Experiences of Home-living Vulnerable Older Adults with Clinical Depression during the COVID-19 Pandemic: A Qualitative Study

ABSTRACT

Objectives

Little is known about the diversity of older adults’ experiences during the COVID-19 pandemic. We therefore investigated the pandemic experiences of home-living vulnerable older adults with depression, an understudied subpopulation.

Methods

We conducted unstructured interviews with N= 20 older (60+ years) adults with clinical depression receiving care in their homes in June and again in December 2020. Interviews were coded according to the grounded theory approach.

Results

We identified eight themes. Participants described feeling disconnected before and during the pandemic, which they attributed to their physical impairments and old age. Their social relations with family, medical providers, and caregivers helped them feel connected. Participants did not feel significantly impacted by the COVID-19 pandemic, but they missed social and physical contact. During the pandemic, isolation was normalized. Participants therefore experienced loneliness due to their isolation, but also a sense of togetherness with the rest of society. Isolation within the home was re-framed as cocooning, which provided a sense of autonomy. Participants nevertheless expressed resignation.

Conclusions

Home-living vulnerable older adults with depression experienced loneliness but also a degree of relief during the pandemic.

Clinical implications

Positively re-framing isolation and the stability of formal caregiving helped participants endure feeling disconnected during the pandemic.

KEYWORDS:

• Everyday experience
• mental health
• loneliness
• social isolation
• grounded theory
• resilience

Disclosure statement

No potential conflict of interest was reported by the author(s).

Clinical implications

• Home-living vulnerable older adults with depression struggle to feel connected, before and during the COVID-19 pandemic.

• Despite or rather because of their isolation, home-living vulnerable older adults with depression experienced loneliness but also a degree of relief during the pandemic.

• Togetherness, cocooning and the stability of formal caregiving helped participants endure loneliness during the pandemic and demonstrate the potential to increase a sense of belonging even under conditions of prolonged and extreme social isolation.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author, [EMK:https://www.medicalschool-berlin.de/hochschule/unser-team/team-fakultaet-naturwissenschaften/professoren/prof-dr-habil-eva-marie-kessler/]. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Additional information

Funding

This work was supported by the German Innovation Fund of the German Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) [01VSF17048].