Tech use flourishes during pandemic, particularly among seniors

Published on January 10, 2022 in RINewsToday

Over the course of 71 episodes of the widely-acclaimed Sopranos, Dr. Jennifer Melfi met with Tony Soprano in her office. The office had paneled walls, was decorated with a diploma on the wall, and next to that was a bookshelf filled with books. Melfi was counseling Mob Boss Tony Soprano for anxiety and depression. This was the typical office setting in any community before the COVID-19 pandemic spread like wildfire across the nation.  But now with the ongoing COVID-19 pandemic, therapists are using alternative ways to reduce increasing depression and mental health needs of the patients. The typical face-to face therapy, like Melfi offered Soprano and her other patients, has been replaced by computer and smartphone-based tele-treatment. 

While it remains unclear whether the technique is as effective as face-to-face psychotherapy that takes place in an office, they do offer a promising alternative to address the growing mental health needs spawned by the continuing COVID-19 pandemic, and in a safe way, according to a research study published last month by the Washington, DC based American Psychological Association.  

“The year 2020 marked 30 years since the first paper was published on a digital intervention for the treatment of depression. It also marked an unparalleled inflection point in the worldwide conversion of mental health services from face-to-face delivery to remote, digital solutions in response to the COVID-19 pandemic,” said lead author Isaac Moshe, MA, a doctoral candidate at the University of Helsinki in a Dec. 13 statement announcing the study’s findings.

“Given the accelerated adoption of digital interventions, it is both timely and important to ask to what extent digital interventions are effective in the treatment of depression, whether they may provide viable alternatives to face-to-face psychotherapy beyond the lab and what are the key factors that moderate outcomes,” he said.

The research article, “Digital interventions for the treatment of depression: A meta-analytic review,” was published online in the journal Psychological Bulletin. Psychological Bulletin, published on Dec. 13, 2021.

According to researchers, digital interventions, instead of the face-to face counseling sessions, typically require patients to log in to a software program on a computer website or app to read, watch, listen to, and interact with a series of content structured modules or lessons. Individuals oftentimes receive homework assignments relating to the modules and regularly complete digitally administered questionnaires relevant to their presenting mental health problems. This allows clinicians to monitor their progress and outcomes in cases where digital interventions include human support. Digital interventions are not the same as teletherapy, which has gotten much attention during the pandemic, according to Mosh, noting that teletherapy uses videoconferencing or telephone services to facilitate one-on-one psychotherapy.

“Digital interventions have been proposed as a way of meeting the unmet demand for psychological treatment,” notes Moshe. “As digital interventions are being increasingly adopted within both private and public health care systems, we set out to understand whether these treatments are as effective as traditional face-to-face therapy, to what extent human support has an impact on outcomes, and whether the benefits found in lab settings transfer to real-world settings,” he said.

According to the website article, researchers conducted a meta-analysis of 83 studies testing digital applications for treating depression, dating as far back as 1990 and involving more than 15,000 participants in total, 80% adults and 69.5% women. All of these studies were randomized controlled trials comparing a digital intervention treatment to participants on a waitlist or receiving no treatment at all, or those receiving treatment as usual or with face-to-face psychotherapy. The researcher primarily focused on individuals with mild to moderate depression symptoms. 

Overall, researchers found that digital interventions improved depression symptoms over control conditions, but the effect was not as strong as that found in a similar meta-analysis of face-to-face psychotherapy. There were not enough studies in the current meta-analysis to directly compare digital interventions to face-to-face psychotherapy, and researchers found no studies comparing digital strategies with drug therapy.

But digital treatments that involved a human component, whether in the form of feedback on assignments or technical assistance, were the most effective in reducing depression symptoms. This may be partially explained by the fact that a human component increased the likelihood that participants would complete the full intervention, and compliance with therapy is linked to better outcomes, according to Moshe.

Depression is predicted to be the leading cause of lost life years due to illness by 2030. At the same time, less than 1 in 5 people receive appropriate treatment, and less than 1 in 27 in low-income settings. A major reason for this is the lack of trained health care providers,” Moshe said. “Overall, our findings from effectiveness studies suggest that digital interventions may have a valuable role to play as part of the treatment offering in routine care, especially when accompanied by some sort of human guidance.” 

Tech use by Seniors skyrocketed

As noted above, while the continuing COVID-19 pandemic has increased the popularity of using digital intervention, teletherapy uses videoconferencing or telephone services to facilitate one-on-one psychotherapy, a newly released AARP Tech Trends reports an increased use of technology by seniors to facilitate social contact to families and friends to reduce isolation.

According to AARP’s report released on Dec. 21, tech use by people age 50 and over, skyrocketed during the pandemic and those new habits and behaviors appear to continue.  What’s more, 70% of those surveyed purchased tech last year, with spending far greater today than it was in 2019; $821 now as versus $394, then. Smartphones, and related accessories, along with Bluetooth headsets topped the list of their purchases, but smart home technology was vital to them, too.

Unsurprisingly the researchers say that technology use has facilitated social connectedness with others throughout the pandemic. They found that the rates of reliance on tech for social connection is consistently high across age ranges: 76% of those in their 50s, 79% of those in their 60s, and 72% of people 70+ all count tech as their link to their families and the wider world.

“The pandemic redrew the lines: Tech has gone from a nice-to-have to a need-to-have for Americans 50+, and their new habits are here to stay,” said Alison Bryant, AARP Senior Vice President of Research in a Dec. 21 statement announcing the study’s findings. “Those who can afford tech are spending a lot more than they did just a few years ago – more than twice what they spent in 2019. And their motivations vary: Some use tech to work, others to stay connected to family and friends, and others still to enable them to age in place or get assistance with needs. At the same time, we’re also mindful of the digital divide, where a lack of affordability can also mean no access to tech and its benefits,” says Bryant.

The Tech report noted that seniors continue to incorporate tech into their daily lives. Certain tech behaviors formed during the ongoing pandemic appear to be here to stay such as video chat, making online purchases, ordering groceries, doing banking, and engaging in health services, with seniors making more purchases and financial transactions online compared to previous years. 

Researchers also found that during the last two years, older adults’ usage of a home assistant and owning a wearable has doubled. The Tech study also reveals that learning how to use and manage smart home technology is a top interest of seniors. Smartphones continue to be adopted in new ways to manage day-to-day living and entertainment. This year, one third of seniors ordered take-out food from a restaurant and one in four listened to podcasts on their smartphones. 

Health-related innovations and daily objects that automatically track health measures on tech devices are also of top interest, say the researchers, noting that 42% of older adults feel tech is not designed with them in mind.

Finally, the AARP Tech Trends report found that 30% of older adults are using tech to pursue personal passions, mostly with video content. Streaming content continues to increase with most of them subscribing on average to three platforms. 

With the ongoing COVID-19 pandemic not going away in the near future, the use of technology will continue to increase to maintain contact with family and friends, to access education, telehealth services, for use in financial transitions, shopping, and entertainment.  

With Thanksgiving approaching, beat the Holiday Blues

Published on November 22, 2021 in RINewsToday

Just a year ago, the coronavirus (COVID-19) pandemic transformed the way we celebrated the traditional Thanksgiving dinner. Normally a personal gathering day with family and close friends, the cooler weather pushed people inside where the virus more easily spreads, forcing families to meet on Zoom for turkey dinner and catching up.

Today, COVID-19 vaccines have made it safer to bring families together to this annual holiday gathering. With the nation’s borders now open and 195 million Americans fully vaccinated and new travel guidelines in place, AAA predicts more than 53.4 million people are expected to travel to reunite with their loved ones, the highest single-year increase since 2005.

But like previous Thanksgiving celebrations, not every family gathering will be as serene as the one portrayed in Noman Rockwell’s iconic Freedom from Want painting that appeared in the March 6, 1943 issue of the Saturday Evening Post. Thoughts of attending the upcoming gathering might just tear open psychological wounds and bring to the surface bad memories, triggering stress, tension, and even depression.

Increased family demands and obligations that begin before Thanksgiving and continue through Christmas, and finally New Year’s Eve, can bring about the holiday blues, sad feelings specific to the holiday season. While there is no formal diagnosis of the holiday blues, these feelings are quite real for some people. Usually, it is felt by people who are going through the first holiday after a loss of a significant person in their life or a bad childhood memory from past the holidays. 

Holiday stresses brought about by last minute shopping for gifts, baking and cooking, cleaning and hosting parties, and even having unrealistic expectations can trigger depression. It can also bring about a feeling of malaise, tiredness, headaches, excessive drinking and overeating and even difficulty in sleeping.

COVID-19 and the Holiday Blues

At the beginning of the COVID-19 pandemic there was less stress because people were not doing face-to-face gatherings, says Elaine Rodino, Ph.D., psychologist in private practice for over 41 years in California and Pennsylvania. “But it still came up because they were worried about Uncle Morrie showing up on Zoom,” she says.

The COVID-19 pandemic is overshadowing this year’s holiday season yet again, says Rodino, who is former president of the American Psychological Associations’ Division 46 (Society for Media Psychology & Technology), and Division 42 (Psychologists in Independent Practice), the Los Angles County Association, and the Central Pennsylvania Psychological Association.

“There’s plenty of mitigating news this year about inflation and how prices are higher on almost all items including Thanksgiving Day dinner. People having financial issues this year can let themselves feel better by realizing that they are not alone. Many people are suffering economically through no fault of their own,” Rodino says.

“We’ve been experiencing many new ways of having to think about things,” adds Rodino, urging people to “be flexible and find new ways to enjoy life with less dependence on material things.”

According to Rodino, preplanning your visit can be the best way to reduce holiday blues. “Give thought to what you’re expecting and determine if your expectations are valid or just wishful thinking. Then decide to literally “make the best of it” by focusing on the good things and the good reasons why you’re making this visit,” she advises.

Putting the Kibosh on Hot Topics at Dinner

What can you do to steer away from heated political debates or sensitive issues including “why aren’t you vaccinated?”

Stressful situations at Thanksgiving gatherings can be reduced if you give thought to what to expect in visiting with your relatives. “Plan ahead on how you’re going to avoid being taken down a rabbit hole of controversy. How are you are going to pivot away from conversations when you see them going in a dangerous direction?”  

Rodino adds, “Remember who they are and how they think. Since it’s only a limited time visit, try to remain neutral. Don’t try to change anyone’s thinking. Things usually go badly when people try to convince others to think the way they do. That never goes well.”

You can plan ahead about how you will handle these conversations. “Do not fight!  There will be no winner. Talk about sports, the weather (not climate change), how delicious the food is, even how cute the dog is,” recommends Rodino.

“It’s best to accept that everyone has their own opinions (even if some seem very bizarre). Just think to yourself that you will soon be going back to your own home. You do not need to try to convince anyone about anything,” adds Rodino.

“When feeling stress, it’s important to realize that it’s time limited. Take care of yourself, whether it’s exercising, taking a warm bath, or just taking a break and reading a book. “There needs to be just some time that you just check out from the holiday stress part,” she says.

The holiday blues should begin to fade away by the first couple of weeks in January, notes Rodino. “So, if people are still feeling that, like say the second, third week of January, then they really should talk with a psychologist, because there could be issues that really need to be sorted out and processed,” she says.

With the ongoing pandemic we need to create new ways of doing things, says Rodino, noting that “People need to become creative and think up new ways to celebrate.”

As to compiling other strategies to cope with the holiday blues, Rodino suggests Googling ideas for surviving the pandemic holidays. “There’s something there for everyone,” she says.

Depression and Suicidal Thoughts

During this time of year, some may even feel a little depressed or have suicidal thoughts. Losses of all types can weigh heavily on anyone, but loss from COVID-19 has tragically impacted on so many and we can now add the pandemic to the challenges many face along with unemployment, experiencing painful chronic illnesses, or just feeling isolated from others. Sometimes, you aren’t ready for professional help from a doctor or mental health professional. Sometimes, you just need someone to talk to.

Think about calling The Samaritans of Rhode Island – where trained volunteers “are there to listen.” Incorporated in 1977, the Pawtucket-based nonprofit program is dedicated to listening to those in need through its nonjudgment befriending hotline/listening line program serving all of the state’s 39 cities and towns.

Executive Director, Denise Panichas, of the Rhode Island branch, notes that the communication-based program teaches volunteers to effectively listen to people no matter the caller’s issues or status. “You don’t need insurance, you don’t need to be in crisis, you don’t need to be in professional care, you don’t need a diagnosis to call. Most importantly, conversations are free, confidential and anonymous.

And, Panichas notes, for those in professional care, Samaritan volunteers can  be there to listen when family, friends and professionals are not available.

Panichas noted The Samaritans of Rhode Island Listening Line is also a much-needed resources for caregivers and older Rhode Islanders. Caregiving is both rewarding but most caregivers don’t want to talk about the stress to family and friends. Caregivers don’t want to be a bother to anyone. Caregivers need to know, however, that they are never a bother to our Listening line volunteers.

This year, The Samaritans partnered with Rhode Island Meals on Wheels to share information about the availability of the Listening Line services to homebound seniors. Family members are encouraged to share The Samaritans telephone number with seniors who are family members living alone, or even for those seniors living in facilities – most have private phones and they can call, too.

The Samaritans of Rhode Island can be the gateway to care or a “compassionate nonjudgmental voice on the other end of the line,” Panichas notes. “It doesn’t matter what your problem is, be it depression, suicidal thoughts, seeking resources for mental health services in the community, or being lonely or just needing to talk, our volunteers are there to listen.”

Suicide prevention education is still a very important feature of the agency’s mission. For persons in need of more information about suicide emergencies, The Samaritans website, http://www.samaritansri.org, has an emergency checklist as well as information by city and town including Blackstone Valley communities from Pawtucket to Woonsocket.

Holiday giving to financially support the programs of The Samaritans of Rhode Island is always welcomed. Donations can be made online at its website or by mail to: The Samaritans of Rhode Island, P.O. Box 9086, Providence Rhode Island 02940.

Emergency? Call 911. Need to talk? Call a volunteer at The Samaritans. Call 401.272.4044 or toll free in RI (1-800) 365-4044.

One Year Later – Two Surveys Examine Impact of COVID-19

Published in RINewsToday on May24, 2021

Over the year the raging pandemic has impacted on the physical and mental health of Americans. With daily COVID case counts now the lowest since last year and hospitals seeing less coronavirus hospitalizations, most states, including Rhode Island, are now opening up.

According to the American Psychological Association’s (APA) latest Stress in AmericaTM poll (findings released on March 11, 2021), the nation’s health crisis is far from over. Just one year after the World Health Organization declared COVID-19 a global pandemic, many adults report increased negative behaviors, such as undesired changes to their weight and increased drinking, that may be related to their inability to cope with prolonged stress.

APA’s survey of U.S. adults, conducted in late February 2021 by The Harris Poll, shows that a majority of adults (61 percent) experienced undesired weight changes—weight gain or loss—since the pandemic started, with 42 percent reporting they gained more weight than they intended. Of these individuals, they gained an average of 29 pounds (the median amount gained was 15 pounds) and 10 percent stated they gained more than 50 pounds, noted the poll’s findings.

Gaining Weight Bad for Your Health

Weight changes come with significant health risks, including higher vulnerability to serious illness from COVID-19.  According to the National Institute of Health, people who gain more than 11 pounds are at higher risk of developing Type II diabetes mellitus and coronary heart disease, and people who gain more than 24 pounds are at higher risk of developing ischemic stroke. 

For the 18 percent of Americans who said they lost more weight than they wanted to, the average amount of weight lost was 26 pounds (median amount lost was 12 pounds). Adult respondents also reported unwanted changes in sleep patterns and increased alcohol consumption. Two in 3 (67 percent) said they have been sleeping more or less than desired since the pandemic started. Nearly 1 in 4 adults (or 23 percent) reported drinking more alcohol to cope with their stress.

“We’ve been concerned throughout this pandemic about the level of prolonged stress, exacerbated by the grief, trauma and isolation that Americans are experiencing. This survey reveals a secondary crisis that is likely to have persistent, serious mental and physical health consequences for years to come,” said Arthur C. Evans Jr, PhD, APA’s chief executive officer, in a March 21st statement announcing the results of the study’s findings. 

Evans calls on health and policy leaders to come together quickly to provide additional behavioral health supports as part of any national recovery plan.

The researchers found that the pandemic took a particularly heavy toll on parents of children under 18-years old. While slightly more than 3 in 10 adults (31 percent) reported their mental health has worsened compared with before the pandemic, nearly half of mothers who still have children home for remote learning (47 percent) say that their mental health has worsened; 30 percent of the fathers who still have children home said the same. 

APA’s study also found that parents were more likely than those without children to have received treatment from a mental health professional (32 percent vs. 12 percent) and to have been diagnosed with a mental health disorder since the coronavirus pandemic began (24 percent vs. 9 percent). More than half of fathers (55 percent) reported gaining weight, and nearly half (48 percent) said they are drinking more alcohol to cope with stress.

As to essential workers, (either persons working in health care or law enforcement), the majority said that they relied on a lot of unhealthy habits to get through the year-long pandemic. Nearly 3 in 10 (29 percent said their mental health has worsened, while 3 in 4 (75 percent) said they could have used more emotional support than they received since the pandemic began. Essential workers were more than twice as likely as adults who were not essential workers to have received treatment from a mental health professional (34 percent vs. 12 percent) and to have been diagnosed with a mental health disorder since the coronavirus pandemic started (25 percent vs. 9 percent).

Furthermore, people of color noted that unintended physical changes occurred during the pandemic. Hispanic adults were most likely to report undesired changes to sleep (78 percent Hispanic vs. 76 percent Black, 63 percent white and 61 percent Asian), physical activity levels (87 percent Hispanic vs. 84 percent Black, 81 percent Asian and 79 percent white) and weight (71 percent Hispanic vs. 64 percent Black, 58 percent white and 54 percent Asian) since the beginning of the pandemic.

Black Americans were most likely to report feelings of concern about the future, say the researchers, noting that more than half said they do not feel comfortable going back to living life like they used to before the pandemic (54 percent Black vs. 48 percent Hispanic, 45 percent Asian and 44 percent white).  They also feel uneasy about adjusting to in-person interaction once the pandemic ends (57 percent Black vs. 51 percent Asian, 50 percent Hispanic and 47 percent white).

“It’s clear that the pandemic is continuing to have a disproportionate effect on certain groups,” said APA President Jennifer Kelly, PhD. “We must do more to support communities of color, essential workers and parents as they continue to cope with the demands of the pandemic and start to show the physical consequences of prolonged stress,” says Kelly.

COVID-19’s Impact on Seniors

A newly released AARP study, released on May 10, 2021, has found that more than a year into the coronavirus pandemic, most adults age 50 and older say that it has had a negative impact on their mental health. Researchers found that seven in 10 older adults reported an increase in sadness or depression due to the COVID-19 pandemic, and nearly 8 in 10 said they had increased concern about the future, worry or anxiety. Half of adults 50 and older reported feelings of anxiety in the last two weeks, and 56% noted difficulties falling asleep or staying asleep, say the study’s findings.

“If you are feeling stressed and anxious after the last year, you are far from alone!” said Alison Bryant, Senior Vice President of Research at AARP in a statement announcing the survey results. “As our survey highlights, most older adults’ mental health and wellbeing was affected by the pandemic—and some of the ways we coped might not have been great for our health, either. With many communities returning to normal, we hope older adults will consider taking steps to reclaim their health this spring and summer,” she said.

Coping with the COVID-19 pandemic

According to the AARP study findings, seniors are responding to the increased stress in a variety of ways. About one in four of the respondents reported they are eating comfort foods or “unhealthy foods” like chips and candy more often than before the pandemic. And 27 percent of people 50 and over have increased the time they spend praying or meditating. One in 10 survey respondents reported seeking mental health care in the last year, a third of whom did so specifically because of the pandemic. Overall, 15 percent of older adults said that experiencing the pandemic made them more likely to seek help from a mental health provider if they had concerns.

AARP’s survey also highlighted how the pandemic increased loneliness and isolation among those age 50 and over.  Among older adults, 58 percent reported feeling increased loneliness, and 62 percent were less likely to socialize with friends and family compared to before the pandemic.