Locked-down elderly facing ‘tsunami’ of health problems

Many have suffered falls and have balance difficulties while there is also a ‘fear element’

Joint mobility, strength, confidence and aerobic fitness have ‘hugely, hugely declined’ because of inactivity. Photograph: iStock

Joint mobility, strength, confidence and aerobic fitness have ‘hugely, hugely declined’ because of inactivity. Photograph: iStock

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Ireland is facing a “tsunami” of health problems among older people forced to stay at home during the Covid-19 lockdowns, physiotherapists are warning.

The Irish Society of Chartered Physiotherapists, which represents about 3,400 practitioners, is calling for the entire health service to be “reoriented” towards rehabilitating the older population as coronavirus restrictions ease.

With a shortage of physiotherapists in the country, practices are already struggling to cope with soaring numbers of older patients presenting with dramatically deteriorated bone and muscle strength because of inactivity.

Many have suffered falls and are experiencing balance difficulties, while there is also a “fear element and lack of confidence” about emerging back into some semblance of normal day-to-day life, said Esther-Mary D’Arcy, the society’s professional adviser.

“We are deeply concerned,” she said. “We could be looking at the majority of people in the older population needing advice and guidance in addressing bone health, balance and muscle mass.”

The society is writing to the National Public Health Emergency Team about the urgent need for a full-scale national rehabilitation and awareness campaign to stem “a tsunami of health issues coming down the road”.

“It is the silent impact of the pandemic,” said Ms D’Arcy. “While Covid has affected and continues to affect many people, the restrictions around the pandemic are actually affecting many, many more.

“We are facing a tsunami of decreased health in the next few years. There has been a widespread decrease in the strength, balance and bone health of older people in particular. This is leading to stiffness, weakness and frailty, which will lead to fractures and surgery. Frailty can be the start of real decline.

“It doesn’t even make economic sense to allow all this deteriorate into an escalation of healthcare costs, because of surgery, hip replacements and the like.

“We need to get the nation moving quickly – physically moving. We need to reorient the health service to rehabilitation, with targeted rehabilitation of people.”

Silent impact

Ms D’Arcy said a steep rise in appointments being made with physiotherapists countrywide was a direct result of “people following orders from public health officials and Government”.

Hospital Report

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Although the society did not disagree with the Covid-19 guidelines, it was “now time for Nphet to consider the silent impact and the other aspects of the pandemic ... which was perhaps not considered.”

People need to be allowed to return safely to fitness facilities such as swimming pools and gyms “sooner rather than later”, according to D’Arcy.

“Physiotherapists are incredibly busy right now, much busier than they anticipated they would be,” she said. “Many are crying out for more physiotherapists. It is much busier than it was before the pandemic.”

Ann-Marie Ennis, who has run Swords Physiotherapy in north Co Dublin for 20 years, said she was witnessing a “huge decrease in people’s physical fitness”.

“The elderly population were usually good at moving, walking into town, the shops, Mass, the hairdressers, or they might go to Aquafit once or twice a week – that has all gone,” she said.

“By following the official advice, they put themselves under house arrest. They’ve just been walking around the house and garden for more than a year now. That’s a long time for a lack of physical activity.”

Joint mobility, strength, confidence and aerobic fitness have “hugely, hugely declined.”

Ms Ennis, who sees 40 or 50 patients a week, said she was about 50 per cent busier than before the pandemic, a surge she attributed directly to the knock-on impact of the restrictions.

The older generation are “very law abiding and took the advice very seriously, probably too seriously for their own physical good, and they’ve lost confidence because of it”.

Broken wrists

Ms Ennis said she was “seeing that right across elderly patients ... increases in falls, broken wrists, needing rehabilitation after injuries, loss of muscle tone, some putting on weight because they’ve been sedentary”.

“If they had balance and physical fitness, I don’t think these falls would have happened,” she added.

As people try to pick up their old routines, returning to outdoor activities, she expects to see even more injuries.

Ms Ennis is also predicting a rise in the number of builders, hairdressers and others doing very physical work sustaining injuries because they have been “deconditioned from not working for so long”.

“But my biggest concern with elderly people is falls,” she said.

“They will have lost their balance and will injure themselves by trying to do too much activity after a long time at home.”

The Health Service Executive said it had been working with community helplines to offer support and services to older people, including online and televised exercise programmes.

A working group was also set up to “co-ordinate efforts in this area and included representatives from Age Friendly Ireland”, a HSE spokeswoman said.

“This group is also focused on the rehabilitative needs of older adults post Covid-19,” she added.

“A webinar has been scheduled for the beginning of May that will include input from expert speakers on the topics of nutrition and falls prevention, focusing on the path ahead as we emerge from Covid-19 lockdown and will be open to HSE staff, third-sector organisations working with older people, advocacy organisations and older people.”

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