Is The Pandemic Purgatory Worse Than The Lockdown?

Is The Pandemic Purgatory Worse Than The Lockdown?

Alice Herb, 88, an intrepid New Yorker, is used to walking miles around Manhattan. But after this year of being shut inside, trying to avoid Covid-19, she’s noticed a big difference in how she feels.

Is The Pandemic Purgatory Worse Than The Lockdown?

“Physically, I’m out of shape,” she said. “The other day I took the subway for the first time, and I was out of breath climbing two flights of stairs to the street. That’s just not me.”

Is The Pandemic Purgatory Worse Than The Lockdown?

Emotionally, Herb, a retired lawyer, and journalist is unusually hesitant about resuming activities even though she’s fully vaccinated. “You wonder, what if something happens, maybe I shouldn’t be doing that, maybe that’s dangerous,” she said.

Millions of older Americans are similarly struggling with physical, emotional and cognitive challenges following a year of being cooped up inside, stopping usual activities and seeing few, if any, people.

If they don’t address issues that have arisen during the pandemic — muscle weakness, poor nutrition, disrupted sleep, anxiety, social isolation and more — these older adults face the prospect of poorer health and increased frailty, experts warn.

Older adults begin to catch up on all that they missed during the pandemic

What should people do to address challenges of this kind? Several experts shared advice:

Reconnect with your physician. Large numbers of older adults have delayed medical care for fear of Covid-19. Now that most seniors have been vaccinated, they should schedule visits with primary care physicians and for preventive care screenings, such as mammograms, dental cleanings, eye exams and hearing checks, said Dr. Robert MacArthur, chief medical officer of the Commonwealth Care Alliance in Massachusetts.

Have your functioning assessed. Primary care visits should include a basic assessment of how older patients are functioning physically, according to Dr. Jonathan Bean, an expert in geriatric rehabilitation and director of the New England Geriatric Research, Education and Clinical Center at the Veterans Affairs Boston Healthcare System.

At a minimum, doctors should ask, “Are you having difficulty walking a quarter-mile or climbing a flight of stairs? Have you changed the way you perform ordinary tasks such as getting dressed?” Bean suggested.

Get a referral to physical therapy. If you’re having trouble moving around or doing things you used to do, get a referral to a physical or occupational therapist.

A physical therapist can work with you on strength, balance, range of motion and stamina. An occupational therapist can help you change the way you perform various tasks, evaluate your home for safety and identify needed improvements, such as installing a second railing on a staircase.

Don’t wait for your doctor to take the initiative; too often this doesn’t happen. “Speak up and say: Please, can you write me a referral, I think a skilled evaluation would be helpful,” said James Nussbaum, clinical and research director at ProHealth & Fitness in New York City, a therapy provider.

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Start slow and build steadily. Be realistic about your current abilities. “From my experience, older adults are eager to get out of the house and do what they did a year ago. And guess what? After being inactive for more than a year, they can’t,” said Dr. John Batsis, associate professor of geriatrics at the University of North Carolina-Chapel Hill.

“I’m a fan of start low, go slow,” Batsis continued. “Be honest with yourself as to what you feel capable of doing and what you are afraid of doing. Identify your limitations. It’s probably going to take some time and adjustments along the way.”

Nina DePaola, vice president of post-acute services for Northwell Health, the largest health care system in New York, cautioned that getting back in shape may take time. “Pace yourself. Listen to your body. Don’t do anything that causes discomfort or pain. Introduce yourself to new environments in a thoughtful and a measured fashion,” she said.

Be physically active. Engaging regularly in physical activity of some kinda walk in the park, chair exercises at home, video fitness programs — is the experts’ top recommendation. The Go4Life program, sponsored by the National Institute on Aging, is a valuable resource for those getting started, and you can find videos of some sample exercise routines on YouTube. The YMCA has put exercise classes online, as have many senior centers. For veterans, the VA has Gerofit, a virtual group exercise program that’s worth checking out.

Bienvenido Manzano, 70, of Boston, who retired from the Coast Guard after 24 years and has significant lower back pain, attends Gerofit classes three times a week. “This program strengthens your muscles and involves every part of your body, and it’s a big help,” he said.

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