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“COVID-19 has rapidly spread across the nation, leading to the implementation of stringent social distancing guidelines by local and regional authorities. In a desperate effort to limit infection rates, in-person social interactions have been reduced, and many have turned towards indoor hobbies and online platforms to connect with their loved ones.
Still, this solution to mitigate the spread of the virus deeply impacts vulnerable groups. Specifically, social isolation of the elderly population, already deemed a neglected issue, is an exacerbated side effect of the coronavirus pandemic.”
Vismaya Bachu is a medical student.
She shares her story and discusses her KevinMD article, “The exacerbation of social isolation among the elderly.”
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Vismaya Bachu. She’s a medical student, and she wrote the KevinMD article “The exacerbation of social isolation among the elderly.” Vismaya, welcome to the show.
Vismaya Bachu: Thank you. Thanks for having me, Kevin.
Kevin Pho: So we’ll get into your article in a little bit, but first off, tell me about your story and your journey to where you are today.
Vismaya Bachu: Hi, Kevin. So I was born in India, and then I came to the United States when I was three. I grew up in Colorado; it’s become my home. I got my bachelor’s in chemical and biological engineering from the University of Colorado at Boulder, and now I’m a second-year med student at Johns Hopkins University.
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Kevin Pho: All right. And how has the pandemic affected your medical training?
Vismaya Bachu: It significantly impacted it. We can’t have in-person classes anymore, so in the middle of the spring, we all kind of were sent home due to social distancing requirements. I think content-wise, we’ve been able to keep up, converting a lot of small groups to online, but of course, we’ve missed out on clinics and patients.
Kevin Pho: And what’s their plan going forward regarding that?
Vismaya Bachu: I think moving forward, especially in the field of medical education, schools across the board are trying to get their students back into clinic to get that experience, because to be a successful doctor, you definitely need the experience. I think moving forward, for next steps, they’re trying to gauge what the state does and what the government is suggesting that we do, and then we just go from there.
Kevin Pho: All right. Let’s get into your KevinMD article, “The exacerbation of social isolation among the elderly.” I think this is a tremendously relevant topic, given the pandemic and its effect, especially on nursing homes. But share the story behind that article, and maybe if you could give a quick summary to my audience.
Vismaya Bachu: So I think, just for a quick summary, my article discusses the challenges that the elderly population are facing in this time and age. A significant percentage of people over 65 are currently in nursing homes or assisted living facilities, who already get relatively minimal contact with, if you want to say, the outside world, and with social distancing requirements, now that’s just gotten worse. So the article kind of calls for a focus on the mental health and ways that we’re able to make that better for those that we care about.
I think the idea for the article pretty much came because in medical school, I was part of a student-run health care team, and we would conduct geriatric home visits from time to time in Baltimore. This entailed that once a month, we would go do vital signs and chat with the patient, and I found that a lot of patient needs, or especially mine, did center around kind of that social isolation, being socially engaged with others. As soon as the pandemic started, we weren’t allowed to go see our patients anymore, so that did get me thinking about what they would be facing, along with so many others that I’ve had the opportunity to meet along the way.
Kevin Pho: So in a typical nursing home, for instance, what are some of the tools that they’re using to help alleviate the problem of social isolation among its residents?
Vismaya Bachu: So I think currently in nursing homes, they have a lot of social engagement that they plan, but it’s all kind of limited generally to their own community. So as far as I’ve seen, they have bingo nights, they have open mic nights, they have telephone calls to relatives, they have visiting hours. So I really do think they’re doing a lot right now to try to help the situation. But a lot of being a part of society is being able to interact with people outside your cohort, so the younger generation, college students, going to the grocery store, stuff like that. And so part of the article calls for everyone outside a nursing home facility to also interact with those inside of it.
Kevin Pho: So what are some proposed solutions you have for that?
Vismaya Bachu: So some of the ones that I found in my own research and from my own experience: Currently, with the advent of technology, I find that with social distancing, a lot of people are connecting over technology anyway. I found that a traditional barrier to the elderly connecting via that method is simply just kind of knowledge and abilities. So one of my proposals is to kind of institute classes in nursing homes to help those people who are in need learn about these technologies and connect with others. I think this would also be better if family members, loved ones, and close ones from outside were able to kind of facilitate that process as well.
Kevin Pho: We don’t know how long the pandemic is going to last. It certainly doesn’t seem to be subsiding. Now, I was wondering if you could share some details about some of the health effects of social isolation among the elderly.
Vismaya Bachu: So there’s been a lot of research regarding the correlation between social isolation and the elderly just in general, and we know that with social isolation comes a lot of not just mental health issues, but elevated blood pressure, higher risk for Alzheimer’s, some physical phenomena as well. In addition to that, when you add depression and anxiety, it’s very important to focus on and alleviate these problems before they happen, rather than treating symptoms after they do happen.
Kevin Pho: Sure. And going forward, say within the next three to six months, given what you know and your research and your experience with the elderly, what do you anticipate the near future to bring?
Vismaya Bachu: I suppose with all the uncertainty now, I don’t know what I anticipate, but I’m hoping that there’s increased engagement, both within those populations and outside. I understand that right now it is considered a vulnerable population, so people definitely don’t want to take risks with going outside or engaging if they don’t have to. But there are so many methods out there, even just like a phone call or sending care packages, that are outside the scope of transmitting anything.
Kevin Pho: And knowing what you know now about the pandemic, is there something that you wish you knew back before the pandemic started as it relates to social isolation and the elderly? Is there any advice that you could have given them, knowing what you know now?
Vismaya Bachu: I think as far as advice, I think it really helps, especially in this time, and just any time in general, to have a really strong support system. And so if I were to go back, I would probably say, you know, as soon as this started, establish your support system, establish your routine, know when you’re going to see who, what circles you are going to interact with safely.
Kevin Pho: Let’s take a step back. I was wondering if you could share with my audience something that you’ve been curious about or anything that you’ve been passionate about recently.
Vismaya Bachu: I guess recently I’ve been passionate, in a very stark change of events as a medical student. I find that with taking the step back from being in person and being able to run all the clubs that we used to do, a lot of us are turning towards research. So I feel like I’ve dove into different research topics, different research ideas, considering specialties in basic science.
Kevin Pho: All right. And what are some of those specialties that may interest you going forward?
Vismaya Bachu: So right now I’m kind of leaning towards the surgical side. One of the topics that I’m currently looking at is kind of the blood-brain barrier. Right now, with a lot of patients, especially on, like, chemotherapy or immunotherapy, the medication has a lot of trouble getting into the brain, because there’s this kind of junction between the body and the blood and the brain. And it’s really great at keeping harmful stuff out, and we want it there, but sometimes when you want, like, chemotherapy to get in, it gets really difficult. So one of the things I’m looking into now is using different methods to open up this barrier in a safe and efficient way, so that we can use current medication in a more efficacious manner.
Kevin Pho: So we’re talking to Vismaya Bachu. She’s a medical student, and she wrote the KevinMD article “The exacerbation of social isolation among the elderly.” Knowing what you know, especially after all the research that you’ve done regarding social isolation, are there any tips that you could share with fellow front-line clinicians who may be dealing with the elderly in office visits, for instance?
Vismaya Bachu: So I’m so happy to see how many workers have really put themselves out there and done such a great job during this pandemic. There are so many people, even at our own hospital affiliated with my school, and others that I’ve seen, that have just done really well. I think people are doing a great job right now at speaking empathetically, being compassionate, being understanding that different people have different backgrounds and come from different situations. I think moving forward, if we can just continue that, and as my generation grows up, we are just cognizant of what everyone has been through, because everyone has such a different story, and we want to treat them like that too.
Kevin Pho: And my final question: What’s your take-home message for the KevinMD audience?
Vismaya Bachu: I think my take-home message is that not just right now, but at all times, advocacy is so important in many, many different ways, whether that be medical care. If you’re advocating for your patient as a med student, as a doctor, as a nurse, you are your patient’s advocate. And even beyond the scope of medicine, when you go to human rights and social justice, being an advocate for what you stand up for is very important and something I think we should all strive to be.
Kevin Pho: Well, thank you so much for sharing your insight, and thank you for being on the show.
Vismaya Bachu: Thank you for having me.
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