Despite the recent easing of lockdown restrictions, many of us are not finding it easy to bounce back from the stress, anxiety and depression felt over the past year. This is especially true of the elderly.

In recent months, Tafta social workers have identified ten new cases of mental illnesses within our Homes, bringing the number of elders affected to 207, or 13% of the total Tafta elder population.

Special care

Elders suffering from mental illness may need round the clock care, for their safety and the safety of others. We’ve had instances where an elderly person has become confused and accused other residents of harming them or stealing their possessions. Others may wander away and get lost.

Tafta provides a complete 24/7 frail care service to residents, including those who are not able to contribute much to their care, through the support of a special group of donors, our Tafta Guardians.

Warning signs

Signs of deteriorating mental health include feelings of fear, anger, sadness, worry or numbness; a lack of interest in activities that previously gave pleasure; insomnia; over eating or loss of appetite; constant tiredness; irritability; physical reactions such as headaches, stomach problems and skin rashes; and the inability to concentrate or make decisions.

It’s easy to understand why older people are suffering more. Statistically, they are at far greater risk of dying from the disease, especially if they have other underlying health conditions, which becomes more likely as we age.

Morbid Fear

This leads to a morbid fear of becoming infected and dying of Covid-19. A fear that is often exacerbated by younger family members, who encourage elders to stay at home and withdraw from daily life in order to stay safe.

“I’ll do the shopping for you,” we volunteer with the best of intentions, leaving our parents or grandparents sitting at home with nothing to do except dwell on the dangers out there, and the reinforcement of the message that they are ‘high risk’.

Social creatures

They may be safe from the disease at home, but withdrawing from daily life comes with its own problems. Human beings are social creatures. Spending time with friends, enjoying a chat and a good laugh, is essential to our wellbeing. If we are cut off socially, we may feel that we are losing our social skills; that we have forgotten how to interact with others, leading to further feelings of anxiety and isolation.

Relationships with friends and neighbours play an especially important role in the lives of elders … cushioning them from loneliness and giving them the confidence of knowing someone ‘has their back’ if help is needed. Owing to fear, the comfort and support of friendship may now be replaced by mistrust and actively avoiding contact.

Testing positive

This fear is heightened when a friend or neighbour tests positive. There is concern for the sick friend – “Will they make it?” – and also concern for themselves – “Have I also been infected?”

There may be fear of the test itself, and the stress of waiting for the results. If they test positive, it’s not just the disease they have to worry about, but also feelings of guilt and worry about those they may have infected … people with weak immune systems who may die because of them.

Developing the slightest symptom – a feeling of fatigue, breathless or a sore throat – leads to a conviction that they have been infected. And from there it’s just one small step to the worst case scenario. “I’ll be taken to hospital … put on a ventilator … and die alone, with no opportunity to say goodbye to my friends and family.”

Managing Covid-19 in an old age home

In a communal environment, such as an old age home, anyone suspected of having contracted the disease must be kept isolated, in order to protect others. Spending a week to ten days in isolation is extremely distressing. Older persons find comfort in familiarity and being surrounded by treasured possessions. Having to stay on their own in a strange room impacts their mental heath.

If you are caring for someone in isolation, you will need patience and a calm, reassuring attitude. Try bringing some of the elder’s small personal items into the room, such as a photograph, blanket or other meaningful possession that restores a feeling of familiarity and normality.

Those who are used to companionship and conversation find loneliness frightening and depressing. Ensure they have a good supply of books or magazines, or access to puzzles like crosswords, suduko and solitaire.

Too much information

Being aware and informed about the disease is helpful. But for those who use social media, there is a danger of being overwhelmed with a constant flood of news, information, myths, opinions, arguments and misinformation that easily leads to heightened anxiety and mistrust.

Retired people often have a great deal of spare time on their hands, making them more vulnerable to information overload. Try to encourage other healthier activities, such as going for a walk (if possible) or challenging friends to games that can be played virtually – online versions of chess and Scrabble are ideal, and can be played against opponents from all over the world, opening the door to new ‘virtual’ friendships.

Friendships, whether face to face or via digital channels, are a key component of human happiness. We cannot let Covid-19 take this away from us.

Since March last year, over 50 000 South Africans have died of Covid-19. Add to this the normal number of deaths from other diseases, accidents and natural causes, and you realise that hundreds of thousands of people are mourning the loss of loved ones right now.

Coping with grief at any time is distressing. Losing someone during the coronavirus pandemic, whether to COVID-19 or to other causes, brings additional challenges. In cases where the deaths were unexpected and sudden, you might feel shocked and totally unprepared. Apart from the normal feelings of loss and regret, you may also feel guilt and even anger if you were not able to say goodbye, visit your loved one in hospital, or attend the funeral.

Additional challenges
Self isolation makes it difficult to find the support and encouragement we need to cope with grief. According to Coralie Deas, South African founder of Griefshare, an international grief support group, “The bereaved need to talk about their loss to sympathetic listeners who really pay attention.” Griefshare has tried to fill that gap by providing online counseling services.

“How a loved one dies has a great effect on the grief recovery journey of the family and friends that remain,” explains Deas. “In cases where people were hospitalised and died alone without the support of their nearest and dearest, the family may have feelings of anger towards the medical staff, the virus, the government and the situation itself.”

Understanding what happened to your loved one in those last days and weeks may help. Speak to the health workers who cared for him or her in the hospital – they may have some special memory of your loved one, or something he or she said, that will bring you enormous comfort.

Grief is a unique journey
Losing a loved one affects everyone differently; there is no right or wrong way to feel. Don’t measure your feelings and reactions against those of others. Everyone works through grief in their own way.

It is important to take care of yourself and your health. Try and get enough sleep and avoid using alcohol and other substances to relieve your grief.

Do not try to hide your feelings. The sadness you feel and the tears you shed are necessary to promote the healing process. Do not deny these feelings, whether privately or in the comfort of family and friends. Crying is a stress reliever and an endorphin releaser that will make you feel better. Talk through your difficult emotions with loved ones.

Grief counseling or joining an online support group, where you can discuss your experiences and feelings with others who understand, can be a huge comfort. Contact the Bereavement Helpline on 082 925 5938 or 079 872 6408.

Natural response
Remember that grief is a natural and ongoing response to loss. Learning to live with the loss means deciding what your life without your loved one looks like. If you didn’t have a chance to say goodbye, you can still do so. Find a quiet time to be alone and talk to your loved one as if he or she is there. Some people prefer to write letters to the deceased, expressing how they feel. Others take solace in their faith and the counsel of a religious leader.

Although you need to give yourself time and space to grieve, it’s also important to carry on with everyday life. Do not be afraid to return to normality. Your loved one would want you to enjoy life and make the most of its opportunities. It’s not disloyal to laugh again, and to feel moments of enjoyment and pleasure even though your loved one is no longer there to share them.

Celebrate your loved one’s life
While it is important to grieve the loss of a loved one, do not forget to cherish his or her life. Consider creating a scrapbook with your children, using photographs and treasured memories to honour your loved one’s life. Or you could arrange for a lasting memorial – such as an inscribed bench – to be placed in a favourite spot. Visiting this place on the anniversary of their death each year, to sit quietly and ‘talk’ to them, is a tradition that can bring great comfort.

Death is a sad occasion. However, in time, you will come to realise that it can also lead to a celebration of a life, a revisiting of joyful memories shared with a special person that you will treasure for the rest of your life.

With the world’s attention consumed by the Covid-19 Pandemic, other life threatening diseases such as cancer have been largely pushed into the background. And yet, cancer continues to claim lives, especially the lives of older people, who are at greater risk of developing the disease. Older people with cancer have the highest risk of dying if they become infected with Covid-19.

Cancer prevention
But, while we all social distance, wear masks and sanitize our hands regularly to protect ourselves from Covid, we don’t invest nearly as much time and effort in following the steps necessary to reduce our risk of developing cancer. These include giving up smoking, limiting alcohol consumption, avoiding excessive exposure to the sun, following a healthy diet with plenty of fresh fruit and veggies, exercising regularly, and going for regular health checks and cancer screening.

We know that when it comes to cancer, early detection is the key to survival. If you experience any of the warning signs of cancer, it is vital to have them investigated by a health professional as soon as possible, especially if there is a history of cancer in your family. In addition, self examination – breast examination for women and testicular self-examination for men – should be part of your regular routine.

Other screening tests that should be carried out by your health professional on a regular basis, include:
• Pap smear (to detect pre-cancerous cells in the cervix
• Mammograms and clinical breast examinations (to detect abnormalities in the breast)
• PSA (Prostate Specific Antigen) Testing to screen for prostate cancer
• Mole mapping and analysis to pick up skin cancer
• Faecal Occult Blood Test – screening for colorectal cancer

Older people and cancer
Older people, especially those with limited (if any) medical aid, may not be undergoing these screening tests regularly, if at all. And yet our risk of developing cancer increases as we age. Because our cell development slows down as we get older, cancerous tumours develop more slowly. Signs and symptoms may be so gradual that we miss them – or we attribute them simply to ‘old age’, because we are resigned to the unexplained aches and pains, joint stiffness, age spots and deteriorating eyesight that are an inevitable part of ageing.

The result is that elderly people generally don’t seek help until it is too late.

Even if they suspect they may be ill, older people are often too frightened to go to the doctor and have their worst fears confirmed. They have grown up during a time when cancer was synonymous with pain, suffering and death. Most are not be aware of the many improvements in treatments available today. Their attitude towards serious illness is one of denial and resignation. Many feel that undergoing treatment at their age is not worthwhile, while others believe that the treatment for cancer is worse than the disease itself. The most feared treatment is chemotherapy, with many believing that the side effects of vomiting and hair loss are unavoidable.

Cancer in the Elderly Survey
Based on a 2017 study by Tania Estapé, PhD, pulished in the Asia Pacific Journal Oncology Nursing in 2018, only one in two elderly people believes that cancer can be prevented. While almost all of them knew that tobacco and exposure to the sun could lead to cancer, only 38% cited diet and being overweight as risk factors. Theirs is a generation that was not encouraged to take responsibility for their own wellness, in terms of making healthy choices regarding food, habits and exercise. When they were growing up, health was something you only thought about when you got sick. Then you went to the doctor, who would decide on the appropriate course of action.

Even today, oncologists tend to treat older patients differently. They are less likely to explain the diagnosis, prognosis and treatment options candidly with older patients, especially if the patient is terminally ill. Instead they tend to treat them like children; decisions about treatment are made between the doctor and the patient’s family, while the patient is kept very much in the dark. Yet the Asia Pacific article states that data collected during the survey show that “77.2% of older people prefer to know their cancer diagnosis and prognosis.”

Cancer and depression
It should come as no surprise that hearing the words, “You have cancer” results in feelings of fear and depression. While the diagnosis is devastating at any age, older people with cancer experience much greater levels of depression and anxiety than young people. These feelings may be heightened if the elder is already experiencing loneliness, bereavement, loss of interest in activities that previously brought pleasure, fatigue and physical weakness.

Religion is a common coping mechanism among the elderly with cancer. Patients attribute the cause and course of their illness to God’s will. They express their acceptance as, “what God wants” or “I put myself in Jesus’ hands”. Some studies show that this type of coping offers an important psychological advantage to those who believe it.

Tafta care
While Tafta is not able to offer cancer screening tests or medical intervention for those suffering from cancer, we do arrange specialised counselling to help patients cope with the shock and fear that often accompanies a cancer diagnosis. We also help with dispensing medication that has been prescribed by the doctor, if the patient resides within our frail care or assisted living units, or uses the services of our carers.

We encourage cancer patients to make use of the services provided by the CANSA Association,
including individual counselling and local support groups for survivors and those living with cancer.

It doesn’t matter how old we get – we still want to be loved … to know that someone thinks we’re special and important. And this basic human need doesn’t go away just because we’ve reached our 60s or 70s. The yearning for loving touch and intimacy remain as strong as ever.

Our youth-obsessed media would have us believe that love is all about youth, beauty, sex and glamour. But couples who’ve stuck together through 40 or more years of marriage experience love that is deeper, more peaceful and enduring. It’s about wisdom, companionship, acceptance and helping one another. There’s less drama and excitement – and more comfortable hours spent together on the couch, watching movies and eating popcorn.

Love springs eternal
Even if you’ve lost your life partner, love, like hope, springs eternal. It knows no age limits, no retirement dates, no physical or mental infirmities. There’s nothing like the feeling of falling in love all over again after 70. It’s a reminder that anything is possible, that new beginnings are all around us, and that there’s still someone for everyone.

However, finding a new love in later years is not without its angst. We no longer have the confidence we had in our teens. Wrinkles, wobby tummies and bald heads make us feel less attractive and even, less worthy of love. ‘Who would want me?’ we think. It’s important to accept that we are not perfect. Neither are potential new loves! But so what if he or she is a little overweight, or wears clothes that are ten years out of fashion? It doesn’t mean that we can’t fall in love with a pair of twinkly eyes, a kind and gentle heart, or a sense of humour that brings a ray of sunshine to every day.

Attractive qualities
One advantage of getting older is that we’ve learned a lot about ourselves along the way, and most of us have stopped worrying about what people think of us. We are more authentic, more accepting of others, more relaxed and easier to talk to. All of which are very attractive qualities! There’s also less pressure on dating once the need to find a partner with whom we can raise a family is past. We can take our time really getting to know someone, and even if things don’t work out, we can still enjoy time spent in pleasant conversation or enjoyable outings that don’t necessarily lead to lifetime commitment.

Different kinds of love
Even so, not everyone is lucky enough to find romantic love in later years. That’s not to say life has to become a loveless desert! There are many different kinds of love, and romantic love is just one of them. Consider the love between good friends. Knowing that someone is ‘there for you’, that you can share your feelings with them or have fun together, produces the same feeling of being loved, special and important.

The love of a family is also incredibly special. “I feel really flattered when my daughter’s family goes away on holiday and invites me to go along with them,” says 67 year old Christine. “It’s like all the love I invested in my children when they were growing up is being returned, with interest. Because now I get extra love, hugs and kisses from my grandchildren as well!”

Sometimes, we find love in unexpected places. We don’t expect someone who’s paid to take care of us to love us. But many carers and their elderly clients here at Tafta develop very strong bonds, and are deeply concerned about each other’s welfare. If being loved means having someone who cares about you, enjoys spending time with you, and thinks you’re special, then what are these bonds, if not love?

If you still feel that nobody loves you, remember these four uplifting truths:

• Your smile can bring happiness to anyone.
• You mean the world to someone, even if they’ve never told you.
• When you think the world has turned its back on you take another look.
• Always remember the compliments you received – and believe them.

Devastating as the coronavirus is, the deadly disease is not the worst thing that happened in 2020.

In the second quarter of last year, disposable income of South African households contracted by 49.7%, forcing many people to take out loans to pay for day-to-day essentials. During the first lockdown, 1.6 million South Africans took advantage of payment holidays offered by financial institutions*. But, while this enabled them to keep the wolf from the door in the short term, interest on loans continued to mount up, resulting in an additional R20.7 billion in debt.

Whilst last year’s interest rate cut to 3.5% was good news for borrowers, it was a blow for investors, especially retired people living on interest from their savings. Those forced to dip into their capital to pay for food, medicines and transport may never recover. Even if interest rates rise again this year, the loss of capital means their income still won’t return to the previous level.

Dealing with debt
If you are struggling to meet your commitments, it’s essential to let your creditors know as soon as possible that you are in difficulty. Don’t just miss payments and hope for the best.

Prioritise your debts and pay the most important ones first to avoid the most serious consequences. For example, your first priority might be to cover rent and electricity bills, so you don’t face eviction or having your lights and water cut off.

Don’t be embarrassed to ask for help. Many people turn to family or friends first. But with the impact of coronavirus having affected almost everyone, they may not be in a position to help. Another option is to seek help from an authorised debt counselor, who can help you decide on the best course of action. Companies like Debt Rescue, National Debt Advisors (NDA) and Zero Debt can consolidate your debt and/or negotiate more favourable terms with your creditors.

What not to do
Do not be temped to take out a loan to pay off some of your debts or cover day-to-day living expenses. This is likely to make your financial situation worse, especially if you have difficulty paying the loan back on time.

Do everything possible to avoid cutting back on items like medical aid and insurance, including life and funeral cover. The effects of these cut-backs could be disastrous.

Cutting back
If you have less money to manage on every month, rather than burdening yourself (or your family) with additional debit, consider making fundamental changes to your lifestyle to accommodate your new financial reality. Here are some ideas to consider:

• Sell your car
  If you are financing a car, consider selling it (or trading it in for a cheaper model). How often do you actually use your car? Calculate how much it costs in repayments, fuel, servicing, new tyres, etc against the cost of using Uber to visit friends or get to and from the shops. As we age, our eyesight and reaction times can be affected, so not driving yourself could even be a safer option.

  Many retirement homes offer shuttle services to the local shopping centre or hospital. So if you are thinking of moving, this is another saving to take into consideration.

• Sell items you no longer use
  Minimalistic living is in! Unfortunately older people, in particular, have often accumulated a plethora of “stuff” – including furniture items that actually get in the way. Now is the time to sell the chair that no one sits in or the display cabinet (and the ornaments inside), as well as kitchen and garden implements you haven’t used in years.

  It’s easy (and free) to sell almost anything on Facebook. But don’t be tempted to spend the money you make on a trip to your favourite restaurant – use it to pay off a debt or deposit it straight into your savings account.

• Re-negotiate your cell phone contract
  Do you really need the latest iPhone? Instead of paying for an expensive contract that includes the cost of phone replacement every couple of years, hold onto your old phone and only pay for the calls and data you use.

  Since airtime is more expensive than data, use internet based apps like WhatsApp or Facebook to make calls. A bonus is that these options offer video calling, so you can actually see your children or grandchildren when you ring them.

• Ditch expensive hobbies
  How much would you save if you cancelled your gym membership or gave up your weekly game of golf? Whilst these activities may be enjoyable, if you can’t afford them, there are other options to maintain fitness. Try one of the free home exercise programmes available online, or go for a walk or run around your neighbourhood.
• Shop online
  If impulse items continually find their way into your shopping trolley, online shopping can remove the temptation. Make a list of what you need and stick to it. You’ll save money driving to the shops and it’s safer right now.

Mental Health issues
As the stress of indebtedness increases, we are going to see a huge increase in mental health issues, exacerbated by the isolation and loneliness of continued lockdowns.

Worrying about debt can make you feel physically ill, unable to sleep or eat properly. You may feel withdrawn from friends and family and find it difficult to concentrate on work or other responsibilities.

If you feel depressed or have suicidal thoughts, seek immediate help from Lifeline 0861-322-322 or SADAG (The South African Depression and Anxiety Group) Suicide Crisis line 0800 567 567 or visit their website www.sadag.org

No matter how bad your debt problem seems, there are people who can help you to overcome it, so you can continue to enjoy life.

[*Survey conducted by Fintech platform, PayCurve]