Occupational Disruption during the COVID-19 Pandemic: The Lived Experience of Community-Dwelling Older Adults

Being and Doing Together in a Naturally Occurring Retirement Community: Pandemic Experiences of Older Adults

Developing effective, sustainable strategies that promote social inclusion, reduce isolation, and support older adults' wellbeing continues to be important to aging communities in Canada. One strategy that targets community-living older adults involves identifying naturally occurring retirement communities (NORCs) and supporting them through supportive service programs (NORC-SSPs). This qualitative descriptive study utilized semi-structured interviews to explore how older adults living in a NORC supported by an SSP, sought to build, and maintain, a sense of community during the COVID-19 pandemic. Analysis revealed how changes in context prompted changes in the program and community, and how despite lack of in-person opportunities participants continued to be together and do occupations together in creative ways that supported their sense of community. NORC-SSPs, like Oasis, play an important role in supporting older adults' capacity to build strong, resilient communities that support wellbeing, during a global pandemic and in non-pandemic times.

Occupational Participation Among Older Adults During the COVID-19 Pandemic

Background. The COVID-19 pandemic led to abrupt occupational disruption for all people. However, some populations, like older adults, were disproportionately impacted particularly in the earlier waves. Purpose. The purpose of this study was to explore and understand how the occupational participation of community-dwelling older adults was experienced during the COVID-19 pandemic, using the Canadian Model of Occupational Participation (CanMOP) to contextualize findings. Method. Sixty-seven older adults participated in semi-structured interviews from September 2020 to May 2021, 37 of which also participated in a follow-up interview one-year later. Findings. Using reflexive thematic analysis, four themes were generated: (1) experiences of loss are complex and layered for older adults, (2) technology as a medium for occupational participation, (3) risk perception influences return to occupation, and (4) age-related challenges for older adults resuming volunteer work. Conclusion. Increasing frequency and severity of influenza pandemics and other disasters are a global concern, and OTs can use their skillsets to foster participation and expand occupational possibilities for older adults. The CanMOP was a helpful tool to understand the nuances underlying the participation of older adults in this context.

The effects of occupational disruption during COVID-19 lockdowns on health: a cross-sectional study

The disruption in daily activity performance during COVID-19 lockdowns is widely understood to have impacted health, but a better understanding of how restricted performance of specific activities are associated with health is needed. This cross-sectional study answers the following question: How were changes in the performance of 16 daily activities associated with health during COVID-19 lockdowns? A total of 116 participants completed an online survey rating their health before and during COVID-19 lockdowns and comparing their recollection of the performance of 16 activities before COVID-19 with their performance during lockdowns. Multiple stepwise linear regression analysis was used to estimate the relationship between self-reported changes in activities during lockdowns and concurrent (during-lockdown) health status, while controlling for pre-COVID-19 health status. Only changes in activities that were uniquely and significantly associated with lockdown health status were retained in the final model. Health before COVID-19 accounted for 3.7% (P = 0.039) of the variance in health during COVID-19 lockdowns. After controlling for health before COVID-19, five types of activity were significantly and uniquely predictive of health during lockdowns, together accounting for 48.3% of the variance. These activities and the variances they accounted for were rest and sleep (29.5%, P < 0.001), play and recreational activities (8%, P < 0.001), work (4.8%, P = 0.002), personal hygiene (3.2%, P = 0.01), and healthy eating (2.8%, P = 0.013). The study suggests that these five types of activity should be prioritized in policy or interventions when participation in activity is constrained by lockdowns or comparable factors.

Adopting new habits and routines in response to COVID-19 lockdown disruptions: A qualitative study

Introduction

COVID-19-related restrictions resulted in changes to time use and occupational participation, impacting individual and collective well-being. This study addressed a knowledge gap concerning the adaptive process during periods of occupational disruption. We explored the experience of occupational disruption and how people managed disruption during the COVID-19 pandemic.

Methods

We used a qualitative descriptive approach and interviewed 18 participants of a larger survey study of time use during the COVID-19 pandemic undertaken around a medium-sized city in Canada. Transcript analysis was conducted inductively using conventional content analysis.

Findings

Two overarching themes were constructed during data analysis: The Disruption Experience and Adopting New Habits and Routines. In the face of disruption, participants described a sense of loss and disconnection, and challenges with time management. Establishing new habits and routines required new learning associated with increased time and flexibility, connecting with others and health and wellness.

Conclusion

During changing pandemic restrictions, participants expressed a sense of loss, disconnection and time management challenges associated with occupational disruptions, but also described ways they adapted, improving their health and well-being. Strategies identified through this work may be used to enhance adaptation during disruptions. Future research should explore differences in adaptation, among more diverse populations.

Social Isolation of Older Adults, Family, and Formal Caregivers During the COVID-19 Pandemic: Stories and Solutions Through Participatory Action Research

This participatory action research (PAR) aimed to understand the health implications of guidelines impacting social isolation among frail community-dwelling older adults and their family and formal caregivers during the coronavirus disease (COVID-19) pandemic. Reflexive thematic analysis (RTA) of data collected from 10 policy/procedural documents revealed four themes: valuing principles, identifying problem(s), setting priorities, and making recommendations. Interviews with 31 participants from Peterborough, Ontario, also revealed four themes: sacrificing social health, diminishing physical health, draining mental health, and defining supports. Recommendations to decision makers were finalized at a knowledge exchange event involving participants and members of Age-friendly Peterborough. Key findings demonstrate the need for Canadian governments and health and social service agencies to enhance access to technology-based interventions, and educational and financial resources for caregivers. Meaningful communication and collaboration between older adults, caregivers, and decision makers are also needed to reduce the gap between policy and practice when addressing social isolation.

COVID-19 stress and coping strategies among older adults: a systematic review of qualitative evidences

BACKGROUND

The COVID-19 pandemic has brought about far more stressful conditions for people worldwide. As a vulnerable group, older adults have suffered various psychological problems, such as stress, because of this pandemic and have applied various strategies to cope with the dire consequences. This study aimed to synthesize qualitative evidence regarding coping strategies for stressful situations among older adults throughout the COVID-19 pandemic.

METHODS

We searched electronic databases, including Scopus, Embase, PubMed, ProQuest, and the Cochrane Library, based on PRISMA standards. The protocol of this systematic review was registered on the PROSPERO (registration code: CRD42022364831). All relevant English-language articles published between 2019 and November 10, 2022, were searched. We reviewed the reference lists for all the included studies and key references. Two reviewers conducted screening, data extraction, and quality appraisal independently, with disagreements resolved by consensus with all team members. The Joanna Briggs Institute (JBI) checklist was used to assess the quality of studies. A thematic synthesis of the selected studies was conducted.

RESULTS

We included 13 studies in our review. Most studies were conducted in the early months of the COVID-19 pandemic. The stress caused by the COVID-19 pandemic was classified into six categories: health management challenges, stress caused by quarantine, economic challenges, media and bad news stress, virus threats, and challenges related to the use of communication technologies. The strategies used by older adults to cope with these challenges were categorized into five categories: protective strategies, avoidance strategies, maintaining social connections, meaning-based strategies, and fun strategies. This research showed that depending on the situation and conditions, older adults use various strategies to cope with COVID-19.

CONCLUSION

Older adults experience much stress during the COVID-19 pandemic. In most cases, older adults can cope with these challenges with simple strategies from previous experiences and learnings. Older people require educational interventions in some cases, such as those involving communication skills. A better understanding of older adults coping strategies may enable policymakers to develop more effective policies and manage the problems of older adults in post-COVID situations.

Changes in Daily Occupations Patterns, Optimism, and Positive Affect During COVID-19 Lockdown

Background. The COVID-19 outbreak caused an initial 2-week lockdown throughout Israel. Purpose. To identify (1) changes in time-usage patterns of daily occupations during the first COVID-19 lockdown, by gender and employment status, and (2) correlations among optimism, positive affect, and daily occupations during the lockdown. Method. In a voluntary, anonymous, retrospective, online cross-sectional survey, 481 participants completed the Life Orientation Test, Positive Affect Questionnaire, and Occupational Questionnaire. Findings. During lockdown, participants spent more time in recreation, rest, and sleep regardless of their employment status, and more women than men lost their employment. Both before and during lockdown, women spent significantly higher percentage of time performing everyday tasks but reported less rest and sleep than men. Recreation was associated with positive affect. Conclusion. The COVID-19 pandemic created a temporary occupational disruption. Although people devoted their time differently, the lockdown forced people to find ways to continue engaging in their occupations.

Exploring Distress and Occupational Participation Among Older Canadians During the COVID-19 Pandemic

Background. The coronavirus disease 2019 (COVID-19) pandemic disrupted daily life with corresponding implications on levels of distress. Purpose. To describe factors associated with high distress among community-dwelling older adults during the first lockdown and explore how occupational participation was managed. Methods. A mixed methods design whereby multivariate regression analysis of a survey (N = 263) identified factors associated with high distress, as per the Impact of Events of Scale-Revised (IES-R). Follow-up interviews with a sub-sample of those surveyed who reflected a range of IES-R scores were conducted (N = 32). Findings. Those with lower resilience and anxiety/depression had 6.84 and 4.09 greater odds respectively of high distress. From the interviews, the main theme, "Lost and Found," and subthemes (Interruption and Disruption; Surving, not Thriving; Moving Forward, Finding Meaning) highlighted the process and corresponding stages, including adaptive strategies, by which participants navigated changes in their occupational participation. Implications. While the results suggest that many older adults, including those with high distress, were able to manage daily life under lockdown, some experienced ongoing challenges in doing so. Future studies should focus on those who experienced or who are at-higher risk for such challenges to identify supports that mitigate adverse consequences if another event of this magnitude occurs again.

Life after lockdown: The experiences of older adults in a contactless digital world

Introduction

The digital response to the Coronavirus (COVID-19) pandemic and its effects on the lives of older adults has been well-documented, but less is known about how they experienced the post-lockdown re-emergence into a relatively contactless digital society.

Methods

We report the findings from a qualitative survey (n = 93) and subsequent interviews (n = 9) with older adults aged 50+, where they describe their struggles with some of the newly implemented digital interactions. These struggles cover a range of settings but include using contactless payments, QR codes and apps to facilitate transactions in cafes, bars, and restaurants.

Results

A thematic analysis of our data revealed the intrinsic (e.g. digital literacy) and extrinsic (e.g. malfunctioning technology) factors that limited social inclusion for these participants, and that sometimes even led to moments of public humiliation.

Discussion

Our findings shed light on some of the motivational factors that underpin the age-related digital divide, whilst also highlighting the role of self-directed agism in limiting motivations to learn new digital routines.

"It's better than nothing, but I do not find it to be ideal": Older adults' experience of TeleRehab during the first COVID-19 lockdown

This qualitative study used descriptive thematic analysis to explore the experiences of 16 older adults (age: 71 ± 6.4) who transitioned from an in-person to telerehabilitation (TeleRehab) group intervention in March 2020. We found the following themes: (1A) Technology Use, describing challenges and need for support; and (1B) Technology Self-Efficacy, describing how technological ability was attributed to past-experience and/or age. Four themes described the intervention experience. First, "Not The Same, But Better Than Nothing" (2A), reflected a preference for in-person intervention. Specifically, in-person training provided a better social experience (theme 2B), and stronger accountability, although the content was well delivered in both modalities (theme 2C). Contextual factors (theme 2D) that played a role were ease of commute, especially important during the winter, and the context of the lockdown, that positioned the TeleRehab intervention as a meaningful social activity. However, sensory impairments, and/or distractions in the home diminished the TeleRehab experience.