At the Stanley M. Isaacs Neighborhood Center on Manhattan’s Upper East Side on Monday morning, a trickle of older New Yorkers, some pushing walkers or riding in mobility scooters, arrived to bad news. All group activities were canceled. Lunch was strictly to go.
A worker wearing a plaid shirt and a surgical mask handed a meal to a woman, then urged her to move along: “You can’t hang out at the center today.”
Anna Reifman, 69, took a meal to warm in her toaster oven. Ms. Reifman, like many at the center, lives alone.
“I’m really isolated now,” she said. “This isn’t just about lunch. I come here to talk to people other than my cat.”
New York is an aging city, and in many ways, it’s a good place to be an older person: There is plenty of public transportation and ample medical care. But the city is unprepared for what it faces today. New York has 1.73 million residents over age 60, more than the total population of Boston and San Francisco combined, with a demographic profile that is getting poorer and older. The coronavirus pandemic stretches the gaps in a system already under pressure.
Shortages in supermarkets, closures in public facilities — all take an extra toll on elders, especially those with limited means: One in five New Yorkers over age 65 lives in poverty, twice the national average. The difficulties cascade: When schools close, home-care workers have to stay with their children, leaving frail elders isolated in homes they cannot manage.
All of it rests on an especially fragile work force of volunteers and low-wage workers who provide essential meals, home care, and social companionship to elders at home — exposed to long subway rides and managing their own child care. If they falter, there is often no net below for their clients.
For 30,000 elders each day, senior centers were an outlet from their homes. And now, by order of the mayor, all on-site activities are closed, though the centers can still provide meals to go.
“I started crying when I told the seniors we were closing down,” said Judy Zangwill, executive director of Sunnyside Community Services, which closed its senior center except for pickup food service last Friday, ahead of instructions from the city. “I heard audible moans.”
It is a terrible irony of the virus: that for older adults, steps to prevent the spread of Covid-19 increase the risks of social isolation, which carries its own devastating health effects. A study by the AARP compared the effects of prolonged isolation to those of smoking 15 cigarettes a day.
Normally programs for elders aim to increase human contact. Now that contact is potentially deadly.
Nursing homes and assisted-living buildings, by order of the city’s health department, banned visitors, including in many cases residents’ private aides. Public libraries, houses of worship, neighborhood cafes — all social spots for elders — are also closed, pushing older people back into what are often lonely apartments: 30 percent of New Yorkers over 65, and 43 percent of those over 85, live alone, according to the Department for the Aging.
Sarah Arico, a regular at Sunnyside’s senior center, said the closing was “very hard to deal with emotionally.” She goes to the center for photography, for exercise classes, for the mental health group and “a good lunch.”
Last Friday, all of that came to a halt. “It is more isolating,” she said. Without the center, she was turning her attention to her dog and to phone calls with friends.
When she picked up food at the center, she said, the staff instructed everyone on line to stand six feet apart.
“Everybody was freaking out.”
But Ms. Arico said that she was making sure she walked outside, using physical activity to bolster her mental health.
“It’s a completely different way of living,” she said. “But I know we are going to get through this. I try to say, nothing is forever, not the good times, not the bad times. We all try to get through.”
As much as the activities and the hot meals, senior centers provide structure in lives that may not otherwise have it, said Ruth Finkelstein, executive director of the Brookdale Center for Healthy Aging at Hunter College. “The way we remember to do something is that it’s tied to something else,” Ms. Finkelstein said. “When that gets disrupted, it disrupts when we eat, which disrupts our sleep, which disrupts whether we take our medications.
“We see this with the way older people experience delirium in the hospital after just a few days of disruption. I’m not saying the current disruption will come to that, but once the disruption starts, it’s very difficult to dam it.”
At JASA’s Club 76 on Manhattan’s Upper West Side, run by the Jewish Association Serving the Aging, Stu Lahn said, “My family is being very hard on me because I’m not being as careful as they would want me to be.” Mr. Lahn said he was most disturbed by not knowing what would happen next. He could replace his social activities at the center using the telephone, but the uncertainty made him feel a loss of control, which in older people can be particularly damaging.
“What’s hard is thinking about how long it’s going to last,” he said. “Tomorrow and tomorrow and tomorrow — it’s the unknown that’s scary.”
Mr. Lahn, who is 79, normally runs the center’s Monday bingo program with an older woman who survived the Holocaust. (She did not feel up to being interviewed for this article.) Since the center closed last week, he has been checking up on her by telephone. “I’m wondering at times whether the Holocaust survivors are better prepared than we are for this,” he said. “I’ve never experienced anything like this.”
Stephanie Cacioppo, an assistant professor of psychiatry and behavioral neuroscience at the University of Chicago, who studies loneliness and social isolation, said that the sense of losing control in the pandemic was both harmful and treatable. Social distance need not lead to social isolation, she said. “You can train your brain like you train your body,” she said.
Caregivers and family members should try to help elders feel in control of the precautions they are being told to take, so that they feel involved rather than punished by the new rules, she said. She also recommended asking about public health crises they lived through in the past, including polio or tuberculosis, even SARS or the H1N1 flu.
Clear information helps; alarmist news programs, on the other hand, can make people feel helpless. In a nursing home or assisted-living building, rumors run wild. “Just having someone giving you an update every three hours, saying I’ll see you later, gives people a sense that there is a future,” Ms. Cacioppo said. “It makes seniors not feel abandoned. They see themselves not as objects, but as contributing.”
Lujira Cooper, 72, said she felt this control slipping away. She goes three or four days a week to the Edie Windsor SAGE Center in Midtown Manhattan, the first full-time senior center for LGBT older adults. The center’s closing was a reversal of the common aging experience: She was staying healthy but the social world around her was unraveling.
Also, she missed the arguing and the birthday celebrations — hers was scheduled for later this month.
“I can clean my house and work on a book I’m supposed to be writing,” she said, “but it’s the missing of talking to people in another setting. I don’t mind being by myself. I mind being forced to be by myself. You can’t go anywhere, you can’t be around people.”
She liked to eavesdrop on people in museums and restaurants — gone. She wondered whether, when the virus receded, people would hug again, or if the practice would disappear. She felt a loss of herself as much as other people, she said. “When you can’t be around people altogether, and people are afraid of catching something, it creates a self-imposed prison.”