key: cord-0788175-5o86o1zp
authors: Fiocco, Alexandra J.; Gryspeerdt, Charlie; Franco, Giselle
title: Stress and Adjustment during the COVID-19 Pandemic: A Qualitative Study on the Lived Experience of Canadian Older Adults
date: 2021-12-08
journal: Int J Environ Res Public Health
DOI: 10.3390/ijerph182412922
sha: e4b5a44ad4f2f6725e0e502f6ac37e1bb90f55eb
doc_id: 788175
cord_uid: 5o86o1zp

In response to the COVID-19 pandemic, social distancing measures were put into place to flatten the pandemic curve. It was projected that older adults were at increased risk for poor psychological and health outcomes resulting from increased social isolation and loneliness. However, little research has supported this projection among community-dwelling older adults. While a growing body of research has examined the impact of the COVID-19 pandemic on older adults, there is a paucity of qualitative research that captures the lived experience of community-dwelling older adults in Canada. The current study aimed to better understand the lived experience of community-dwelling older adults during the first six months of the pandemic in Ontario, Canada. Semi-structured one-on-one interviews were conducted with independent-living older adults aged 65 years and older. A total of 22 interviews were analyzed using inductive thematic analysis. Following a recursive process, two overarching themes were identified: perceived threat and challenges of the pandemic, and coping with the pandemic. Specifically, participants reflected on the threat of contracting the virus and challenges associated with living arrangements, social isolation, and financial insecurity. Participants shared their coping strategies to maintain health and wellbeing, including behavioral strategies, emotion-focused strategies, and social support. Overall, this research highlights resilience among older adults during the first six months of the pandemic.

On 11 March 2020, the World Health Organization declared the coronavirus disease (COVID-19) a global pandemic. Shortly after, on 17 March 2020, the Ontario government of Canada declared a provincial state of emergency, which resulted in institutional closures and the implementation of physical distancing measures to reduce the spread of the SARS-CoV-2 virus. Later that month, additional measures were implemented by the government to help flatten the pandemic curve, encouraging the public to stay at home (i.e., cocooning) and prohibiting social gatherings of more than five people. With a resulting decline in new COVID-19 positive cases, on 27 April 2020, the government released a plan to reopen the province, while maintaining public health measures including mask wearing, hand washing, physical distancing, staying at home unless absolutely necessary, and the creation of small networks of trusted friends or relatives, otherwise known as "social bubbles". Although the province continued to slowly reopen during the summer months, rates of infection began to increase once again in August 2020 with the new Delta variant, resulting in a second wave of the COVID-19 pandemic (for an overview of Ontario's response to COVID-19 between March and July 2020, see [1] ).

Amidst the pandemic, concern for the health and wellbeing of older adults has been a dominant focal point, with reports of increased risk for infection and death [2] [3] [4] . Further, the projected risk of social isolation and loneliness [5] was expected to have a profound Participants were between 65 and 81 years of age, with an average age of 72.23 years (SD = 4.25), representing the youngest-old and middle-old segment of the aging population. The sample was mostly female (59%) and identified as Caucasian, or of European descent (54%). Two dominant religions represented in the sample were Christianity (27%) and Judaism (32%). A majority of the sample were partnered (n = 14, 64%); one participant reported being in a common-law relationship and one participant reported being in a same-sex marriage. Two female participants were widows; six participants (27%) were single, never married. Most participants lived with their spouse, either alone (55%) or with children (9%). Six participants lived alone (27%) and two women were not married, living with a family member. Four participants identified as being a caregiver; one of whom was a secondary caregiver for their mother living in a long-term care residence. With the exception of three participants who were renting their apartment, participants owned their property, either living in a house (45%) or a condominium unit (32%). A majority of the sample (54.5%) identified as having a medium-low to medium-high socio-economic status.

With respect to health, a majority of participants rated their general health as good to excellent, with an average score of 4.27 (SD = 4.78) on the PHQ-9. Approximately 68% of the sample reported having a medical condition; 23% reported that they were being treated for depression and/or an anxiety disorder; 23% reported presenting with a chronic pain condition including osteoarthritis; 36% reported being treated for hypertension. Additional ailments included thyroid disorder, hypercholesterolemia, diabetes, digestive problems, ulcerative colitis, asthma and other respiratory ailments, and glaucoma. Of note, while seven participants (32%) reported "no medical conditions", four of these seven participants listed medical conditions, including glaucoma, hypercholesterolemia, and prior prostate cancer (fully recovered).

Overall, participants did not report a high level of worry with respect to catching the virus (mean score of 3.93, ranging from 1 to 6.5 on a 10-point scale). Please see Table 1 for participants' characteristics. 

Two overarching themes were identified from the 22 transcribed interviews: (1) Threat and Challenges Associated with the Pandemic (Figure 1) ; (2) Coping with the COVID-19 Pandemic (Figure 2 ). The first theme was uncovered from a range of perspectives on key experiences that were expressed as being a threat or a challenge stemming from the pandemic by some participants, but not others. The theme of threat and challenges gave rise to seven subthemes, including: the threat of the virus, financial threat, media consumption and fear messaging, the challenge of living arrangement, physical distancing and minimal social interactions, health management and services, and the necessity of using new technology. The second theme exemplified how participants were managing or coping with the pandemic, which translated into behavioral strategies, emotion-focused strategies, and social support. Selected quotes by theme and subtheme are presented in Table 2 . 

Two overarching themes were identified from the 22 transcribed intervie Threat and Challenges Associated with the Pandemic (Figure 1) ; (2) Coping w COVID-19 Pandemic ( Figure 2 ). The first theme was uncovered from a range of p tives on key experiences that were expressed as being a threat or a challenge ste from the pandemic by some participants, but not others. The theme of threat an lenges gave rise to seven subthemes, including: the threat of the virus, financial media consumption and fear messaging, the challenge of living arrangement, p distancing and minimal social interactions, health management and services, and cessity of using new technology. The second theme exemplified how participan managing or coping with the pandemic, which translated into behavioral strategie tion-focused strategies, and social support. Selected quotes by theme and subthe presented in Table 2 . Fear for continued pandemic I fear that the virus is going to continue . . . that we're not going to find a way to deal with it, like we're not going to find a vaccine early enough and the that this will just go on. (#15, 65 y/o Ukrainian female, living alone in a house) Fear for continued pandemic I worry we will get a second wave, and it won't be in the fall, it will come this summer. And then we'll get a third wave. I guess that it will be never ending. (#22, 65 y/o Caucasian female, lives with spouse and children in house) Fear for continued pandemic I worry that things will not be as they were, that we won't go back, where there's going to be a total new normal in terms of traveling and being able to see people and be comfortable with people. I think that's my biggest concern, that just things will not be as they were. ( Ageist fear messaging All we heard was it definitely is going to impact people over the age of 65 or 70, and stay home. Basically, we don't have enough ventilators for you folks-you need to flatten the curve because you're the ones that are really going to put a stress on the system. I had a social obligation. Like, even if I did poke my head out the door it's like 'Oh my gosh people are going to know I'm over 65 and they're going to probably look down on me because I'm not in my house. So, for a while I was afraid to go out for a walk even. (#6, 71 y/o Caucasian female, lives alone in a house) Even if something small broke down like my smoke detector . . . it started beeping and I couldn't get anybody to come in to take the stupid thing down and put in a new one because no one was coming into the house and that was true for anything really, anything that you needed done. It's very much that feeling of helplessness. (#15, 65 y/o Ukrainian female, lives alone in a house)

That's the biggest thing for me is that living alone I have quite frankly started to name the spiders in my house. I don't really have a bubble. So that's the thing that I'm kind of missing. That everybody has made, created these little bubbles with their immediate family, 'cause those are the people that they really need. They need to bubble with, and I totally get that, but when I don't really have family in the city, it's harder for me to have a bubble. And that's the thing that I have found the hardest. 

We're not in a one-bedroom apartment, we're in this large house that we share. We're in the fortunate group that can do that, if I want to hide from her, I can go hide-if she needs to hide from me she can. I can hide out in the backyard . . . (#12, 70 y/o Caucasian male, lives with spouse in a house) We've got a big backyard, we're back on a ravine, so we've got privacy back there, we can go sit back there. We tend to sit out front, decked out front as well because the neighbors walk by and you talk to people. And its big enough so that we can have someone on the deck and still be social distanced by 6 feet. Gone are the days sitting around eating a meal, going to the movies, all that stuff. I mean, normally we would like to get together, go for a walk, or a swim, and then go eat or have a coffee, and we would walk in the valley or somewhere nice. That's gone. (#20, 67 y/o Caucasian female, lives with spouse in a condominium)

Missing social groups Social distancing, I think, is probably the one that has affected me more because I cannot go out with my friends, we can't gather together . . . it makes me a little sad that the things I used to do, go out and have a cup of tea or coffee with my friends, I cannot do that. Before COVID, maybe three or four of us will go for a coffee or we go for lunch or we do things together, and I enjoy that very much. Well, I live on my own now, which is a big change. So that's an adjustment for me because cooking for one . . . and what I do is I put the radio on as soon as I wake up, and that helps because somebody is talking, you know? I'm so happy for my radio. [My husband] didn't die of COVID-19 it was just his heart gave out, you know? In the hospital, I could not visit because of the COVID and so his decision was to have palliative care, which in a way was really good because he was with me, you know? . . . I make sure I have a distance which is kinda sad in a way, but that's the way it is right, can't be hugging anybody . . . I find that very hard especially after a loss you know. (#2, 74 y/o Caucasian female, lives alone in a condominium)

My wife was admitted to hospital and for 12 days I couldn't visit her... I was worried and I worried that she was feeling lonely, but then the procedure she had had a positive effect on her health so I'm glad with the end result. (#17, 77 y/o Middle Eastern male, lives with spouse in condominium)

And during that week I was supposed to have a retirement party-three of them scheduled for the last week. And so when I went home, everything was cancelled. I didn't get to say goodbye to my friends. Some of them probably didn't even know I was retired. Everything just went poof and it was gone. . I went to three-to-five classes for aquafit and I swam approximately a mile a week-that's gone. So I've been more than half a year without this wonderful exercise that made me feel a lot more energetic than I am now. (#7, 81 y/o Caucasian male, lives with same-sex spouse in an apartment) Transient health concern For a couple of weeks ago I was having some difficulty sleeping and I actually talked to my doctor about it and she had suggested that I try melatonin. . . . I think it was just, not stress so much as just feeling tired of the sameness of it all. You know, just worn down a little bit. (#3, 67 y/o Caucasian female, lives alone in a condominium)

You still get the intrusive thoughts [obsessive compulsive disorder] but you don't have to act on them. But I noticed it has been exacerbated during this pandemic. (#20, 67 y/o Caucasian female, lives with spouse in a condominium)

The fact that I have some anxiety, certainly the anxiety intensified because I didn't have the systems to be able to talk to. (#6, 71 y/o Caucasian female, lives alone in a house)

Health services I used to go just over half a block away and go see my doctor and get appointments within the week and now you have to go through all these gatekeepers, you have to go through somebody on the phone that doesn't know you, and then I talked to the nurse who does know me and then she talked to the doctor and, you know, so it's levels and levels of bureaucracy to get to your doctor. (#10, 72 y/o Celtic Jewish female, lives with family in group housing)

One of thing that I find really frustrating is that I cannot see a doctor [for chronic pain condition]. I can have a telephone appointment, but what I needed was for somebody to examine me . . . and it leads to a lot of frustration for me and a lot of anxiety and it's also hard to diagnose the problem. (#15, y/o Ukrainian female, lives alone in a house) Health services I have had access to my family doctor. I have had a phone call with him, then I have also had a phone call with a specialist because my family doctor has sent me to a specialist. It did go well but I don't think it was sufficient. If I was sitting in his office, I'm pretty sure he would have asked me a few more questions. (#18, 78 y/o Black female, lives alone in a house)

Health services I had great support from the palliative care team [that supported husband] and I must say, I'm okay, the support was good. I'm lucky that I'm quite healthy, so I didn't have to go to too many appointments. And you know, most of my appointments are for my eye, and so one is cancelled because they were not very important, or delayed. So I was lucky to be in good health, so it didn't affect me much that way. Need for assistance Some older adults don't have the means to really communicate. For example, they don't have computer skills, Zooming, and so on... Some need help, encourage them to be more active . . . help them find the means of communicating with others. There was one person but then she was adamant she didn't want to use the Zoom. She thought it's so complicated and she didn't have a camera, she didn't have a microphone. I really tried to push her and finally she is now happy that she is doing it, so there are people to help . . . These people don't have the skill and some of them really not forthcoming they are not . . . because they think they are too old to learn these new techniques. (#17, 77 y/o Middle Eastern male, lives with spouse in a condominium) Resistance I have a very close friend and she is nagging me like crazy to do Zoom because she loves Zoom. I'm willing to try it just so that we can connect, but also because everything seems to be on Zoom. I should learn how to use it now, but I also should learn how to use it for what's coming up because everything seems to be on Zoom. Making a schedule I try to make sure I have a schedule. I get up, I do a fitness routine, I get dressed, I have a zoom something in the morning or, you know I really try hard to make sure that I do have the structure. And I also make sure that I get out every day because I think, first, the fresh air . . . so I see lots of green, which is very important for me. (#21, 75 y/o Jewish female widow, lives alone in a condominium)

Each day I would have a goal for myself and usually when I do that I'm home, I get up, let's do this but let's get out, but I found that I really had to force myself some days to do things that that were on my list, so I did them but I didn't do them with a great deal of enthusiasm. One activity I'm doing that I wasn't doing before, I started to learn to bake. I've started with scones, which I never did before, and we've been watching the great Canadian and Great British baking show, and that kind of inspired me to, you know, sort of challenge for me, so in a positive way that's affected that. (#10, 72 y/o Celtic Jewish female, lives with family in group housing)

One positive aspect is that I sort of did activities that I wanted to do before but didn't have the time, like trying to improve my language and my voice. 

The garden has been a tremendous comfort to counteract all that other negative stuff. (#7, 81 y/o Caucasian male, lives with same-sex spouse in an apartment) codes Subtheme 2: Emotion-focused strategies

You have to kind of believe that it's going to be OK because I think if you're a negative person and you just go to bed at night and go you know it's all for naught. Well, that's tough. I think that's a hard way to live, and I think that's going to make people ill. mind to what you could be doing, the pandemic takes a little back seat for that while . . . We're both ice cream people, so we just go get an ice cream and sit in the car and eat it and come home, you know. I think you have to pick your pleasures. They're little, but they're not as little as they used to be. Now getting an ice cream cone is a big deal. Transplant patients have learned to look after themselves... and so I don't know! I guess I'm so grateful to be alive that I'm going to enjoy every minute of it. The gratitude that I have today is much greater than I ever had before . . . possibly the experience that I've gone through, I've had a second chance at life, like I should be dead, right? . . . and so you have a choice, you can either bounce off the walls or you can enjoy what you got! Yeah we're living through a tough time right now, you have a choice to enjoy it or not, I choose to enjoy it. (#9, 73 y/o Caucasian male, lives with spouse in a house)

Our grandparents were refugees, and their parents had to deal with the pilgrims, and they had to come here with a suitcase. Also, in the Irish side, our grandfather came here and his father died. I think our family has ingrained in our DNA 'just get on with it, and do what you have to do to keep on going,' and I think that really helps in the pandemic time. (#10, 72 y/o Celtic Jewish female, lives with family in group housing)

We came here at a vibrant age. Immigrant here. So we face difficulty in mid-20s. So maybe not like pandemic COVID-19 hardship, we had already hardship without the language, plus some level of racism and then during that time I was pregnant. (#19, 78 y/o Korean female, lives with spouse in a condominium)

We haven't had all the negatives that other people have experienced, we don't have little kids to worry about we don't have to homeschool, we don't have to worry about if we're going to keep our jobs. My age is such that I don't have the physical infirmities that will cascade upon me when I hit 85 or 90. I'm in that lovely part of the seniors spectrum where I've got all the advantages and none of the disadvantages. (#12, 70 y/o Caucasian male, living with spouse in a house) Need for more support I am always wishing for more support and I, so that's you know, that's an ongoing theme for me . . . my hopes and my wishes for you know social interaction and for people, you know coming to take care of me is unrealistic, and it was unrealistic before the pandemic. It's great that my brother would come every Saturday but I also wanted him to phone me twice a week. Or even my friend in [ All participants reflected on perceptions of threat stemming from the COVID-19 pandemic. Overall, participants did not express extensive worry about personally contracting the coronavirus. Participants largely attributed this low level of worry to their good health and strong immune system, as well as their ability to follow "appropriate precautions" such as mask wearing, hand washing, and physical distancing. However, a few participants shared that they did experience infrequent worrisome thoughts, though nothing that significantly impacted their lives. In particular, one participant who presented with an autoimmune disorder and depression felt that they were more vulnerable, especially since they would not be eligible for the vaccine.

Although participants were not generally worried about their personal risk of catching the virus, some participants shared concern about others' risk of catching the SARS-CoV-2 virus, especially family members who were immune-deficient or living and working in high-risk environments (e.g., nursing homes). Feelings of frustration and disappointment were expressed towards individuals who were not following the safety recommendations, especially younger generations who were described as selfish, irresponsible, and reckless. Some participants shared that their biggest fear was a continuation of the pandemic with no end in sight. Participants emphasized the need for a vaccine to bring the pandemic to an end, and dreaded subsequent waves and lockdowns.

Financial concerns were shared by participants who were not retired, or who were dependent on their non-retired spouse. One widowed woman who self-identified as having a low socioeconomic status shared her greatest concern of affording rent to pay for her apartment without continued income. Another woman feared that her husband's reduced income would eventually make it challenging to maintain their standard of living. In particular, she felt discouraged that her age minimized her employability despite her skill set and that she was dependent on her husband's income and pension. Another male participant noted that financial instability was his greatest source of stress during the pandemic. He shared that his income was significantly lower than the previous year and although the government financial relief benefit was greatly appreciated, he had concerns of future financial strain following the expiration of his subsidy at the end of the month. Conversely, participants who were retired shared that they felt financially stable during the pandemic and were grateful for being in their retirement, not reliant on employment.

A majority of participants reported that the consistently negative and fearful messaging presented in the media caused discomfort, and in some cases, anxiety. While consumption of media increased at the beginning of the pandemic, with some participants commenting on the addictive nature of the news, many participants recognized the me-dia's negative impact on their wellbeing and chose to decrease their consumption. Many participants expressed feeling discomfort due to chronic fear messaging on the news regarding the enhanced threat of the virus among older adults. Some participants expressed a mismatch between media messaging of increased risk among older adults and their own personal health; many participants felt the messaging was ageist and stigmatizing. Some participants emphasized that they were healthier now, or just as healthy as when they were younger. Some participants also felt the media overemphasized fear messaging and lacked adequate pandemic-related education and health promotion for the public.

Living arrangements appeared to be an important factor that determined how well older adults were managing the pandemic. While living alone and living in small spaces presented with challenges, those living with others and living in a larger space benefited from their living arrangement. Participants who lived alone, especially those without existing family and "social bubbles", felt an increased sense of isolation and loneliness due to the inability to connect with others during the lockdown. With institutional closures, such as community centers and shopping malls, older adults who lived alone were stripped of their usual opportunities for social participation. One participant also shared concern with reduced tangible support, such as changing their smoke detector, due to restrictions associated with in-person visitations. In contrast, participants who lived with their spouse or family were less likely to express feelings of loneliness and isolation. Many expressed reliance on their spouse to serve as an emotional buffer and to help balance their mood. Participants living with others emphasized companionship and the importance of having someone else to take care of and spend time with, even if those interactions were of trivial nature.

For those living with others, the living space was an important factor that either positively or negatively impacted their pandemic experience. People living with others in a small space shared experiences of relationship strain due to a lack of personal space. Furthermore, some participants reflected on the difficulty of individual quarantine when living in a small space and the risk of spreading the virus within the household. In contrast, participants living with others in a larger space reflected on the utility of having different areas in the home to spend time away from their loved ones when needed. Having their personal space allowed them to engage in their individual interests during the day, which was especially important for spouses with different interests. Those living in houses also shared how they were able to utilize their outdoor space, such as the front porch or back yard, to safely connect with others while maintaining social distancing.

Regardless of living arrangement, a majority of participants reflected on changes in social engagement, many of whom lamented the loss of social connections due to recommended restrictions brought forth by the COVID-19 pandemic. The closure of gyms and community centers impacted participants' fitness regimes and daily group-based activities. Places of worship were closed, which removed an important community channel for many older adults. Some participants, especially those who self-identified as being "a hugger", reflected emotively on the challenge of not having physical contact with friends and loved ones. Some participants shared stories of their desperate attempts for physical contact, such as simulating human contact by holding a body pillow.

Participants shared the experience of missing social gatherings with friends, lamenting the loss of social dinners, going to the movies, or going out for coffee with friends. One participant with post-traumatic stress disorder (PTSD) who lived with a family member disclosed that the inability to see their friends made it more challenging to manage their symptoms of anxiety. However, a few participants who lived with their spouse shared they were doing well with minimized social interactions. Some participants reflected on missing their family, especially their young grandchildren. In some cases, the inability to connect with family was due to border closures and travel restrictions; in other cases, it was due to a mismatch of risk assessment and fear. More specifically, some older adults shared that they were not allowed to see their grandchildren because their children or in-laws assumed they were too fragile to be around the grandchildren.

Some participants had experienced important life events during the pandemic, which were more difficult to endure due to social restrictions. A few participants reflected on the difficulty of physical distancing while mourning the loss of their loved one or feeling helpless while their loved one was in hospital without visitation options. One participant also shared their experience of retiring during the pandemic without a proper celebration to support the transition, resulting in a lack of closure.

In reflecting on personal health during the pandemic, a majority of participants expressed no major challenges or changes in their personal health. Few experienced transient sleep problems at the beginning of the pandemic due to initial worries about the virus. However, some older adults with existing health concerns who rely heavily on health services expressed challenges with managing their health and navigating a changing healthcare system during the pandemic. Participants with pre-existing mental health concerns such as anxiety, depression, and PTSD largely attributed worsening of symptoms to a lack of control and social isolation. Furthermore, participants with pre-existing physical health ailments expressed various concerns, such as increased pain and muscle loss due to pandemic-related changes in their exercise regime.

Most participants were satisfied with the level of continued care for their medical conditions. One participant expressed a preference for the changes in their medical care, appreciating the ease of meeting with their doctors on a virtual platform. However, some older adults who relied heavily on healthcare services expressed concern about clinic closures and hesitations about the quality of virtual healthcare.

Given the restrictions on in-person interactions, a majority of participants expressed an increased reliance on and use of technology such as chat groups, Zoom, and Facetime. Many participants reflected on the learning curve associated with technology use and the additional supports needed when setting up Internet connections and online applications. Despite some of the initial resistance and challenges experienced by some participants, older adults recognized the new necessity of technology to remain connected with their social network during the pandemic and also noted unexpected benefits related to the ability to work, worship, and learn online. Still, almost all participants noted that social engagement via technology would never truly replace their need for human connection. Importantly, some participants acknowledged that learning how to use communication tools such as Zoom may be daunting for some older adults who believe that they are "too old to learn" and that the government should provide social assistance to support technology use within this segment of the population.

To minimize the distress associated with media consumption, a number of participants shared that they pointedly reduced their consumption of the news. Those who wanted to stay informed reduced consumption to once or twice a day; one participant chose to peruse newspaper headlines as a way to stay informed, but not become overwhelmed.

A majority of the sample reflected on the responsibility of following COVID-19 health and safety regulations. Wearing a mask, hand washing, and physical distancing were seen as important behaviors to aid in curbing the spread of the coronavirus. Following the recommended practices was seen as an important civic responsibility, and contributed to a sense of personal safety. Persons with compromised immune function, or those living with an immune-compromised spouse, highlighted the importance of wearing a mask despite the discomfort. One participant with asthma and partial facial paralysis shared their experience of actively searching for a mask that was relatively comfortable, not only to protect their own wellbeing, but to protect others as well. This level of social consciousness was expressed by a number of participants in the sample. Despite experiencing discomfort with wearing a mask, one participant with asthma shared that wearing a mask sent a message of social responsibility to others in their community.

Behavioral strategies such as maintaining a daily schedule were an important coping strategy for many older adults. Participants also spoke to the importance of staying busy and finding new hobbies, such as gardening, baking, quilting, reading, and painting. Some participants shared the importance of pivoting, finding new opportunities to replace activities in which they were no longer able to engage. For example, one participant shared their ability to pivot from going to the gym to creating a new art portfolio. Some participants viewed these activities as contributing to their wellbeing while others simply viewed them as a means of distraction. A few participants who did not have varied interests or hobbies before the pandemic seemed to experience a greater challenge with the pandemic and finding purpose in their daily life. One participant without directive interests or hobbies likened the pandemic to Groundhog Day, with an overconsumption of television each day with their husband.

Keeping physically active was another common behavioral method of coping with the pandemic and maintaining wellness. Some older adults shared that their new "free time" allowed them to be more physically active than before the pandemic. In addition, simply being outdoors was perceived as an important strategy for maintaining wellness, especially for those living in smaller spaces.

All participants shared the various emotion-focused strategies that were used to help manage living with the pandemic. Gratitude for small pleasures, acceptance of the current situation, and optimism for the future was commonly shared by older adults. Furthermore, perspective-taking was notable in persons who had previously experienced hardship, trauma, or loss. For example, one participant who was a transplant patient noted that we have a choice to enjoy life, regardless of the current circumstances. Another participant shared that the pandemic was not as stressful as the hardship they experienced as a new immigrant to Canada. Taking a more general perspective, one participant reflected on what humanity has already suffered and survived, including war, the plague, and the great depression.

Meaning-making and positive re-appraisal were important strategies shared, allowing older adults to find the silver lining in their pandemic experience. Participants shared how the pandemic created new avenues for skill development, self-reflection and creativity, and how it allowed them to strengthen their relationship with family members. For some, the pandemic brought a sense of respect for the community as they watched people "step up to the plate" to adjust to new circumstances. Still, a few participants reflected on the need for greater social justice with respect to racism and the treatment of older adults living in residential care and nursing homes. One participant shared that their duties had become "more clear" as an anti-racism social activist.

A majority of participants reflected on the importance of social support during the pandemic. Receiving support from family and friends, including both emotional and tangible support, was greatly valued by participants. As noted above, older adults living with their spouse or family were grateful for the consistent companionship during lockdown. One participant reflected on the support received by their children who lived overseas, which included special "care packages" with traditional Korean snacks and cards from the children and grandchildren.

Half of the sample reflected on their social bubble and the valuable support from neighbors and friends. Some participants shared their attempts to maintain safe social gatherings with friends outside, on the porch in their back yard, or on their front lawn to adhere to government regulations. Some participants commented on how neighbors have helped through porch drop-offs, running errands, and sharing items such as books. Further, participants detailed how friends have supported them through regular calls and virtual meetings. Some participants emphasized the importance of connecting with friends as a way of not feeling alone in "pandemic worry". Importantly, interviews also revealed that older adults living alone might necessitate a greater need and quantity of social support than is regularly available.

Participants not only reflected on how they were being supported, but also shared the importance of supporting others and the ways in which they were supporting friends, family, and their communities during the pandemic. A few participants expressed how they have become more active in their communities by reaching out to others through regular phone calls, and the sense of purpose this has brought to their own lives. Yet, other participants reflected on the challenges of supporting others during the pandemic. For example, one participant expressed guilt over not being able to assist her essential worker colleagues during the pandemic, and another participant expressed difficulties in supporting her mother who was living in a nursing home.

Within the first few months of the pandemic, communities across the world faced a momentous disruption to their livelihood. Although initial reports suggested that older adults were at increased risk of psychological distress stemming from social isolation and loneliness [5] , emerging evidence suggests that older adults have displayed greater emotional resilience during this pandemic, relative to younger age groups [5, 13] . The present study provides a qualitative perspective of the lived experience of communitydwelling older adults within the first six months of the COVID-19 pandemic. Most notably, the current qualitative results support existing quantitative and qualitative findings of resilience among older adults during the pandemic.

Despite targeted fear messaging on the news and social media, suggesting an increased risk of viral contraction among older adults, participants did not express heightened concern regarding their personal risk of catching the virus due to their age. However, the news media portrayal of COVID-19 as an age-related disease created anxiety in some participants. While media consumption initially increased among many older adults in order to remain informed of the evolving coronavirus and the recommended safety practices, participants also noticed the negative impact that media consumption was having on their emotional wellbeing. Recognizing the need to regulate media consumption, those who chose to decrease their media intake shared that they experienced an improvement in their psychological wellbeing. These findings are aligned with previous research pertaining to COVID-19 media consumption. In a study by Losada-Baltar et al. [14] , greater time devoted to COVID-19 information was associated with greater psychological distress during lockdown. Furthermore, data from the American Trends Panel, which sampled adults aged 18 years and older, revealed that greater COVID-19 media consumption was associated with greater psychological distress, which was partially explained by increased perceptions of COVID-19 threat [18] . Together, results highlight the importance of recommending guidelines surrounding media consumption. More specifically, qualitative findings underscore the importance of being an active participant in media consumption, which includes bringing awareness to how specific media are influencing personal wellbeing, and the ability to disengage from counterproductive behaviors. Furthermore, targeted fear messaging may prompt ageist sentiments and behaviors among younger individuals, as some older adults expressed a mismatch between their personal perceptions of wellbeing and their children's perceptions of risk due to age. This led to frustrations over feeling constrained in seeing family members and running errands, infringing on their desire to maintain independence.

Ageist attitudes have undeniably been exposed during the pandemic. However, the dialogue of systemic ageism during the pandemic has largely focused on nursing homes and older adults living in residential care, without considering the experiences of ageism among community-dwelling older adults. In a qualitative study of 19 older adults' lived experience during the first COVID-19 lockdown in southern Switzerland, some older adults felt stigmatized in being portrayed as part of the vulnerable, and in some cases undesirable, population [19] . This sense of stigma was expressed in the current sample, with one participant not wanting to leave their house out of fear of being judged. This research highlights the negative ramifications of portraying older adults, a heterogeneous group, as an at-risk population, which promotes social exclusion, stigmatization, and victimization.

General low concern for contracting the SARS-CoV-2 virus among participants was commonly attributed to a sense of one's personal health or to the engagement in prescribed cautionary behaviors. Older adults shared that they felt healthy, with a strong immune system; some expressed that they were just as healthy now as when they were younger. Those with a compromised immune system felt confident in the prescribed safety measures, emphasizing the importance of physical distancing, hand washing, and the wearing of masks. Due to the prevalence of contentious discourse around mask wearing, many participants conveyed their strong belief in the importance of wearing a mask, not just for personal safety, but for the safety of others. Indeed, following the prescribed safety measures was viewed as a civic duty. Many participants expressed disappointment and anger towards individuals who did not follow the prescribed safety measures, with a common focus on younger generations. This tension with noncompliant citizens and youth aligns with the aforementioned qualitative study in southern Switzerland, which reported anger towards those who did not respect COVID-19 prevention measures as well as the institutions that were not enforcing the rules [19] . This cohort of older adults also expressed anger towards the youth, perceiving a sense of ageism from this generation and a disregard for the lives of vulnerable persons [19] . In the current sample, greater concern for others' wellbeing was emphasized among older adults, which is aligned with the notion that aging is associated with greater altruism [20] . Considering that altruistic attitudes predict positive effects in later adulthood [21] , caring for the personal safety of others and engaging in prosocial behaviors (discussed below) during the pandemic may reflect a characteristic of resiliency among older adults.

Due to institution closures, participants who were still working expressed financial concerns. Older adults who were dependent on employment income were concerned about their ability to pay the rent and to sustain their current standard of living. Although these concerns were shared among a minority of the participants within the current sample, it is important to recognize that some older adults continue to work in later adulthood out of necessity [22] . Further, these stories reflect the economic hardship experienced by many individuals, with exacerbated concerns surrounding housing insecurity due to the pandemic, which may negatively impact health outcomes [23] . Conversely, those who were retired commonly expressed gratitude for being financially secure in their retirement. Many older adults acknowledged that the common pandemic stressors experienced by Canadians, including loss of employment and homeschooling young children, were not a concern for older adults, which may partially account for quantitative findings of increased perceptions of stress among younger adults relative to older adults [13] .

Participants shared the challenges associated with social distancing measures and institution closures. Within the current sample, stories were very similar with respect to loss of social connection and daily routine due to the closure of community centers, gyms, and places of worship. Similar to a qualitative study in older adults living in the UK [24] , participants lamented the loss of the "old normal", and longed for activities that they enjoyed, including outings with friends and travel. Stories of loss and bereavement during times of social confinement highlighted the importance of social connectedness during important life transitions-a testament to the value of community and family support. Overall, participants expressed a sense of being supported during the pandemic. Participants living with a spouse expressed gratitude for having someone to spend time with; however, living space was highlighted as an important factor for managing the pandemic day to day, with larger spaces affording the benefit of having moments of solitude. Research to date has largely focused on the effect of the pandemic on indices of loneliness, without considering the need for solitude. Although the need for solitude may differ by age, personality, and circumstance, solitude has been found to support the freedom to engage in personal interests and to foster creativity and spirituality [25] .

Many older adults shared a deep sense of community with their neighbors, reflecting on times spent socializing at a distance, helping one another with running errands, or sharing resources. Further, engaging in social outreach activities in their communities provided older adults with a sense of purpose during the pandemic. A sense of purpose in later adulthood has been shown to support healthy lifestyle behaviors [26] and is a cornerstone of wellness in late life [27] . Altogether, stories of personal lived experiences underscore the importance of social capital, including neighborhood cohesion and norms of reciprocity, which may facilitate a sense of purpose and minimize the potential isolating effect of the pandemic. Indeed, engagement in prosocial behaviors as means of communal coping may also foster wellness within the community [28] .

While the worry of contracting the virus was minimal within the sample, some participants with existing psychological health ailments (e.g., obsessive-compulsive disorder, post-traumatic stress disorder, depression) expressed that their symptoms were initially exacerbated by the pandemic. Perceived exacerbated symptoms within the initial months of the pandemic were also reported in qualitative interviews among older adults with major depressive disorder in the United States who were enrolled in a clinical trial prior to the pandemic [29] . However, qualitative reports also highlighted resilience in response to the pandemic, and quantitative scores on indices of depression and anxiety did not significantly differ from pre-pandemic scores [29] . Accordingly, ensuring that proper health support systems for persons with existing health ailments are essential. Importantly, none of the participants shared the onset of new psychological or physical diagnoses resulting from the pandemic, which is aligned with the aforementioned quantitative report by Dionne et al. [13] . Rather, participants shared various strategies employed that helped them manage day-to-day pandemic living, an indication of resilience and ingenuity. With regards to access to healthcare, a notable portion of the sample discussed their experience with adapting to changes in access to medical services. Many participants were thankful to be in relatively good health and, therefore, able to adapt to delays in visits with their medical specialists. Of note, one participant who lived alone and was particularly reliant on their family doctor was very disappointed with the closure of their clinic, which was located in a lower-income neighborhood. Although this was one older adults' experience, it highlights existing inequitable access to care between high and low-income Canadians [30] .

A myriad of coping strategies recounted across interviews highlights the importance of adaptive behavioral and emotional coping strategies to mitigate the potential negative impact of pandemic stress on wellbeing. Behavioral strategies were important for the management of institution closures. A majority of older adults, including those with mobility issues, spoke about keeping physically active during the pandemic. Such behavior is supported by a large body of research that highlights the importance of physical activity for physical and emotional wellbeing among older adults, including resistance to negative aging stereotypes [31, 32] . As noted above, a number of participants expressed low worry about contracting the virus, which was frequently attributed to their sense of good physical health and hardiness. Accordingly, the ability to remain physically active during the pandemic may support a sense of physical and emotional wellness, even among persons with existing health ailments. This is aligned with a qualitative study among older adults in France, which highlighted the importance of finding ways to support older adults in remaining physically active at home through the development of national policies [33] .

While the ability to pivot daily activities was shared by a majority of the sample, one participant shared difficulty finding new ways to shift their activities of daily living. They found that they had "no purpose" and were unable to draw on existing interests or hobbies. According to self-determination theory, the ability to engage in internalized goal-directed behaviors is largely dependent on the need for autonomy, competence, and relatedness [34] . Consequently, persons who lack a sense of autonomy and choice during the pandemic may find it more difficult to rely on internal motivations and to pivot their daily activities to support their wellbeing. This may be especially salient for individuals who rely on external sources of pleasure and gratification [34] .

A range of adaptive emotion-focused coping strategies was shared across interviews, all of which support wellbeing. A prominent emotion-focused strategy that was used among participants was perspective-taking, which afforded a sense of strength in overcoming adversity. Examples of gratitude, meaning-making, and positive reappraisal were commonly noted in the qualitative analysis, all of which are interconnected and foster positive emotions. These findings align with a qualitative study in a sample of Midwestern American older adults aged 70 to 97, which reported the use of adaptive emotion-focused coping strategies, including seeking social support and having a positive mindset, to foster resilience during the early weeks of the pandemic [35] . According to Fredrickson's broaden-and-build model, the cultivation of positive emotions such as gratitude is a cognitive-emotional process that broadens the individual's thought-action repertoires, which over time fosters the building of emotional, social, and physical resources, which in turn enhance wellbeing [36] . Finally, participants expressed the ability to let go of the desire to change what was outside of their reach, focusing instead on the smaller changes and adaptations that they had the power to make within their daily lives. Shifting focus away from what is outside of one's control toward that which is controllable is important for wellbeing as it fosters healthy lifestyle behaviors, psychological wellbeing, and physical health [37] .

Silver linings around the pandemic were shared by many, including the need and benefits of learning a new tool, namely Zoom. Although resistance to the use of new technology varied, many were grateful that they had a new means of communicating with loved ones and a way to continue engaging in social and learning activities. Previous research suggests that internet use among older adults supports wellbeing and is associated with reduced loneliness and greater life satisfaction and psychological wellbeing [38] . However, resistance to learning new technology was present among some older adults due to novelty and the lack of confidence to use new technology. Similar qualitative findings were found in a sample of older adults living in Northern Italy, with varied uptakes in technology to minimize the effects of social isolation during the first wave of the pandemic [39] . In this study, some participants spoke to accessibility issues due to impairments in vision and hearing [39] . The stories shared by older adults point to the importance of telecommunication support, including accessibility and skill development. While characteristics of aging cohorts continue to change, it is important to address aging stereotypes within the community, including the well-known "I'm too old to learn" stereotype, which hinders healthy aging [40, 41] . Continuing education and social programming is essential to breaking down barriers that are created by aging stereotypes, and to foster skill development in later adulthood. Finally, the co-development of technology by older adults may enhance accessibility issues for older adults with age-related impairments in vision and hearing.

Despite the valuable contribution of this report to the growing body of literature, it is important to reflect on study limitations. First, although data sufficiency was met following interviews with 22 participants, all participants resided in the province of Ontario, Canada. While participants lived in both urban and rural environments, the experience of older adults in Ontario may not be representative of other geographical locations. Second, although the authors intentionally worked towards recruiting an ethnically diverse sample, a majority of the sample was Caucasian, with a select few who identified as being part of a minority group. As social determinants influence health and wellbeing [42] , it is important to consider how the overrepresentation of some ethnic groups in essential workplaces, as well as financial insecurity and multigenerational living may differentially impact the experiences of older adults during the pandemic. Similarly, the age of participants ranged from 65 to 81 years, therefore, not representing adults within the oldest-old (i.e., 85+ years) segment of the population. Older adults 85+ years of age may present with different experiences as it relates to health, leisure, and the use of new technology during the pandemic. However, given the qualitative nature of the study design, this analysis does not attempt to generalize findings to the greater population. The value of qualitative analysis is in the ability to provide a descriptive snapshot of the experience of a given sample. A final limitation pertains to the timeline of the interviews, all of which were conducted within the first six months of the pandemic, spanning from April to October 2020. Although this allowed for a range of experiences, including the initial lockdown, the gradual reopening of the province, and resurgence of COVID-19 cases with a second wave of the pandemic, it is unclear whether the activities and coping strategies employed during the first six months of the pandemic continued into the winter months and during the extended waves of the pandemic.

Overall, the lived experiences shared by older adults in the current study are largely reflective of recent quantitative studies suggesting that older adults have been relatively resilient during this pandemic. They did not feel that they were at increased risks of contracting COVID-19; they did not report the onset of new health-related concerns within the first six months of the pandemic; they did not feel a need to be treated differently due to their age. What has surfaced during the pandemic is a need to break down age-related stereotypes that compromise the livelihood and wellbeing of aging Canadians; the need to engage in careful reflection on media intake and its impact on emotional wellbeing; the need to develop and foster prosocial behaviors and communal coping to support wellness within the community; the need to establish accessible health support systems for persons with existing mental health ailments; and the need to create social programming that increases access to telecommunications at any age. Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.

To protect the identity of participants, additional qualitative data can be made upon request.

The authors declare no conflict of interest.

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