The World Health Organization (WHO) has identified older adults as especially vulnerable to the novel coronavirus outbreak (WHO, 2021). COVID-19 virus has created some complications, showing more fatal implications among older adults (OCHA Services, 2021). Meanwhile, the United Nations in May 2020 published a report warning that the COVID-19 pandemic is causing untold fear and suffering for older people across the world. As the virus spreads rapidly and health and social protection systems get overwhelmed, older people may increasingly face vulnerability, abuse, and neglect, which should become the focus of policy considerations (United Nations, 2020). Moreover, mortality data from Oxford COVID-19 Evidence Service (2020) indicated a risk of mortality of 3.6% for people in their 60s and the percentage increases to 8.0% and 14.8% for people in their 70s and 80s.
In an effort to curb the spread of coronavirus, most countries issued regulations that encouraged people to stay at home and to avoid contact with other people, possibly for an extended time, in order to shield older adults. There were also enforced lockdowns and curfews. The global recommendation for older population, therefore, has stressed the issue of social isolation (Public Health England, 2020; Käll et al., 2020). In its more general context, social isolation may include avoiding social contact with family members and friends, social distancing, organizing the delivery of essential goods and items such as groceries and medications.
This research focuses on older adults (60 + years old) in the Emirate of Abu Dhabi of the United Arab Emirates (UAE) during the COVID-19 pandemic. It investigates specific psychological and social concerns and other health challenges reported by older adults, including but not limited to social isolation and loneliness, technology awareness and challenges, health and psychological self-perception, and physical health challenges. A descriptive approach is adopted drawing on the Abu Dhabi COVID-19 survey results. This research also aims to test the effect of time on certain feelings and challenges amongst older adults.
An Overview of COVID-19 Counter-Measures in the UAE and Abu Dhabi
While promoting awareness and prevention as the most effective ways of handling the pandemic (Federal Competitiveness and Statistics Authority, 2020), the UAE government issued policies and rules concerning older adults during the COVID-19 pandemic as it progressed (Ministry of Health and Prevention, 2021; UAE Government Portal, 2020). The rules and policies covered many aspects of everyday living, including but not limited to isolation, limits of family visits, and maintaining required distances at home. The recommended COVID-19 prevention protocol and rules also highlighted the necessity to avoid certain conventional social behaviors such as shaking hands, embracing, and kissing (The Middle East Explained, 2021a; Emirates Policy Center, 2020). In addition, the rules prohibited older adults from going to public places, shopping centers, worship places, and other public gatherings (UAE Health, 2021). The UAE government also warned about social distancing through various communication channels, i.e., broadcasts, TV announcements, newspapers, and social media. Acknowledging that social distancing may aggravate loneliness among older people, the messages had a positive and promising tone that conforming to such rules will increase the chances to end the pandemic sooner (Ministry of Health and Prevention, 2020).
In the Emirate of Abu Dhabi, as part of its efforts to improve the health level of older adults, the Family Development Foundation (FDF) implemented several initiatives to control and minimize the spread of the COVID-19 (Family Development Foundation, 2020). In cooperation with the Department of Health, the FDF focused on campaigns of “Educating Senior Citizens and Residents” in various regions of Abu Dhabi, with the ultimate goal to “increase their health awareness levels and enable them to adopt the preventive precautionary measures that contribute to maintaining their health and safety.” As a step further, family members, friends, local charities, voluntary organizations, and community organizations were encouraged to develop comprehensive networks to ensure each older person has some meaningful social contact to support (Authority for Social Contribution, 2021). Through such organized and comprehensive approaches, social charities, organizations, and healthcare providers were allowed to work together to support older people through this period of social isolation and loneliness. The government also communicated with older adults in Abu Dhabi to inform them that they were not required to go to testing centers for testing for the COVID-19 (SEHA, 2020). Instead, related government units called them and recommended a public health representative to visit them at home for the testing. All services for older adults were provided free of charge.
The role of technology in combating the pandemic was apparent in Abu Dhabi. The public messages sent by concerned government agencies stressed the influential roles of technology in keeping communications active, especially concerning older adults (The Middle East Explained, 2021b). Older adults were encouraged to take advantage of those communication technologies during this social crisis to think about uncommon opportunities for individual learning, career development, and for communicating with family and friends (Ministry of Health and Prevention, 2020).
Literature Reviews
Older adults are at a significantly increased risk of severe disease following infection from COVID-19. The WHO announced in April 2020 that more than 95% of COVID-19 deaths were among people over 60 years of age, and more than half of all deaths occurred in people of 80 years plus (WHO, 2020). In Sweden, for example, 90% of the deaths from COVID-19 were among people more than 70 years of age (Medical News Today, 2020). There have been distressing international news and reports of older people abandoned in care homes during the pandemic (Keeley, 2020; Sparks, 2020). In addition, numerous media coverage and online commentary about potential rationing of care with older people suggest older adults are potentially more disadvantaged than persons in other age groups (Haffower, 2020; Lee, Jeong, & Yim, 2020).
The COVID-19 pandemic literature in general has reflected concerns related to common health issues and mental health risks associated with older adults. Apart from some physical health issues such as weight losses (Owen et al., 2021; Constandt et al., 2020), the literature has recorded a wide range of psychological feelings, challenges, and concerns reported by people during the pandemic. These psychological feelings and challenges include untold fear and suffering (United Nations, 2020), sadness (Santini et al., 2020), loneliness (Käll et al., 2020; Santini et al., 2020), stress (Klaiber et al., 2020; van Tilburg et al., 2020), irritability (Patel, 2021), emotional exhaustion (Jeste et al., 2020), depression (Santini et al., 2020), sleeping disorder (Pires et al. 2021), overeating (Altena et al., 2020), and excessive screen use (Colley, Bushnik, & Langlois, 2020). Research has also concentrated on various concerns and challenges affecting the whole community in general and older adults in particular, including imposed restrictions (Käll et al., 2020; Santini et al., 2020), not being to go out in public (Takashima et al., 2020), disturbance of social life (Klaiber et al., 2020), less physical activities (WHO, 2020), less access to regular medical visits (Mishra et al., 2020), less get together with younger children (Takashima et al., 2020), and loneliness (Käll et al., 2020; Santini et al., 2020).
Social isolation, in particular, has been identified as a severe public health concern among older people (Gerst-Emerson & Jayawardhana, 2015; Heidinger & Richter, 2020). Loneliness, as a subjective and complex emotion, reflects a lack of contact with or physical separation from family and friends. The isolation might be broader to include social networks and the lack of involvement in social activities. Victor et al. (2005) stressed that social isolation is usually experienced as a feeling of anxiety and dissatisfaction associated with a “lack of connectedness or communality with others, and a deficit between the actual and desired quality and quantity of social engagement.” It is worth noticing that social isolation and loneliness are correlated and often used interchangeably (Steptoe et al., 2013). Most studies acknowledge that older people’s social isolation and loneliness are essential and paramount due to the detrimental and influential impact on their mental and physical health (Barth, Schneider, & Kanel, 2010). Loneliness is a real risk factor to the health and well-being of all people, where older people can be more vulnerable to being lonely (Santini et al., 2020). More specifically, social isolation and loneliness increase older people’s risk of anxiety, depression, cognitive dysfunction, heart disease, and mortality (Holt-Lunstad, Smith, & Layton, 2010). Social isolation might lead to other outcomes, affecting older adults’ level of awareness and knowledge.
In addressing the challenges faced by older people, Sigh (2020) elaborated that we need to examine both physical and social impact and the underlying reasons. Empirical research has shown that COVID-19 negatively impacted older adults’ body weight and nutritional status (Constandt et al., 2020; Li et al., 2020; Owen et al., 2021), which may suggest a higher risk for lockdown-induced weight loss for the older population. The results of the Canadian Perspective Survey indicated a significant impact of COVID-19 on screen time and mental health (Colley, Bushnik, & Langlois, 2020), as more than 60% of respondents reported increasing TV time and internet usage. Similarly, Helander, Cushman, and Monnat (2021) reported that the COVID-19 pandemic had increased people’s screen time due to various reasons including increased time spent on virtual education, working from home, online shopping, and electronic communication with friends and family. The positive association between numbers of family member’s older adults’ wellbeing have been studied in many different settings (Margolis & Myrskyl, 2011). Díaz-Venegas, Sáenz, and Wong (2017) used logistic regression to determine how family size affects psycho-social, economic, and health wellbeing in old age in Mexico. The results of their study showed that having fewer children is associated with lower economic wellbeing and higher odds of being uninsured for the older cohort. Older adults with children are more likely than older adults without children to have frequent social interactions, and social contacts like this offer opportunities for providing emotional and instrumental support that enhances wellbeing throughout the life course, and the importance of these contacts is especially evident at advanced ages (Baranowska-Rataj & Abramowska-Kmon, 2019).
In terms of public policies and programs, health and social care policies and campaigns worldwide acknowledged the issue of loneliness and social isolation well before COVID-19. For example, the Campaign to End Loneliness (2011) in the UK helped create a wide network of national, regional, and local organizations to work cohesively and ensure that social isolation and loneliness of older people remain a public health priority. The New Zealand government has emphasized its commitment to an aggressive vision of positive aging principles to promote community participation and prevent social isolation and loneliness (Ministry of Social Development, 2001). However, in most developed countries, a different population of older people at risk of becoming more socially isolated resides in residential care homes. During the COVID-19 pandemic, such elderlies encountered challenges as their family members and friends were not permitted to visit them, although most countries adopted regular consultation with medical and related professionals in order to support older people (Berg-Weger & Morley, 2020). Therefore, there is an urgent need to support older people since there might be more negative impacts on their physical and mental health from social isolation and ageist discourses around COVID-19. In such conditions, older adults might require more support to have and retain their connectedness and communality to better enable a sense of belonging. In the United Kingdom (UK), an example of support was rendered by the Public Health England, which issued a publication of guidance on maintaining mental health and well-being during COVID-19 social restrictions (Public Health England, 2020). The UK government also embarked on a media campaign to recruit volunteers to support older people who needed assistance. The campaign was taken as an inclusive approach to ensure that older people are not left isolated over an extended period. Other responses to socially support older people included the development of social networks through online technologies.
The negative effects of COVID-19 are more severe and compounded for older adults who do not have access to modern technology platforms or could not acquire more effective means of communication (Johns Hopkins University, 2020). It is apparent that empirical research has focused on the technical aspects of the pandemic related to older adults (Berg-Weger & Morley, 2020; Käll et al., 2020). Several studies promoted the use of online technologies to provide social support networks and a sense of belonging during the pandemic (Newman & Zainal, 2020). Some also suggested that cognitive-behavioral and psychological therapies be delivered online to decrease loneliness and improve mental wellbeing (Käll et al., 2020). Other creative ways of supporting the general population, including older people, included more creative online applications and online platforms (Shankar et al., 2017). However, such technological aiding facilities might be inhibited by disparities among older population in access to or literacy in digital resources (Berg-Weger & Morley, 2020). As a result, some analysts recommended that interventions should involve more frequent communications via telephone, messaging, SMS, or other simple social media resources (Brian Suffoletto, 2016; Kuerbis, van Stolk-Cooke, & Muench, 2017; WHO, 2017).