Our Social Network: A Community-Based Program to Address

Older Adult Mental Health Amidst COVID-19

Kathleen Melei, OTDS
Huntington University Doctor of Occupational Therapy Program
Doctoral Capstone Project

Project Description Results Quantitative Results Qualititative

Purpose: To explore the effects of COVID-19 social distancing guidelines on older adult mental
health and quality of life. Utilizing survey and interview responses from community-dwelling COVID-19 Quality of Life Scale • Participant’s values and interests were often inherently social
older adults, current evidence, and an occupational therapy perspective, a community-based • Only one responded “yes” to feeling lonely or isolated
“I feel my personal safety is at risk” 35.20% Opportunities
program was developed for a county health department in Illinois. for Social • All participants did express a longing for restored participation with family and
Connection friends.
"I feel more depressed than before” 39.60% • Participants seemed most affected by the lack of physical closeness with
Background Information others, dramatic changes in daily routines, or changes in relationships.
• Participants valued activities that allowed continuity with relationships and
While older adults rely on medical isolation to prevent infection from COVID-19, the "I feel more tense than before” 50% routines.

resulting social isolation can also be detrimental to physical health, mental health, and • Participants were less willing to participate in completely novel activities but were
“I think my physical health may willing to modify the activity or context to continue a previous activities.
32.20%
overall quality of life. deteriorate” Opportunities • Complete loss of experiences: several cancelled vacations, retirement plans,
•Physical Health for Activity leisure activities, and even family rituals
“I think my mental health has
•Contact with other humans is critical to survival1 29.50% • They expressed feelings of boredom, frustration, tension, and depression while
deteriorated
also commenting on decreased physical activity and leisure participation.
•Social isolation is associated with increased: blood pressure, hospitalizations, heart
“I think my quality of life is lower than • Decreased motivation and interest in typical activities which decreased participation
disease, obesity, immuno-deficiency, vitamin D deficiency, and falls​2,3,4,5 65.60%
before even more.
•Social Isolation decreases: life expectancy, pulmonary reserves, and independence • Participants discussed feelings of frustration and disappointment with the behavior

with Activities of Daily Living (ADLS)6,7,8 Opportunities and beliefs of the community at large.
for Service • Participants mentioned feeling disillusioned and saddened by close family and
• Mental Health friends’ behavior, beliefs in relation to the pandemic and the election.
• Social isolation can result in lost sense of direction, purpose, or meaning9. • Participants reported changes in their ability to participate in desired occupations in
the most meaningful way.
• COVID-19 and resulting isolation is associated with several mental health problems: PTSD,
• Participants reported a lost sense of freedom or opportunity, mental
depression, anxiety, hopelessness, attachment disorder, helplessness, suicidal ideation, Strategy exhaustion, and anxiety over contracting COVID-19.
Training
confusion over God’s role, and increased substance use10. • Only one participant Participants also demonstrated use of coping activities and
coping thoughts despite (or due to) these increased difficulties.
Method:
Mixed Methods Design to create two needs assessments:
Discussion
General Needs Assessment: Online Survey
N = 230 Mean age of 72.8
Community-dwelling adults living in Indiana and Illinois​ Our Social Network provided community stakeholders with a program manual, a continuing education
Specific Needs Assessment: Semi-structured Interviews Education A large majority of participants agreed or strongly agreed that they had a video series for training on using the manual, and an online network.
Regarding Mental lower overall quality of life (35%), increased depression (29.5%), and
N=5 Ages 70-83​ Health increased anxiety (32.2%).
Residents of Will County (n=2) and Cook County (n =3)
• Number of weekly interactions decreased from a median of 20 to a Implications
Program Development median of 5 following COVID-19 (Z = -10.13, p < 0.001), .
Based on triangulation of data with previous evidence and stakeholder interviews. • Number of community activities decreased from a median of 3 to a
median of 0 following COVID-19 (Z = -11.586, p < 0.001)
• Number of physical activities decreased from a median of 3 to a median The project:
Data Analysis Opportunities for • accentuates the value of occupation for addressing social isolation and loneliness.
of 1 following COVID-19 Significant changes in number of interactions and
Social Participation • affirms the role of OT during the COVID-19 pandemic.
number of activities (Z = -7.455, p < 0.001)
Design: cross-sectional, analytical • 19.1% increase in reports of inadequate support during COVID-19 • provides recommendations and guidelines for OT-based, community programs.
(p<0.001) • supports the role of OT in public health.
• To determine if there is a difference in lifestyle routine before and following the onset of the
• 7.4% increase in reports of reliance on others during COVID-19
COVID 19 pandemic. (p<0.001) Future Research might explore:
• the COV19-QoL scale11
• To determine the if there is a statistically significant difference in scores on the COV19- Lower COV19-QoL Scores were associated with the following • the subjective and objective experiences of social participation.
QOL scale by demographics access to healthcare and lifestyle routine.
demographics: • different theories beyond the MOHO to analyze qualitative data
• Age 65-75 compared to 75-85 (Z = -3.05, p = 0.002) • different domains of behavioral health
Design: Qualitative • Live alone compared to live with others (Z = - 2.16, p = 0.03)
Effective Outreach • resilience, peer support, technology, or retirement.
• Report inadequate social support compared to adequate (Z =-7.243, p
Occupational Competence

Program Objectives
Future studies are crucial as the pandemic is still progressing which might result in changes to
Occupational Identity
< 0.001) the current data in the future.
Environmental Adaptation
• Self-isolated always compared to rarely (Z = -2.85, p = 0.003) and never
Survey and
Interview Data
Model of Human Occupation
(MOHO) Constructs Program Strategies Activity Modification
(Z = 3.22, p <0.001)
Skills Training
Contact Me: Resources:
There was a significant difference in scores between individuals in the age
Recruitment
Recognition of *available
Online vs. In-person
Performance Skills
group 65-75 (Mdn = 17) compared to 76-86 (Mdn = 19), with the older age References and Join Our
Program Procedures
group having better CoV19-QoL scores (Z = -3.05, p = 0.002) upon
Continuity Acknowledgments Request Social Network