How to care for older people in the pandemic (and a printable guide!)

do's and don'ts of caring for older people in the pandemic — Malaka Gharib/ NPR

During this pandemic, I've been worried about my grandma — Nanay, to me. That's Tagalog for mother.

Her name is Felisa Mercene. She's a Filipino American immigrant. She's 92. Since March, she's been living in isolation from most of our family in Southern California. Her relatives have been wary of visiting. What if they had COVID-19 and infected her?

3,000 miles away in Washington, D.C., where I live, I wondered: Is she feeling safe? Is she happy? Or ... is she lonely?

It got me thinking. How do we make sure the older people in our lives — parents, grandparents, neighbors, relatives, friends — are doing OK in the pandemic?

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I turned to three experts for advice.

Print and fold your own guide on how to care for older people in a pandemic

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1) How do I make sure the older person is comfortable and safe with their pandemic living arrangement?

I ask this question because I've been thinking a lot about Nanay's situation.

Since I was a little girl, Nanay lived with my aunt, Tita Pinky. Tita Pinky's house is the center of family activity. Relatives would come and eat and hang out. And Nanay loved it.

Then the pandemic came along. Tita Pinky is a doctor — and she started leading her hospital's COVID-19 response.

Suddenly we were all afraid that Tita Pinky might catch the coronavirus and inadvertently infect Nanay. So we decided it would be safer if she moved in with my uncle, Tito Ovid.

But Nanay didn't want to move.

"Because of my garden, I do not want to go away because of my flowers," she says.

We made her move anyway.

Was it a good idea for our family to move Nanay? Silvia Perel-Levin is with the International Network for the Prevention of Elder Abuse at the U.N. I asked her what she thought.

"You have said we have [moved] our grandmother instead of saying my grandmother chose to [move] herself. So I would say that the first mistake was to make a decision for her," she says.

Oh no, I thought. Did we really not consider Nanay's feelings?

Perel-Levin says it's a common way that younger people deal with older people. We figure they're old, they're vulnerable — and they may not be thinking clearly.

"Just think if it were you, would you like somebody to do this to you?" she asks.

But then I did a little investigating and found out — to my relief — that we had given Nanay a choice. My uncle asked her: Do you want the flowers or do you want to protect your health?

"And I agree with them because I'm already afraid," says Nanay.

In the end it was a good idea. In July Tita Pinky and three other family members got sick with COVID-19. With Nanay at Tito Ovid's house, Tita Pinky could recover at her home without worrying about infecting.

Takeaway: Ask older people what they want.

2) If we encourage changes in an older person's life, how do we know they're happy about it?

In March, Nanay moved in with my uncle, Tito Ovid. He's got an extra bedroom, a swimming pool and a nice, big garden. But I wondered. Was Nanay happy there?

Perel-Levin says if you want to know, all you have to do is ask.

Well, I do. I'll say, "Nanay, how are you?" And I'll usually get an "I'm OK."

But what Perel-Levin wants me to do is dig a little deeper — and listen. So instead of switching topics after her response, I waited a beat to see if she'd say anything else.

Nanay says that everyone's been treating her very well. Tito Ovid and his wife prepare food for her. Her other children come and visit from a social distance. She feels, she says, "like a princess."

I breathed a sigh of relief. Well that's good, I thought. I waited another beat, and then ... Nanay said something else.

"You know, Malaka, to tell you the truth, sometimes I cry alone because I long for my room, I long for my flowers, I long for the surroundings."

Hearing her say that just broke my heart. And what I wanted to know next was how to help.

Takeaway: Dig deeper to find out how the person is really feeling.

3) How do I help an older person who misses the life they had before the pandemic?

Bette Ann Moskowitz is the author of Finishing Up: On Ageing and Ageism. She's 80 years old.

And she had a good suggestion. Ask the older person what might make them feel better. She gives an example of what you could say: "Gramma, I know you're not happy here and I get it. What could you do to make it better for you if you were going to stay? What things could you change?"

If they don't have any solutions, Moskowitz says you could ask, "How can we help?"

A few months into the pandemic, Nanay had a breakthrough. She realized that COVID-19 was going to be around for a while — and she'd be staying at Tito Ovid's a lot longer than she expected. So she just ... told us what she wanted. We didn't even have to ask (although I wish we had).

She had to do something, she says, so she will not be bored. Nanay didn't want to be the way she imagines older people to be.

"I don't want to just sit around and wait for my meals and look at the sky," she says. "If I do that, I will die."

She sprang into action. She asked Tito Ovid to get her some flowers that she could grow at his house. She asked my mom to buy her word search puzzles and books. ("Those word search books saved my life!" says Nanay.) And she started scrapbooking again, making photo albums for the family.

Takeaway: See if the older person can come up with solutions to their problems.

4) Any other special needs to consider?

Family and religion play a role in many people's lives. That's definitely true for my grandma.

"Filipino families in general really show a lot of their love and connection just by physically being together," says Alicia del Prado, a Filipino American psychologist. Think of how much Filipinos enjoy their family parties, she adds — singing karaoke and gossiping while eating lumpia, pancit and barbecue sticks.

So any time you can find ways to maintain those strong family bonds — calling the older person on the phone or on FaceTime, bringing a familiar Filipino dish over to the their residence, just popping by to say hi — that's a huge plus.

And don't forget prayer, adds del Prado. More than 80 percent of Filipinos are Roman Catholics. Keeping that spiritual connection alive during the pandemic can do a lot for an older person's mental health and wellbeing, especially if they are religious.

That's actually one of the things that Nanay says she misses the most about life before the pandemic: going to mass. Thankfully, that was an easy request. My aunt went online and found a mass to stream via Zoom.

Takeaway: When offering up TLC, don't forget to take the older person's culture into consideration.

5) Bonus question: How can I help the caretakers of older people?

My grandma has four adult children with busy lives — and it can be stressful to figure out the schedule to take care of her. Who can check in on her when my uncle and aunt are at work? Who can help her get up and down the stairs? Who can cook Nanay's low-sodium meals?

Moskowitz has some helpful words you can say to frazzled caretakers:"I know grandma sometimes is needier than we can manage. How can we do this together?"

That might be hard in a pandemic. But I think of how my family does it. Although Tito Ovid and my aunt are caring for Nanay full-time, other family members drop by to bring meals — alleviating some of the stress of preparing a meal.

And sometimes, a caretaker just needs to hear permission that they can take time out for themselves. "You can also say [to the caretaker], 'take a walk. You need a break,' " she adds.

Takeaway: Acknowledge the hard work of the caretakers — and find ways to help them get a little self-care.

Your turn: Share Your Advice

How can we make sure older people are feeling safe and comfortable during the pandemic? Email goatsandsoda@npr.org with the subject line "Older people" with your advice. We may feature it in a story on NPR.org.