The Experience of Homebound Older Adults During the COVID-19 Pandemic

• Published in: Journal of general internal medicine : JGIM Vol. 37; no. 5; pp. 1177 - 1182
• Main Authors: Ankuda, Claire K., Kotwal, Ashwin, Reckrey, Jennifer, Harrison, Krista L., Ornstein, Katherine A.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.04.2022; Springer Nature B.V
• Subjects: Adults; Aged; Aging; Anxiety; Coronaviruses; COVID-19; COVID-19 - epidemiology; Cross-Sectional Studies; Dementia disorders; Electronic mail; Homebound Persons; Humans; Internal Medicine; Loneliness; Longitudinal Studies; Medicine; Medicine & Public Health; Mental depression; New technology; Older people; Original Research; Pandemics; COVID-19; Isolation; NHATS; Social contact; Homebound
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-021-07361-9

Background Homebound older adults have heightened risks for isolation and negative health consequences, but it is unclear how COVID-19 has impacted them. We examine social contact and mood symptoms among previously homebound older adults during the COVID-19 pandemic. Design/Setting Cross-sectional analysis using data from the National Health and Aging Trends Study (NHATS), a nationally-representative longitudinal study of aging in the USA. Participants A total of 3,112 community-dwelling older adults in 2019 who completed the COVID-19 survey in the summer/fall of 2020. Measurements Homebound status was defined via self-report as rarely/never leaving home or leaving the house with difficulty or help in the prior month. We measured limited social contact during COVID-19 (in-person, telephone, video or email contacts <once/week), as well as loneliness, anxiety, and depression. Results Among homebound older adults, 13.2% experienced limited social contact during COVID-19 vs. 6.5% of the non-homebound. Differences in social contact were greatest for contacts via email/text/social media: 54.9% of the homebound used this <once/week vs. 28.4% of the non-homebound. In adjusted analyses of those without limited social contact prior to the pandemic, the homebound had higher but not significantly different odds (OR 1.83; 95% CI 0.95–3.52) of limited social contact during COVID-19, with increased risk among the older individuals, those with dementia, and those in assisted living facilities. Of the homebound, 13.2% felt lonely every/most days during the pandemic vs. 7.7% of non-homebound older adults. Homebound and non-homebound older adults reported similar rates of increased loneliness, anxiety, or depression during COVID-19. Fewer homebound older adults learned a new technology during the pandemic (16.3%) vs. non-homebound older adults (30.4%). Discussion Isolation among homebound older adults increased during COVID-19, partially due to differences in technology use. We must ensure that homebound persons have the connection and care they need including new technologies for communication during and beyond COVID-19.