We shuffle them up like a set of old documents relegated to the storage unit. Just important enough not to shred up and discard, but still not worthy of display in our most prominent filing cabinets.
The Covid-19 pandemic was a stark reminder of how we treat our elders. We brushed those statistics off as a consequence of compromised immune systems, chronic illnesses, age, and the general weakness present in an aging body. Our ears perked up when nurses and health-care practitioners were laid up in the ICU, when hospitals were so full of patients that regular health care, surgeries, check-ups, injuries, and emergencies were turned away. No room at the inn.
It was alarming, and still is, to know that frontliners were dying, and that others were dying because they couldn’t get the care they needed. Still, with the deaths, the high case numbers, and the general fear and anxiety associated with the virus, it wasn’t Covid-19 itself that caused anger. It was the lockdowns.
On March 17, 2020, Ontario Premier Doug Ford declared a State of Emergency in Ontario, and the province-wide shutdown began. Lockdown policies shuttered businesses, public spaces, libraries, hospices, and old-age homes, penning up elderly folk. Suddenly, everyone’s worlds shrank to the rooms in our homes, the sidewalks we could stroll on for an hour every day, the grocery stores filled with impersonal masked faces.
Senior citizens were among the hardest hit by Covid-19. The lockdown severed them from their communities. Their sense of belonging—meagre and abused as that belonging already was—was exchanged for exile. So, an entire population of people already swept to the side, already isolated, already vulnerable, were placed in a government-enforced limbo. They were left alone and ill-prepared for months of hyper-isolation without the help of the technology that younger people had access to.
My father’s mother lives in Portugal, in the mountains above a small town called Arcos de Valdevez. Her plot of land is surrounded by grapevines and worn grey stone walls. Stray cats roam on their soft pads through the bright blue, pink, and yellow wildflowers that bloom in her garden, five feet from the brick house she and her daughter, my aunt, live in. In the morning, the sun breaks across the terraced hills and floods this beautiful but shambled space. At night, the sky turns into a thick black blanket studded with brilliant diamond stars. Inside the house, my grandma sits in front of a small twenty-inch TV, listening to Nacional Journal while she scribbles Portuguese words into her crossword puzzle book.
I once received a call through Skype, sometime at the height of the second wave in Portugal. On my phone, I saw my grandma and aunt’s pixelated faces lagging and jumping across the screen in unnatural rhythms. They asked me how they could make the quality better. I gave them some options, but they were unsure of how to follow my directions. Their voices started to crack and then they suddenly froze; a robotic voice rang out and the call dropped.
A combination of little access to a quality internet connection, a lack of technological aptitude, and an unfulfilled desire to connect with the world—beyond her stone walls and stray cats, past the mountains that rise like bars around her home, over the sea that she will never cross—placed my grandmother in isolation.
She sits in front of the TV until she’s too tired to get up and bring herself to bed. She only responds to simple questions, she eats breakfast, lunch, and dinner with a mean, stoic face, then returns to her crossword puzzles. Isolated. Depressed. My father’s family all live in Portugal, not too far away from where they grew up as children. But out of fear of spreading the virus to each other, they no longer hold dinners at the house, and hardly visit her, even just to stand on the dirt road that leads to the front door.
The digital divide, or the “grey divide,” is used to describe the gaps in access and ability to use new technology. This is not a new issue, but the Covid-19 pandemic has displayed the need for this digital divide to close. Pushing for online interactions was a major player in mitigating the negative effects of “social-distancing” and “self-isolation.”
The government asked Ontarians to hold birthday parties over Zoom calls, for young groups of adults to spend their nights in virtual watch-party rooms bingeing shows together, for in-person mentorship programs and recreational activities to move online. This worked for those with enough technological prowess and intuition, who could easily construct a social network that resembled real-life social connection. They found the pain of social isolation eased through chat rooms, forums, videos, virtual coffee chats, online concerts, and memes they could swap back and forth.
But what were the elderly to do in this situation, already hindered by that gray digital divide? In a study published by Thomas N Friemel from the University of Zurich in Germany, senior citizens aged 65 and older living in Switzerland were interviewed to understand the frequency of their internet use. Only one-quarter of the 1103 seniors interviewed used the internet enough to be considered “onliners.” That means roughly three-quarters of this group were “offliners.” According to the study, of the offliner group, 60.4 per cent had never used the internet in their lives.
The campaigns pushing for online community building were not meant for our eldest members of society. There were no campaigns asking us to visit our elderly, begging us to keep in contact with the old folk we had in homes. There was no national thank you’s, kudoo’s or attaboys for them. They were left behind. But not by everybody.
I spoke with the Executive Director of the Ontario Society of Senior Citizens Organizations (OSSCO) Elizabeth Macnab to gain insight on how elderly people coped with the lockdown measures and formed communities amid the pandemic. The OSSCO provides learning programs for senior citizens including computer literacy workshops. In some of their programs, they estimate that over 750 older-adult learners participated.
According to Macnab, these seniors “are not just learning something, they’re building connections.” While it may seem that their family is the only community an elderly person has, the truth is that many of them maintain strong connections with the people they live with, especially in retirement homes. Macnab states that a person only needs about five people in their social network to thrive, but that as people get older and lose connections with friends, their social network goes to “a circle of four, then it’s three, then it’s two, then you go, my goodness the person is dying of loneliness and social isolation.”
Macnab also says that during the pandemic she learned that within “the retirement homes, all social activity ended.” Where they were once able to connect with other residents and build the social connections that are essential to any person’s life, they now had no way to socialize. Macnab says that some of the residents they spoke with said “they felt like they were in prison,” and that without some of the programs available through the OSSCO, “they would have no interaction except through the staff for nearly a year.”
The social networks most young people access daily are not the same networks available to senior citizens. The infrastructure for young people to transplant their ordinary public lives into the virtual world was solidified well before the lockdowns in Ontario affected everyone. There was no infrastructure for the seniors. Their networks were old-fashioned, strictly in person—the odd phone call, the even rarer FaceTime. When the lockdowns forced us inside, we cut off senior citizens from their community.
Specifically, they were cut off from what Macnab calls “casual relationships”—the organic and spontaneous interactions that occur when senior citizens are able to walk over to the coffee shop and see who they might encounter, or when they can come down for dinner from their rooms and chat with friends.
“They want to socialize and contribute to the wellbeing of the group,” said Macnab. Exactly what anyone else wanted to do, from the children that couldn’t go to school anymore, to the business owners that couldn’t open their doors, to the senior citizens that lived quiet lives. Seniors with access to OSSCO’s programs were lucky enough to have an avenue to build connections, but not all seniors were given these same opportunities.
Macnab told me that, “If we are not as a society engaged and living intergenerationally, we won’t succeed.” Funding and creating opportunities for senior citizens to learn computer literacy, while at the same time building community, is only the first step. The next step is to remove the barriers to access – such as the financial cost of technology — and develop purpose-built user interfaces and hardware that are accessible and familiar to seniors with and without disabilities.
Without these solutions, our senior citizens suffer from more than just the inability to see their loved ones on a screen. What effect does this have? What do we know about social isolation as it relates to health and wellbeing? How does social isolation connect with depression and anxiety? And does depression and anxiety lead to more illnesses and disorders?
In a study led by the Danish National Institute of Public Health, researchers conducted an analysis of data on individuals from the U.S. born between 1920 and 1947. What makes this study interesting and valuable, as related to the grey digital divide and Covid-19, is that it considers two forms of social isolation, both of which are extremely relevant to the handling of province-wide lockdowns.
The first form of social isolation is social disconnectedness. The study defines social disconnectedness as “a scarcity of contact with others.” The second form of social isolation is perceived isolation, which is an individual’s subjective perception of their connection to social networks and personal relationships. Perceived social isolation considers feelings of loneliness, low intimacy with friends, or partners, and the idea that there is no support available, regardless of the actual level of social connectedness or the size and participation of their social network.
The researchers of this study found that “social disconnectedness predicted higher amounts of perceived isolation, which in turn predicted higher amounts of depression and anxiety symptoms.” This echoes the issue that Covid-19 lockdowns brought to our elderly community members. There is a cycle that occurs, a loop that drives old folk deeper into a spiral of social withdrawal.
According to the study, elderly people that think that there are no social supports available to them are more likely to suffer from depression. In Ontario, the government prohibited members of these elder’s social network from going to visit them if they were living in retirement homes or long-term care homes. They were cut off even from close contact with care providers and their friends and instead saw nurses, doctors, and staff only.
Now, while those lockdowns were necessary to save lives and to ensure that the healthcare system was not overwhelmed, it is important to note that the government failed to consider how to facilitate social networks in a demographic that thrives on social connections but prefers to maintain them offline. That’s the crux of the issue. Where Covid-19 exposed all the faults in our flawed social systems. Like a house with a rotten foundation blown down by a sudden hurricane, our society cracked under the weight of a pandemic that was foreseen but not planned for.
Depression on its own is a public health issue for seniors living in isolation from their families and caregivers, but there are added complications that come from depression in the elderly. A study published in the British Journal of Psychiatry found that depression increased the risk of Alzheimer’s disease and cognitive decline among people with more than eight years of education.
There is also evidence that links stress and depression with higher rates of cardiovascular disease. Results from a clinical review of depression and cardiovascular disease, led by researchers from departments of cardiology in Australia and Sweden, showed that there is a causal relationship between depression and cardiovascular disease.
It is the town below those mountains that help my grandmother feel connected. Up there on the mountainside where horses whine on the slopes and clouds meander along the cool breeze, where internet is expensive and hard to access —she’s all alone. She needs the casual conversations sparked up under awnings in front of shops, on the small patios outside of restaurants, in the market where she bought the food, toiletries, and crossword puzzle books she needed for the week. Just like the people here need their trips to Tim Hortons, or the cafeteria, or a games night to maintain a social network. The lockdown affected everyone across the globe, and it created prisons for many of us, but it was our elderly that might have felt the most trapped by the lockdowns in Ontario.