing activities of daily living (ADL), mobility, and physical health correlate with resilience in older adults.[14] So helping your residents maintain their emotional well-being and get regular preventative care will not only prolong their good health, it will better prepare them to withstand tomorrow’s challenges as well.