Life

A Psychologist Explains How to Get Elderly People to Take This Seriously

And how to keep them from feeling isolated during social distancing.

Isolated older man seated and looking out a window.
Nadofotos/iStock/Getty Images Plus

Accepting the reality of social distancing, citywide lockdowns, and indefinite quarantines has been a slow-rolling process, both geographically and demographically. Vermonters arrived at the current reality long after Seattle residents did, and Republicans remain days behind Democrats. Young people have been more reluctant to self-isolate than boomers. One trend that seems to alarm a lot of us is that many elderly Americans, the highest risk category for coronavirus fatalities, have been oddly reluctant to cancel all activities and remain at home. I keep hearing from friends about aging parents insisting on bridge games and restaurants. There are reasons for this resistance. John Leland, reporting in the New York Times on the closing of recreational and senior services in Manhattan, noted the irony of cutting seniors off from the very things that affords them joy: “[F]or 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.” My own contemporaries, suddenly confronted with endless Zoom meetings and home-schooling, are feeling the added pressure of dealing with aging parents who refuse to surrender their golf tournaments, beauty appointments, and even cruises, in the face of the spreading virus. One older person reminded me yesterday that at 80, your appointments are how you organize your entire world. Having them stripped away is incredibly destabilizing.

Writing in the New Yorker this week, Michael Schulman amassed plenty of panicked examples of adult children describing their parents as newly stubborn toddlers: “I couldn’t talk my mom out of going on her cruise,” someone lamented, adding, “I finally was able to convince my dad not to take a trip to Florida this weekend. He finally relented but my parents just don’t think of themselves as old, despite their being in their 70s.” One woman said, “When I called mine on Thursday they were leaving the DMV and driving to a bakery for challah.” Another fretted that her 70-year-old father-in-law was about to have a dinner party for 14 people. There was the mom who was determined to go on a tour of Civil War battlegrounds and an obstinate snowbird who had just had a kidney transplant.

After hearing a lot of harrowing tales of truly counterproductive and shouty conversations between my friends and their parents, I reached out to Nando Pelusi, a licensed clinical psychologist with a private practice in New York City. Pelusi serves on the board of advisers of the National Association of Cognitive Behavioral Therapists, and he agreed to answer some questions on how to do better at difficult conversations with older parents. Our conversation has been edited and condensed for clarity.

Dahlia Lithwick:  I’ve read all sorts of speculation about boomers believing themselves to be immortal, and more compelling theories about aging and loss of control. But still, it’s a bit paradoxical that the highest risk cohort doesn’t seem to be persuadable about staying home. What is going on here?

Nando Pelusi: Many older people maintain they have “seen it all,” and buffer their responses to novel circumstances—and usually it works for them. Acquired wisdom leads to entrenched convictions, and cognitive flexibility recedes with age. An older person may be fed up with “fake news” and discount genuine scientific findings, so the art of persuasion requires some offer, such as staying home with them for a period. That demonstration of care and commitment carries emotional power.

In the past day, I have heard really ghastly recitations of friends of mine screaming at their parents, leveling threats, and generally freaking out. That strikes me as not the very best way to persuade your adults to change behaviors.

Force tends to elicit anger or resentments. Better to engage by looking for common interests. An older person might enjoy the attention (even if negative) that they are receiving. An appeal to logic is received more when someone believes you have their best interest in mind. Take a Socratic approach, asking, “Would you rather be frustrated for a short while, or risk suffering and possibly dying, and harming others in the long run?” I frame this pandemic as a crisis of the short term in order to avoid suffering much more in the long term.

Do you want to role-play for a second? Pretend I’m an 82-year-old intent on going to a movie or restaurant or the store tonight? What would you tell me?

I would ask them if they agree that their vulnerability to contracting and transmitting this virus is societally dangerous as well as personally high. The question implies that their “intent” is self-direction, which we would respect, but ignorance of the current best information hurts others—and license to hurt others is not allowed.

If they don’t agree, some basic info is in order—show them how a virus works: It is vanishingly small. Compared to a cell, a virus looks like a French poodle standing next to the Empire State Building. It can attach itself anywhere onto the receptive cell and takes over the instructions of the cell, creating a cascade of problems. Suffering is multifaceted and multivaried and you can’t count on luck during this lockdown.

One irony here is that we have the tech resources to connect people to one another, without risking infection. Yet while our kids seamlessly transition to Zoom classrooms, our elders really rely on their walks and human contact.  Can this be hacked in a way we haven’t considered?

One hack might be for younger people to reach out even more during this period.  Also, reframe this into a gift of time—during this period of conscientious cloistering, as an opportunity to pursue talents and to “cultivate your garden.” This goes for all of us as well, of course.

We should all of us be doing far, far more to reach out to older Americans, who are more likely to be ill, alone, and living in poverty. There are fantastic resources springing up to deliver meals and other services to mitigate the isolation. But can you suggest some action people could take to help someone who is older, even as everyone is overwhelmed with their own worries?

Yes, set them up with FaceTime, Hangouts, Zoom, for as many connections as possible. Getting older people more connected online and feeling connected via social media could temporarily supplant their need for IRL interactions. Reminder that this is (hopefully) transient and we have a common cause!