Angela Smith can’t access her email – she has no computer, no tablet, no high-cost data plan and the library’s closed.
Smith, 48, is taking care of her 74-year-old mother, Minnie, in the Cedar Extension High-Rise senior apartments on East 30th Street, a Cuyahoga Metropolitan Housing Authority building just down the street from Cleveland’s main post office.
Angela has Type 2 diabetes and Minnie has rheumatoid arthritis in her hands, feet and hips.
Since the pandemic began and most of the activities that used to take them out of the house – shopping, socializing, attending senior wellness groups – have been shut down or become too dangerous, the Smiths have become increasingly isolated at home.
Lori Smathers is battling the same isolation. Smathers, who lives with her 27-year-old daughter in a house a couple miles away on East 49th Street in the Slavic Village neighborhood, has no computer either. She’s got a cell phone, but isn’t comfortable using video on it.
Smathers, 59, has been in recovery from an addiction to alcohol, crack and heroin for 13 years, and is disabled due to anxiety, depression and arthritis.
She takes about 10 medications to manage her conditions.
For low-income older adults and those with disabilities, who have a higher risk of death due to COVID-19, the challenges of staying healthy and avoiding isolation during the pandemic have been particularly hard.
“They can’t see their family, they can’t see their grandchildren, they can’t do whatever, and that’s led to depression, anxiety and just a lot of loneliness,” said Dr. James Campbell, department chair of geriatric medicine at the MetroHealth System, who before the pandemic would make monthly visits to University Settlement to offer health assessments to clients there.
Depression and anxiety can worsen existing health conditions, Campbell said, and lead to declining health. Often, the first sign of a problem is when older adults stop eating as well or as much, he said.
“Eating is a very social event,” he said. “We’ve had people losing weight, getting malnourished… it becomes a cascade.”
Many of the most vulnerable in the community, who were already relying on the help of non-profit, government and social service agencies to get by before the pandemic, are now even more dependent on these organizations to help them stay both mentally and physically healthy.
For Smathers and the Smith family, University Settlement’s Adult Wellness program has been that lifeline. Before the pandemic, they’d visit the non-profit on Broadway Avenue in person, where from 9:30 a.m. to 2:30 p.m. five days a week they could get two meals and a snack per day, participate in games and activities, receive health checks and information from local university nursing and medical students and get help with everything from utility issues to doctor’s appointments.
About 80 older adults and adults with disabilities, most living on a low income, took advantage of those free services last year, said Allison Woods, manager of the program.
Since the pandemic began and the Settlement’s Adult Wellness program could no longer offer on-site services, the program – like most other social service organizations – has shifted to virtual and delivery, Woods said. About 55 people in the neighborhood now receive a weekly grocery and hot meal delivery, as well as periodic visits to drop off activities.
It’s a neighborhood-scale effort being duplicated by dozens of organizations across Northeast Ohio, including local hospitals, which are providing technology and medical supplies to help manage chronic conditions from home, as well as community centers, food banks and mental healthcare providers.
The University Settlement deliveries, and the visits, have been a “godsend” for Angela Smith and her mother, she said, because they bring not only food, but also necessities like dish soap, bleach and other household items. Minnie Smith also relies on Meals on Wheels to deliver a meal once a week.
“The need is still huge… The need for food is just incredible at this point,” Woods said.
Across the country, there’s been a 60 percent increase in the number of people seeking help from food banks, according to Feeding America. The Greater Cleveland Food Bank, which has seen high turnout for supplies since the beginning of the pandemic, has served 375,000 families through December, with one-third of those being first-time clients. For four out of five Meals on Wheels programs across the country, demand for services has at least doubled, according to the organization.
The Settlement’s three weekly visits from its adult wellness program, even though they’re only five to 10 minutes long, allow the Smiths a chance to interact with someone outside their household and get help troubleshooting problems with doctor’s appointments, medications and technology.
Lack Of Technology A Challenge
In low-income communities, the lack of internet connections, computers and the high-cost data plans needed for smartphones have made it far more difficult for people, especially older adults, to remain connected to the resources and services they need.
“It’s a population that’s not electronically sophisticated,” Campbell said. “We’re often doing phone calls instead of Zoom, or WebEX, or visual images, which, again, makes it a little more challenging.”
Recently, Woods helped Angela Smith respond to an important email, as she had no way to access her account after both the library and Cuyahoga Community College had to shut down access to public computers.
“I talked to a lady at Tri-C who said ‘you could go to a coffee house,’ and I’m like yes, if I had a laptop or computer or something like that, but nobody has that,” she said.
Since the pandemic began, Smathers hasn’t attended any 12-step meetings, which are mostly being offered online via Zoom and other video services. But, she said she still talks over the phone to many other people in recovery, and is not worried about relapse.
University Settlement has helped Smathers with faxing required forms to receive welfare, she said, as well as just about anything else she needs and can’t access online.
The lack of technology is a big problem, Woods said, and some clients don’t even have a telephone. University Settlement received some money from the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act to help increase access to the internet and plans to distribute computers and tablets to clients soon.
Staying Healthy, Avoiding Isolation
For now, both Smathers and the Smiths say they’re doing well. For the foreseeable future, they know they’ll have to remain hunkered down at home in order to stay safe.
They attend most of their doctor’s appointments over the phone, and are fending off boredom and isolation with books, games, jigsaw puzzles and other activities.
Angela Smith, who until recently was taking a bus at 2 a.m. to pick up her medications at a 24-hour CVS pharmacy nearby in order to avoid crowds, now has both her prescriptions, and her mother’s, delivered to her home.
Smathers gets out every day to walk her dog.
They’re both looking forward to the day when they’ll once again be able to socialize with their friends and family, attend Bible study groups and reconnect with their support systems outside the house.
When that day comes, the community will have regained an important asset too, Campbell said.
“I always like to remind people that we’ve also lost a huge resource because older people are sheltering in place,” he said, as so many were volunteers and primary or secondary childcare providers for family. “It’s not just the older people who are suffering, it’s the people who the older people were helping who have suddenly lost their support.”
This story is part of Coping With COVID-19, an ideastream reporting project and local journalism collaborative funded by Third Federal Foundation and University Settlement. The series expands coverage of the local impacts of COVID-19 in Northeast Ohio and investigates how the coronavirus pandemic has highlighted and laid bare the existing inequities that stem from decades of disinvestment in public health, the social safety net, preventive medicine and communities of color.