Dementia Experts Point to Patients' Special Needs During COVID-19 Pandemic

By Carolyn Crist 

April 10, 2020

(Reuters Health) - The "double hit" of dementia and the coronavirus pandemic creates an especially vulnerable group of patients and caregivers, dementia experts say.

During the COVID-19 outbreak in China, national organizations released guidelines about how to provide support, and multidisciplinary teams started free counseling services. Other countries can follow their approach, the experts wrote in The Lancet.

Led by Huali Wang of the Dementia Care and Research Center at Peking University Institute of Mental Health (Sixth Hospital) and the Beijing Dementia Key Lab in Beijing, an international panel of authors points out that people living with dementia may have limited access to accurate COVID-19 information and may have trouble remembering safety guidelines or understanding the importance of staying at home.

These individuals are "likely to be among the most hard-hit by the pandemic in terms of mortality and other harmful effects on their health and welfare," said Peter Lloyd-Sherlock of the University of East Anglia in the United Kingdom. Lloyd-Sherlock, who wasn't involved with this paper, researches health and well-being in older people.

"The focus needs to be on how community-based health services and other organizations can help these people and their families," Lloyd-Sherlock told Reuters Health by email.

The authors of the paper note that older people in many countries tend to live alone, with a spouse, or in a nursing home. As more businesses stop non-essential services and shift to working online, those with dementia who depend on in-person support might be lonely, abandoned and withdrawn, the co-authors wrote.

In addition, long-term care facilities in many states have banned visitors, and group activities have been prohibited. Residents lack face-to-face contact with loved ones and become more socially isolated.

"We have observed that under the dual stress of fear of infection and worries about the residents' condition, the level of anxiety among staff in nursing homes increased and they developed signs of exhaustion and burnout after a month-long full lockdown," the authors wrote.

Mental health professionals, social workers, nursing home administrators and volunteers should be able to deliver mental health care for those who need it, including services for stress, exercise, meditation and relaxation - and these services should be available to caregivers as well, who will face difficulty in helping their loved ones, the authors said. It's also important for family members to stay in touch during this difficult time.

"Stay engaged and follow closely day to day. You may not be able to see your loved ones daily, but you can check in with them," said Dr. Michael Malone of Aurora Sinai Medical Center in Milwaukee, Wisconsin. Malone, who wasn't involved with this paper, is medical director of Aurora Senior Services and Aurora at Home.]

"Try to define what you can do to reach to them -- a letter, a FaceTime call, or a call to the nursing staff who is actually with your loved one," Malone told Reuters Health by email. "Tell them that you are thinking of them and that you love them."

Alzheimer's Disease International has published COVID-19 guidelines on its website at

The corresponding author of the paper did not respond to a request for comment.

SOURCE: The Lancet, online March 30, 2020.