De-Conditioning in Elderly during COVID-19


On 24 March 2020, the Government of India under Prime Minister Narendra Modi ordered a nationwide lockdown, limiting mostly movement of the entire 1.3 billion population of India as a preventive and protective measure against the COVID-19 pandemic in India. Older people, children below age 10 years, and persons with long-term conditions; have been strictly advised by the Government to protect themselves during the pandemic and not to go outside their homes for any reason. Strict Lockdown was continued for more than 3 months and started to unlock from June.


It was very tough for everyone especially for an elderly person to stay at home over a night and not to go anywhere for social gatherings, parks, and temples, etc. For many older people, spending more than 6 months at reduced levels of activity emerged an impact on multiple aspects of health like neurological events like stroke, respiratory and cardiac stamina, fine motor skills, a loss of muscle mass and strength, increase pain in joints and muscles, balance and fall, cognitive decline, emotional wellbeing and medical treatment in future. This was called “De-Conditioning Syndrome” a side effect of social isolation, reduced physical activity, and unable to go to a healthcare center for pre-existing and new non-COVID illnesses.


How to care for the elderly during COVID and get back to the old routine?

1. Physiotherapy

Physiotherapist trains person on their various physical aspect to improve their standing, walking and balance, power in the arms and legs, endurance, stamina, and decrease fatigue. Thus, following the exercise program that is recommended by a physical therapist is of utmost importance.


Do regular exercises: Regular exercise preserves lean muscle mass and reduces the deterioration of hormone levels which improve protein synthesis. Some common exercises for seniors to improve strength, balance, and to improve overall fitness are-

(i)   Aerobic exercise: Waling within the home, stairs, jumping, etc

(ii) Standing balance exercise: tai-chi, Standing with feet together and one leg with support, toe, and heel standing with support, etc.

(iii) Breathing exercise: slowly inhale from the nose and exhale from the mouth

(iv) Joints Movement: Move all the joints of the body at least once a day

(v) Yoga and meditation to relax and remove negative thoughts from the mind

It is recommended to perform 2-3 sets of 8-12 repetitions of each exercise for key muscle groups. Also, these may be effective if carried out 2-3 times per week.


2. Occupational Therapy

Occupational Therapy helps the elderly to be independent in daily living activities such as moving in the bed, transferring themselves from one place to another, dressing, eating, toileting, bathing, driving, and community integration (education, employment, etc.).


To start with, you may need to prioritize the daily tasks you want to achieve each day, schedule yourself and make an activity planner either on a paper pad or on mobile apps (available on iOS & Google play store).

Pace your activity throughout your day and take rest between tasks if you feel tired or low energy. Maintaining a balance between being active and resting may take time, but building a daily routine can help you feel better. Feed or take fluid independently, wash your clothes himself/herself, cleaning your room, etc.


3. Healthy Diet

Eat a healthy, well-balanced diet. This includes:

(i) Proteins, such as cereals, paneer, lean meats, and fish, to build muscles.

(ii) Fresh fruits and vegetables to get vitamins and minerals

(iii) Carbohydrates, such as whole grains, jaggery, etc. to boost energy.

(iv) Drink enough fluid to keep your urine pale yellow, maintain blood consistency.


4. Healthy Sleep

A good night’s sleep help in improving concentration, memory storage, and formation, vision enhancement, is an immunity booster for senior citizens and allows them to repair any cell damage that occurred during the day, which in turn helps to maintain good health and prevent disease. It is recommended to take 7-9 hours of sound sleep every day.


5. Virtual Social Engagements

Social engagements are critical to one’s wellbeing, memory, and mood. This also helps senior in maintaining their mental health during COVID-19

(i)    Talk to your family and friends daily

(ii)   Do video calls if the facility is available

(iii)  Writing or Painting to explore your thoughts

(iv)  Online sharing games

(v)   Social Platforms like Facebook, Twitter, etc.


Author

Dr. Robins Kumar

Rehab Expert

Co-Chairman, Dharma Foundation of India

+91-990848401, robins.342@gmail.com


About the Author

Being a Rehab expert he has 11 years of experience in dealing with patients of orthopedic, cardiac care, Geriatric, cancer and neurological diseases requiring holistic rehabilitation intervention from the different hospitals like Max Super specialty Hospital, Medanta the Medicity Hospital, Gurugram. He has published multiple national and international journal papers on a different aspects of the elderly. Along with his research and clinical expertise, he is certified by WHO-FIC (Dutch) in developing outcome measures based on the guideline of the international classification of functioning (a WHO framework) for measuring functional outcomes in patients undergoing rehabilitation. He is Co-Chairman of Dharma Foundation of India, a charitable trust under the Certificate Section 60 of the Indian Trust Act 1882 registered in 2010in New Delhi, by a group of dedicated healthcare providers to work for wellbeing and quality of life for the disabled and vulnerable population of India.



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