By Dr. Joseph Saturley

Stress has remained a topic of interest for me since childhood because as a child I struggled to manage my stress.

Thankfully, I was surrounded by family members and friends, whose love formed a support system that helped me manage my stress.

Many people, however, are not as fortunate, suffering immense stress by themselves, without the support of anyone. During the coronavirus pandemic, there is a distinct group of people struggling to manage the stress: those receiving elder care.


For Skilled Nursing Facility and Assisted Living Facility (senior care) residents, this pandemic has been extremely difficult to endure, corrupting all sense of normalcy and routine in their lives.

Moreover, with their families unable to visit them due to safety regulations, many elderly loved ones have been to suffer through this since March.

For residents, the negative effects of these conditions are, in a word, profound. But to truly grasp why, we must examine these stressful circumstances in the broader context of residents’ lives.


Although everyone experiences stressful events throughout their lives, as people age, these stressful events happen fast and repeatedly.

To understand the impact of this stress, researchers Holmes and Rahe developed an inventory called, the Social Readjustment Rating Scale (SRRS).[1] With this, they identified 43 stressful life events and assigned a numerical value to each event. These values indicate the influence each event has in causing stress-related health issues.

Holmes and Rahe believed that stressful events had a cumulative effect for the following 12 to 24 months following an event. That means the effects of the stress would continue for a year or maybe more.

Later, researchers Rahe, Mahan, and Arthur proposed that if combined values were below 150 life stress points indicated a 30% chance of a stress related health issues.[2] Additionally, they identified that scores between 150 and 299 raised the chance of developing a stress-related health issue to 50%. Worse yet, they found that scores of 300 or more indicated an 80% chance of stress related health issues.

I combed through the list myself to identify a few events, which many elderly individuals have experienced and continue experiencing during this pandemic:

  • Death of a spouse: 100
  • Major change in the health or behavior of a family member: 44
  • Death of a close friend: 37
  • Death of a close family member: 63
  • Major personal injury or illness: 53
  • Major change in usual type and/or amount of recreation: 19

These five events—amounting to 316 stress points—indicate more than an 80% chance of developing stress related health issues. Moreover, some of these events occur multiple times, compounding the stress. What’s more, elderly bodies are more susceptible to major illnesses and even fatalities from stress related health issues.


During this pandemic, what matters most to residents is the love they receive from family. Although safety and social distancing regulations may prevent us from physical contact with our loved ones, there are many ways we can show love.

Though consider outdated, letter writing proves to be an excellent way of expressing love to older adults. A sweet letter can enliven a resident’s mood and help them focus on the brighter side of things.

Another way that people are keeping in touch with their older loved ones is through window visits or video chats. Getting to see loved ones can help them manage their stress. Even something as simple as a phone call can help cheer up older loved ones.

Believe it or not, residents talk about these encounters weeks after they happen. That’s because these gestures boost the quality of life for older adults. They show them love, and right now, all residents at senior living facilities (ALFs and SNFs) could use some love. So let’s help reduce their stress levels, and write that letter, make that call, or (if it’s allowed) visit those loved ones!

[1] Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic 

Research, 11, 213.

[2] Rahe, R. H., Mahan, J. L., & Arthur, R. J. (1970). Prediction of near-future health change from subjects’ 

preceding life changes. Journal of Psychosomatic Research, 14(4), 401-406.