COVID-19, Social Distancing, and an Ethic of Care

Rethinking Later-Life Care in the U.S.

  • Nari Kim University of Delaware
  • Lindsay Naylor University of Delaware
Keywords: Social distancing, isolation, emotions, care ethics, U.S. eldercare

Abstract

In 2020, the novel coronavirus (COVID-19) disrupted life around the globe. In the United States, governors issued state of emergency orders and mandated shelter-in-place and social distancing measures. While these measures are important, they ignore the nuances of risk for vulnerable groups, such as older adults. Moreover, social distancing measures made more visible the reality that many patients in care homes often die in isolation. In this commentary, we argue that a rethinking of later-life care is necessary and to understand this need, that critical geographers should expand on how we evaluate care. Here we start from a space of radical care ethics to examine the emotional experience of place and the role it should play in how we think about later-life care. Reflecting on state-mandated social distancing, we show that the current system of geriatric care in the United States does not promote dignified living for older adults and how older adults’ complex emotions are ignored in current later-life care. We conclude by recommending that the emotional experiences of place must be taken into consideration for scholars examining place-based later-life care of older adults.

References

Abbasi, Jennifer. 2020. “Social Isolation—the Other COVID-19 Threat in Nursing Homes.” JAMA 324 (7): 619. https://doi.org/10.1001/jama.2020.13484.

Adams, K. B., S. Sanders, and E. A. Auth. 2004. “Loneliness and Depression in Independent Living Retirement Communities: Risk and Resilience Factors.” Aging & Mental Health 8 (6): 475–85. https://doi.org/10.1080/13607860410001725054.

Andrews, Gavin J., Malcolm Cutchin, Kevin McCracken, David R. Phillips, and Janine Wiles. 2007. “Geographical Gerontology: The Constitution of a Discipline.” Social Science & Medicine 65 (1): 151–68. https://doi.org/10.1016/j.socscimed.2007.02.047.

Andrews, Gavin J., Noel Gavin, Sheila Begley, and David Brodie. 2003. “Assisting Friendships, Combating Loneliness: Users’ Views on a ‘Befriending’ Scheme.” Ageing and Society 23 (3): 349–62. https://doi.org/10.1017/S0144686X03001156.

Angus, Jan, Pia Kontos, Isabel Dyck, Patricia McKeever, and Blake Poland. 2005. “The Personal Significance of Home: Habitus and the Experience of Receiving Long-Term Home Care: The Personal Significance of Home.” Sociology of Health & Illness 27 (2): 161–87. https://doi.org/10.1111/j.1467-9566.2005.00438.x.

Askins, Kye, and Matej Blazek. 2017. “Feeling Our Way: Academia, Emotions and a Politics of Care.” Social & Cultural Geography 18 (8): 1086–1105. https://doi.org/10.1080/14649365.2016.1240224.

Beachum, Lateshia. 2020. “Seniors Are the Most Vulnerable to Coronavirus. You Can Help Protect Them.” Washington Post, March 11, 2020, Online edition, sec. Health. https://www.washingtonpost.com/health/2020/03/11/coronavirus-seniors-help/.

Binette, Joanne, and Kerri Vasold. 2019. “2018 Home and Community Preferences: A National Survey of Adults Ages 18-Plus.” AARP. 2019. https://doi.org/10.26419/res.00231.001.

Blunt, Alison, and Ann Varley. 2004. “Introduction: Geographies of Home.” Cultural Geographies 11 (1): 3–6.

Bonanad, Clara, Sergio García-Blas, Francisco Tarazona-Santabalbina, Juan Sanchis, Vicente Bertomeu-González, Lorenzo Fácila, Albert Ariza, Julio Núñez, and Alberto Cordero. 2020. “The Effect of Age on Mortality in Patients With COVID-19: A Meta-Analysis With 611,583 Subjects.” Journal of the American Medical Directors Association 21 (7): 915–18. https://doi.org/10.1016/j.jamda.2020.05.045.

Bondi, Liz. 2005. “Making Connections and Thinking through Emotions: Between Geography and Psychotherapy.” Transactions of the Institute of British Geographers 30 (4): 433–48. https://doi.org/10.1111/j.1475-5661.2005.00183.x.

———. 2014. “Understanding Feelings: Engaging with Unconscious Communication and Embodied Knowledge.” Emotion, Space and Society 10 (February): 44–54. https://doi.org/10.1016/j.emospa.2013.03.009.

Brickell, Katherine. 2012. “‘Mapping’ and ‘Doing’ Critical Geographies of Home.” Progress in Human Geography 36 (2): 225–44. https://doi.org/10.1177/0309132511418708.

Brown, Lee. 2020. “Italian Priest Dies of Coronavirus after Giving Respirator to Younger Patient.” New York Post, March 24, 2020, Online edition, sec. News. https://nypost.com/2020/03/24/italian-priest-dies-of-coronavirus-after-giving-respirator-to-younger-patient/.

Caretta, Martina Angela, and Caroline V Faria. 2020. “Time and Care in the ‘Lab’ and the ‘Field’: Slow Mentoring and Feminist Research in Geography.” Geographical Review 110 (1–2): 172–82. https://doi.org/10.1111/gere.12369.

Centers for Disease Control. 2020a. “Coronavirus Disease 2019 (COVID-19): Supporting Your Loved One in a Long-Term Care Facility.” Washington, D.C.: Centers for Disease Control. https://www.cdc.gov/coronavirus/2019-ncov/downloads/supporting-loved-one-in-long-term-care-facility.pdf.

———. 2020b. “COVID-19 and Your Health.” Centers for Disease Control and Prevention. February 11, 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html.

Curryer, Cassie. 2016. “Ageing-in-Place and the Risks Associated with Housing in Later Life.” In Refereed Proceedings of TASA 2016 Conference, 39.

Davidson, Joyce, and Christine Milligan. 2004. “Embodying Emotion Sensing Space: Introducing Emotional Geographies.” Social & Cultural Geography 5 (4): 523–32. https://doi.org/10.1080/1464936042000317677.

De Witte, Melissa. 2020. “Try ‘distant Socializing’ Instead.” Stanford News (blog). March 19, 2020. https://news.stanford.edu/2020/03/19/try-distant-socializing-instead/.

Dombroski, Kelly, Alison F. Watkins, Helen Fitt, Jillian Frater, Karen Banwell, Kierin Mackenzie, Levi Mutambo, et al. 2018. “Journeying from ‘I’ to ‘We’: Assembling Hybrid Caring Collectives of Geography Doctoral Scholars.” Journal of Geography in Higher Education 42 (1): 80–93. https://doi.org/10.1080/03098265.2017.1335295.

Dowd, Jennifer Beam, Liliana Andriano, David M. Brazel, Valentina Rotondi, Per Block, Xuejie Ding, Yan Liu, and Melinda C. Mills. 2020. “Demographic Science Aids in Understanding the Spread and Fatality Rates of COVID-19.” Proceedings of the National Academy of Sciences 117 (18): 9696–98.

Dyck, Isabel, Pia Kontos, Jan Angus, and Patricia McKeever. 2005. “The Home as a Site for Long-Term Care: Meanings and Management of Bodies and Spaces.” Health & Place 11 (2): 173–85. https://doi.org/10.1016/j.healthplace.2004.06.001.

England, Kim. 2010. “Home, Work and the Shifting Geographies of Care.” Ethics, Place & Environment 13 (2): 131–50. https://doi.org/10.1080/13668791003778826.

Fannin, Maria. 2006. “Global Midwifery and the Technologies of Emotion.” ACME: An International Journal for Critical Geographies 5 (1): 70–88.

Fried, Marc. 2000. “Continuities and Discontinuities of Place.” Journal of Environmental Psychology 20 (3): 193–205. https://doi.org/10.1006/jevp.1999.0154.

Giesbrecht, Melissa, Kelli I. Stajduhar, Ashley Mollison, Bernie Pauly, Sheryl Reimer-Kirkham, Ryan McNeil, Bruce Wallace, Naheed Dosani, and Caelin Rose. 2018. “Hospitals, Clinics, and Palliative Care Units: Place-Based Experiences of Formal Healthcare Settings by People Experiencing Structural Vulnerability at the End-of-Life.” Health & Place 53 (September): 43–51. https://doi.org/10.1016/j.healthplace.2018.06.005.

Golant, S. M. 2003. “Conceptualizing Time and Behavior in Environmental Gerontology: A Pair of Old Issues Deserving New Thought.” The Gerontologist 43 (5): 638–48. https://doi.org/10.1093/geront/43.5.638.

Golant, Stephen M. 2014. Age-Friendly Communities: Are We Expecting Too Much? Montreal: Institute for Research on Public Policy.

Gory, Mark La, Russell Ward, and Susan Sherman. 1985. “The Ecology of Aging: Neighborhood Satisfaction in an Older Population.” The Sociological Quarterly 26 (3): 405–18. https://doi.org/10.1111/j.1533-8525.1985.tb00235.x.

Goveas, Joseph S., and M. Katherine Shear. 2020. “Grief and the COVID-19 Pandemic in Older Adults.” The American Journal of Geriatric Psychiatry 28 (10): 1119–25. https://doi.org/10.1016/j.jagp.2020.06.021.

Hall, Sarah Marie. 2019. “Everyday Austerity: Towards Relational Geographies of Family, Friendship and Intimacy.” Progress in Human Geography 43 (5): 769–89. https://doi.org/10.1177/0309132518796280.

———. 2021. “Care, COVID‐19 and Crisis: Area as a Space for Critical Contributions.” Area 53 (1): 2–3. https://doi.org/10.1111/area.12702.

Hanlon, Neil, Mark W. Skinner, Alun E. Joseph, Laura Ryser, and Greg Halseth. 2014. “Place Integration through Efforts to Support Healthy Aging in Resource Frontier Communities: The Role of Voluntary Sector Leadership.” Health & Place 29 (September): 132–39. https://doi.org/10.1016/j.healthplace.2014.07.003.

Hepworth, Mike. 2006. “Ageing and the Emotions: Framing Old Age in Victorian Painting.” In Emotional Geographies, edited by Liz Bondi and Joyce Davidson, 1st ed., 191–204. London: Routledge.

Huang, Hui-Tzu, Yeu-Hui Chuang, Yi-Hua Hsueh, Pao-Chen Lin, Bih-O Lee, and Ching-Huey Chen. 2014. “Depression in Older Residents With Stroke Living in Long-Term Care Facilities:” Journal of Nursing Research 22 (2): 111–18. https://doi.org/10.1097/jnr.0000000000000028.

Klinenberg, Eric. 2001. “Dying Alone: The Social Production of Urban Isolation.” Ethnography 2 (4): 501–31.

Kwon, Jiye, Connor Grady, Josemari T. Feliciano, and Samah J. Fodeh. 2020. “Defining Facets of Social Distancing during the COVID-19 Pandemic: Twitter Analysis.” Journal of Biomedical Informatics 111 (November): 103601. https://doi.org/10.1016/j.jbi.2020.103601.

Lawson, Victoria. 2009. “Instead of Radical Geography, How About Caring Geography?” Antipode 41 (1): 210–13. https://doi.org/10.1111/j.1467-8330.2008.00665.x.

Lawton, M. Powell. 1982. Competence, Environmental Press, and the Adaptation of Older People. New York, NY: Springer.

Lawton, M. Powell, Lucille Nahemow, C Eisdorfer, and MP Lawton. 1973. “Ecology and the Aging Process.” In The Psychology of Adult Development and Aging, 619–74. Washington, D.C.: American Psychological Association.

Löfqvist, Charlotte, Marianne Granbom, Ines Himmelsbach, Susanne Iwarsson, Frank Oswald, and Maria Haak. 2013. “Voices on Relocation and Aging in Place in Very Old Age—a Complex and Ambivalent Matter.” The Gerontologist 53 (6): 919–27.

Ludington-Hoe, Susan, Gene Cranston Anderson, Joan Swinth, Carol Thompson, and Anthony Hadeed. 2004. “Randomized Controlled Trial of Kangaroo Care: Cardiorespiratory and Thermal Effects on Healthy Preterm Infants.” Neonatal Network 23 (3): 39–48. https://doi.org/10.1891/0730-0832.23.3.39.

Ludington-Hoe, Susan M. 2011. “Evidence-Based Review of Physiologic Effects of Kangaroo Care.” Current Women’s Health Reviews 7 (3): 243–53.

Luterman, Sara. 2020. “It’s Time to Abolish Nursing Homes.” The Nation, August 11, 2020. https://www.thenation.com/article/society/abolish-nursing-homes/.

MacKian, Sara. 2004. “Mapping Reflexive Communities: Visualizing the Geographies of Emotion.” Social & Cultural Geography 5 (4): 615–31. https://doi.org/10.1080/1464936042000317730.

Malpas, Jeff, ed. 2015. The Intelligence of Place: Topographies and Poetics. London; New York: Bloomsbury Academic, an imprint of Bloomsbury Publishing Plc.

Marek, Karen Dorman, Frank Stetzer, Scott J. Adams, Lori L. Popejoy, and Marilyn Rantz. 2012. “Aging in Place versus Nursing Home Care: Comparison of Costs to Medicare and Medicaid.” Research in Gerontological Nursing 5 (2): 123–29.

Massey, Doreen. 2004. “Geographies of Responsibility.” Geografiska Annaler: Series B, Human Geography 86 (1): 5–18. https://doi.org/10.1111/j.0435-3684.2004.00150.x.

Massey, Doreen B. 1994. “A Global Sense of Place.” In Space, Place, and Gender, 146–56. Minneapolis: University of Minnesota Press.

McHugh, Kevin E., and Elizabeth M. Larson-Keagy. 2005. “These White Walls: The Dialectic of Retirement Communities.” Journal of Aging Studies 19 (2): 241–56. https://doi.org/10.1016/j.jaging.2004.07.004.

Means, Robin. 2007. “Safe as Houses? Ageing in Place and Vulnerable Older People in the UK.” Social Policy & Administration 41 (1): 65–85. https://doi.org/10.1111/j.1467-9515.2007.00539.x.

Melik, Rianne van, and Roos Pijpers. 2017. “Older People’s Self–Selected Spaces of Encounter in Urban Aging Environments in the Netherlands.” City & Community 16 (3): 284–303. https://doi.org/10.1111/cico.12246.

Middleton, Jennie, and Farhan Samanani. 2021. “Accounting for Care within Human Geography.” Transactions of the Institute of British Geographers 46 (1): 29–43. https://doi.org/10.1111/tran.12403.

Milligan, Christine. 2016. There’s No Place like Home: Place and Care in an Ageing Society. New York, N.Y.: Routledge.

Milligan, Christine, and Janine Wiles. 2010. “Landscapes of Care.” Progress in Human Geography 34 (6): 736–54. https://doi.org/10.1177/0309132510364556.

Naylor, Lindsay. 2021. “The Body as a Site of Care: Food and Lactating Bodies in the U.S.” Gender, Place & Culture 0 (0): 1–9. https://doi.org/10.1080/0966369X.2021.1882952.

Naylor, Lindsay, Abigail Clarke-Sather, and Michael Weber. 2020. “Troubling Care in the Neonatal Intensive Care Unit.” Geoforum 114 (August): 107–16. https://doi.org/10.1016/j.geoforum.2020.05.015.

Ng, Terence, Charlene Harrington, and Martin Kitchener. 2010. “Medicare and Medicaid in Long-Term Care.” Health Affairs 29 (1): 22–28.

NYT. 2020. “More Than 40% of U.S. Coronavirus Deaths Are Linked to Nursing Homes.” The New York Times, June 27, 2020, Online edition, sec. U.S. https://www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html.

Paulin, Emily. 2020. “Is Isolation Killing America’s Nursing Home Residents?” AARP. January 3, 2020. https://www.aarp.org/caregiving/health/info-2020/covid-isolation-killing-nursing-home-residents.html.

Payne, Jennifer L., Jeannie-Marie E. Sheppard, Martin Steinberg, Andrew Warren, Alva Baker, Cynthia Steele, Jason Brandt, and Constantine G. Lyketsos. 2002. “Incidence, Prevalence, and Outcomes of Depression in Residents of a Long-Term Care Facility with Dementia.” International Journal of Geriatric Psychiatry 17 (3): 247–53. https://doi.org/10.1002/gps.589.

Pierce, Joseph, Deborah G Martin, and James T Murphy. 2011. “Relational Place-Making: The Networked Politics of Place: Relational Place-Making.” Transactions of the Institute of British Geographers 36 (1): 54–70. https://doi.org/10.1111/j.1475-5661.2010.00411.x.

Pile, Steve. 2010. “Emotions and Affect in Recent Human Geography: Emotions and Affect in Recent Human Geography.” Transactions of the Institute of British Geographers 35 (1): 5–20. https://doi.org/10.1111/j.1475-5661.2009.00368.x.

Roberts, Celia, Maggie Mort, and Christine Milligan. 2012. “Calling for Care: ‘Disembodied’ Work, Teleoperators and Older People Living at Home.” Sociology 46 (3): 490–506.

Rodney, Tamar, Nia Josiah, and Diana‐Lyn Baptiste. 2021. “Loneliness in the Time of COVID‐19: Impact on Older Adults.” Journal of Advanced Nursing 77 (9). https://doi.org/10.1111/jan.14856.

Rothan, Hussin A., and Siddappa N. Byrareddy. 2020. “The Epidemiology and Pathogenesis of Coronavirus Disease (COVID-19) Outbreak.” Journal of Autoimmunity 109 (May): 102433. https://doi.org/10.1016/j.jaut.2020.102433.

Scheidt, R, and P Windley. 2006. “Environmental Gerontology: Progress in the Post-Lawton Era.” In Handbook of the Psychology of Aging, 105–25. London: Elsevier. https://linkinghub.elsevier.com/retrieve/pii/B9780121012649500094.

Schladebeck, Jessica. 2020. “SEE IT: Alabama Husband Serenades Wife through Window of Nursing Home amid Coronavirus Separation.” New York Daily News, March 21, 2020, Online edition, sec. Coronavirus. https://www.nydailynews.com/coronavirus/ny-coronavirus-alabama-husband-nursing-home-serenades-wife-20200321-sxxc4725yjfevcg4emc2afhcje-story.html.

Seale, Clive. 1995. “Dying Alone.” Sociology of Health & Illness 17 (3): 376–92.

Seladi-Schulman, Jill. 2021. “Coronavirus vs. SARS.” Healthline (blog). September 14, 2021. https://www.healthline.com/health/coronavirus-vs-sars.

Simandan, Dragos. 2016. “Proximity, Subjectivity, and Space: Rethinking Distance in Human Geography.” Geoforum 75 (October): 249–52. https://doi.org/10.1016/j.geoforum.2016.07.018.

Smith, Allison E. 2009. Ageing in Urban Neighbourhoods: Place Attachment and Social Exclusion. Bristol, UK: Policy press.

Smith, J., and A. M. Freund. 2002. “The Dynamics of Possible Selves in Old Age.” The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 57 (6): P492–500. https://doi.org/10.1093/geronb/57.6.P492.

Stienstra, Deborah, and Harvey Max Chochinov. 2012. “Palliative Care for Vulnerable Populations.” Palliative & Supportive Care 10 (1): 37–42.

Sullivan, Margaret. 2020. “Trump Wants America to ‘Normalize’ Coronavirus Deaths. It’s the Media’s Job Not to Play along.” Washington Post, May 10, 2020, Online edition, sec. Media. https://www.washingtonpost.com/lifestyle/media/trump-wants-america-to-normalize-coronavirus-deaths-its-the-medias-job-not-to-play-along/2020/05/09/72de4c32-9090-11ea-a9c0-73b93422d691_story.html.

Tarrant, Anna. 2010. “Constructing a Social Geography of Grandparenthood: A New Focus for Intergenerationality: Social Geography of Grandparenthood.” Area 42 (2): 190–97. https://doi.org/10.1111/j.1475-4762.2009.00920.x.

Tronto, Joan. 1993. Moral Boundaries: A Political Argument for an Ethic of Care. New York, N.Y.: Routledge.

Warnes, Anthony M. 1990. “Geographical Questions in Gerontology: Needed Directions for Research.” Progress in Human Geography 14 (1): 24–56. https://doi.org/10.1177/030913259001400103.

Wiles, J. L., A. Leibing, N. Guberman, J. Reeve, and R. E. S. Allen. 2012. “The Meaning of ‘Aging in Place’ to Older People.” The Gerontologist 52 (3): 357–66. https://doi.org/10.1093/geront/gnr098.

Wiles, Janine. 2003. “Daily Geographies of Caregivers: Mobility, Routine, Scale.” Social Science & Medicine 57 (7): 1307–25. https://doi.org/10.1016/S0277-9536(02)00508-7.

Williams, Miriam J. 2017. “Care-Full Justice in the City: Care-Full Justice in the City.” Antipode 49 (3): 821–39. https://doi.org/10.1111/anti.12279.

Williams, Simon N., Christopher J. Armitage, Tova Tampe, and Kimberly Dienes. 2020. “Public Perceptions and Experiences of Social Distancing and Social Isolation during the COVID-19 Pandemic: A UK-Based Focus Group Study.” BMJ Open 10 (7): e039334.

Wilson, Helen F. 2017. “On Geography and Encounter: Bodies, Borders, and Difference.” Progress in Human Geography 41 (4): 451–71. https://doi.org/10.1177/0309132516645958.

Wiseman, Rob. 2014. “Social Distance in Hunter-Gather Settlement Sites: A Conceptual Metaphor in Material Culture.” Metaphor and Symbol 29 (2): 129–43. https://doi.org/10.1080/10926488.2014.890469.

———. 2016. “Social Distance in Settled Communities the Conceptual Metaphor, Social Distance Is Physical Distance, in Action.” Journal of Archaeological Method and Theory 23 (4): 1023–52. https://doi.org/10.1007/s10816-015-9256-9.

Wood, Lydia, Kate Swanson, and Donald E. Colley III. 2020. “Tenets for a Radical Care Ethics in Geography.” ACME: An International Journal for Critical Geographies 19 (2): 424–47.
Published
2021-12-16
How to Cite
Kim, N., & Naylor, L. (2021). COVID-19, Social Distancing, and an Ethic of Care. ACME: An International Journal for Critical Geographies, 21(1), 65-80. Retrieved from https://acme-journal.org/index.php/acme/article/view/2094