Managing Social Isolation during the COVID-19 Pandemic: Perspectives from US Department of Veterans Affairs Home-Based Primary Care Veterans and Caregivers

Abstract

The COVID-19 pandemic proved especially devastating for older adults who are primarily homebound, as well as their caregivers. The objective of this study was to describe how United States (US) Veterans—and their caregivers—who receive care from the US Department of Veterans Affairs (VA) Home Based Primary Care (HBPC) program managed increased social isolation due to the COVID-19 pandemic. We designed a qualitative study and conducted phone interviews with Veterans and their caregivers receiving VA HBPC care, interviewing N = 44 Veterans and caregivers from eight VA HBPC programs across the US. We audio recorded and transcribed all interview data and applied an inductive and deductive approach to thematic analysis to analysis. The following themes emerged illustrating how Veterans and caregivers managed increased isolation during the pandemic: 1) normalizing challenges; 2) caregivers struggling to manage isolation, as Veterans were accustomed to being homebound; 3) relying heavily on social support of family and/or friends and neighbors, and engaging in creative activities; and 4) those living in their own homes found increased isolation more manageable than those living in assisted living facilities. Results show HBPC Veterans & their caregivers with stronger social networks drew upon previously curated social capital to manage isolation and took a “we’re all in this together” attitude toward the pandemic. Results can inform community programs, healthcare systems, and policy makers to target efforts when creating supportive programs and policies for older adults and caregivers, especially those with smaller social support networks and those living in assisted living facilities.