Socially isolated seniors are at risk for developing dementia at a startling rate of up to 50% and nearly one fourth of adults 65 or older are considered socially isolated.3 Those statistics alone are disheartening, then along comes COVID-19. This disruptive life event, and the mandatory precautions to restrict family and friends from visiting nursing homes, initiated to keep seniors safe, have put them at even more risk.

Neurodegeneration and Pressure Injuries
Neurodegenerative conditions such as dementia, Alzheimer’s or Parkinson’s disease are more prevalent in the elderly and predispose seniors to skin issues and pressure injury. These conditions can result in motor, sensory and cognitive changes as well as behavioral changes. Seniors with neurodegenerative impairment tend to be less mobile and may suffer from spasticity or rigidness which can contribute to pressure injury development. It’s estimated that almost 40% of individuals suffering from dementia will develop ulcerations.1
Pressure injuries can cause significant suffering including pain, depression, or infection and can result in a five-fold increase in mortality.2 Pressure injuries may increase the care required for nursing home residents, resulting in stress on nursing resources and a financial strain to an already taxed health care system.
Depression
Social isolation has also been linked to loneliness and depression. Depression is characterized by feelings of sadness, sleep disorders, decreased appetite, energy, and difficulty concentrating.3 Loneliness is a symptom of depression. Maintaining relationships with friends and family helps to prevent psychological stress and loneliness. These relationships provide a sense of value and meaning and are an important source of social support for older adults.4 Virtual interaction with family is encouraged during this time of isolation due to COVID-19, however, access to the internet or computers, computer literacy and comfort with this form of communication all impact the success of virtual connectedness.
Malnutrition
Social isolation and loneliness also contribute to malnutrition in the elderly. By nature, humans are social beings and healthy eating habits are closely tied to eating meals with others.5 Malnutrition can lead to decreased mobility and weight loss which also increases the risk for pressure injury.1 Nutritional assessments are a critical component in predicting risk for pressure injury. Poor nutritional status can delay wound healing, and even contribute to infection or sepsis.6
What You Can Do
While it is necessary to isolate residents to keep them from exposure to COVID-19, it is also necessary to bolster skin care prevention to minimize the effects of isolation, immobility, and poor nutrition. Consider increasing the frequency of skin assessments during this time. Follow the National Pressure Injury Advisory Panel guidelines for preventative skin care that recommend avoiding alkaline soaps and cleansers for bathing, keeping the skin hydrated, using barrier products to protect skin from moisture and cleansing promptly after incontinence episodes. These interventions are essential to keeping skin intact. Boost a poor diet with liquid protein to bolster the nutritional status of residents impacted by the effects of social isolation related to COVID-19. At this unprecedented time, prevention is key.
How DermaRite Can Help You
Education
Additional guidance for caregivers is offered in the new COVID-19 Recovery Series. DermaRite Academy, our free online learning portal, also offers several courses on dementia as well as many other topics that will benefit every caregiver.
Nutritional Products
DermaRite offers two great tasting liquid protein options to meet the nutritional needs of your residents – ProHeal and ProHeal Critical Care. Both are easy to use, provide up to 17 grams of protein in a convenient 1 oz serving and provide all the essential and non-essential amino acids to support the nutritional requirements needed during this stressful time. The ProHeal line is sugar, soy, lactose, and gluten free, and can be safely used with most diets. More information can be found here.
Skin Care
DermaRite is your go-to-source for all your preventive skin care needs. Explore the whole line of skin protectants here.
ProHeal™ and ProHeal™ Critical Care Liquid Protein
ProHeal is a medical food developed for the dietary management of wounds and conditions requiring supplemental protein. ProHeal is a liquid protein supplement that contains a concentrated blend of hydrolyzed collagen and whey protein for maximum protein content and absorption.
Learn more >
References:
- Jaul, E., Barron, J., Rosenzweig, J. P., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC geriatrics, 18(1), 305. https://doi.org/10.1186/s12877-018-0997-7
- https://www.bmj.com/rapid-response/2011/10/31/pressure-ulcers-advanced-dementia-may-need-different-approach
- National Academies of Sciences, Engineering, and Medicine 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press
- Berkman, L. and T.A. Glass. 2000. Social integration, social networks, social support, and health. In L. Berkman and I. Kawachi (eds.) Social epidemiology, New York: Oxford University Press. Pp. 137-173
- https://thevarsity.ca/2019/03/15/loneliness-and-isolation-associated-with-malnutrition/
- https://woundeducators.com/nutritional-assessment/
- https://npiap.com/