From “Vulnerable People” to “Vulnerable Resources” — Older Adults’ Social Support Realities During COVID-19
This blog post is based on the main findings of the CSCW ’ 21 paper: “Hugging with a Shower Curtain: Older Adults’ Social Support Realities During the COVID-19 Pandemic”, which is authored by Novia Nurain, Christina Chung, Clara Caldeira, and Kay Connelly. It will be presented at the ACM CSCW’21 on Tuesday, Oct. 26th, 2021 at 11:30 am (EST). The paper has received Impact Recognition Award at CSCW’21.
“I got an old shower curtain, and I held up the shower curtain, I just folded my arms around her (friend), because you know sometimes you just need to do those things.” (72-year-old woman, P14, 2020)
The COVID-19 pandemic led to dire consequences globally. According to the New York Times, around 43.1 million COVID-19 cases have been reported in the USA till Sept. 2021. The number was even worse for older adults, 8 out of 10 deaths have been reported among people aged 65 and above. Around 43% of USA older adult citizens mentioned experiencing major changes in their lifestyles. They have encountered more challenges as they rely more on in-person interactions for social support and services. However, disease mitigation measures, such as stay-at-home orders and social distancing, limited older adults’ in-person interactions, hindering social support reception and provision during the COVID-19 crisis.
How has Older Adults’ Social Support Changed During the COVID-19 Pandemic?
We conducted a study involving 15 semi-structured interviews with older adults aged 65 and above living alone in the community. The study was conducted in Indiana, USA.
In the USA, the first COVID case was identified in January, 2020. By early March, Indiana, where the study took place, initiated stay-at-home orders. People were restricted from leaving their home for anything other than essential activities. Participants were already living with restrictions for about 4 to 5 months while the study took place between June and July, 2020. So there were more restrictions in place for the first interviews than for the last ones.
Older Adults’ as Support Providers of Peers
“I have friends who are older than I am, I have been asking them. I call a friend and ask “I’m going to the grocery store. Is there anything I can bring to you?” ” — P8
We encourage to view older adults as resources for society during a crisis.
Most often society has a tendency to think of older adults as recipients of support, especially in a crisis situation. However, in our study, we found that older adults not only received support, they also provided support to others, especially their peers who were older and vulnerable than themselves. We found that older adults provided tangible support (e.g., food, money, household tasks), emotional support (e.g., empathy, concern, and care), informational support (e.g., advice, feedback, suggestions), and network support (e.g., mutual checking) during the pandemic.
Tensions Around Social Support
“I used to volunteer at Shalom community center, which helps homeless people [..] Since the COVID hit, I stopped volunteering there.” — P2
We found that there exists a tension between social support and safety, autonomy, and independence. Older adults felt a sense of limited autonomy and independence while receiving support from others. For instance, participants shared that they didn’t feel comfortable when their loved ones (i.e., family members and friends) were overprotective because of their age-related risk factors and providing tangible support (i.e., food and groceries) even though they did not explicitly seek the support. Hence, tensions brewed between social support seeking and maintaining autonomy.
Most participants pointed out their desire to maintain good health and ensure safety during the pandemic. They discussed how their need for safety disrupted their roles as support providers in some instances. For instance, participants stopped engaging in different volunteer activities to mitigate the risk of being infected by the virus.
How Could We Design to Aid Older Adults’ Support Provision and Reception?
We propose a support ecology framework to aid the design of socio-technical support systems for older adults. The proposed framework captures the changing nature of social support and comprises three interconnected constructs. These are 1) support roles, 2) support concerns, and 3) support sources.
The framework can be used by researchers in different settings to identify spaces where more work needs to be done. For instance, consider parent-child care relationships for chronic conditions such as Type2 diabetes. Here, the framework can be used to investigate specific support needs for both care providers (i.e., parents) and receivers (e.g., the child living with chronic disease) regarding interactions among evolved support roles, sources, and concerns.
The framework can also be used to design collaborative peer support systems that take into account safety, autonomy, and independence. Current aging in place socio-technical support systems mostly focus on ensuring older adults’ safety, by monitoring their behavior and signaling to remote caregivers. Here, the caregivers set rules that lead to the loss of older adults’ autonomy and independence. Our proposed framework can be applied to incorporate the factors that help with autonomy (e.g., provide agency to older adults) and reduce the factors that limit autonomy (e.g., rule setting by the caregivers) to maintain the balance of independence, autonomy, and safety.