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COVID-19, Qualitative Research, Older adults, Public and Patient Involvement
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McCarthy A, Morrissey A, O'Neill A et al. A qualitative study of older adults’ experiences during the early outbreak phase of the COVID-19 pandemic [version 1; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2025, 8:51 (https://doi.org/10.12688/hrbopenres.14110.1)
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Research Article
A qualitative study of older adults’ experiences during the early outbreak phase of the COVID-19 pandemic
[version 1; peer review: 1 approved, 1 approved with reservations]
PUBLISHED 08 Apr 2025
OPEN PEER REVIEW
REVIEWER STATUS
This article is included in the Coronavirus (COVID-19) collection.
This article is included in the Ageing Populations collection.
Abstract
Corresponding author:
Aoife McCarthy
Competing interests:
No competing interests were disclosed.
Grant information:
This study was supported by an unrestricted grant from the University of Limerick, Health Research Institute to Prof. Katie Robinson.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Copyright:
© 2025 McCarthy A et al.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to cite: McCarthy A, Morrissey A, O'Neill A et al. A qualitative study of older adults’ experiences during the early outbreak phase of the COVID-19 pandemic [version 1; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2025, 8:51 (https://doi.org/10.12688/hrbopenres.14110.1)
First published: 08 Apr 2025, 8:51 (https://doi.org/10.12688/hrbopenres.14110.1)
Latest published: 08 Apr 2025, 8:51 (https://doi.org/10.12688/hrbopenres.14110.1)
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Introduction
December 2024 marked 776,973,432 cumulative cases of COVID-19 and 7,077,725 associated deaths worldwide (World Health Organization, 2024). Older adults have increased susceptibility to COVID-19 infection and those older adults infected are at increased risk of mortality (Zhang et al., 2023). The pandemic presented specific risks for older people including increased incidence of later life depression (Oh et al., 2023), reduced physical activity levels (Saunders et al., 2023), the threat of financial abuse and fraud (Teaster et al., 2023) and increased prevalence of social isolation and loneliness (Su et al., 2023).
Ageism was evident in policy responses and public discourse since the COVID-19 outbreak, for example in othering and de-prioritization of older adults’ lives in public discourse (Søraa et al., 2020) and in initial perceptions that the virus is really an older person’s problem, and the patronising nature of some policy responses (Brooke & Jackson, 2020; Fraser et al., 2020). In many jurisdictions, including Ireland, public health guidelines or government-imposed restrictions to curb the pandemic placed more stringent restrictions on older adults than younger people (Hale et al., 2021). As the pandemic has progressed, empirical research has explored older adults perceptions of ageism and its impact on their health and wellbeing (Brinkhof et al., 2023; Chasteen et al., 2023; Karmann et al., 2024; McDarby et al., 2022; Shiovitz-Ezra et al., 2023). Although attention to ageism has increased in the wake of the global pandemic it is not a new phenomenon and the level and impact of ageism observed during the pandemic is similar to those reported in the literature before the pandemic (Werner & AboJabel, 2023).
The impact of social distancing and lockdown policies on older people was identified as a research priority at an early stage during the pandemic (Richardson et al., 2020) as studies of previous infectious disease outbreaks indicated negative mental health and psychological outcomes of social isolation (Brooks et al., 2020). Since then, older adults’ pandemic experience have been extensively reported and the resilience of this cohort is evident in research reporting their coping strategies (Ahmadi et al., 2023; Bellanova et al., 2024; Brooks et al., 2022; Lapierre et al., 2023; Neves et al., 2023). Notwithstanding these coping strategies, the psychological impact of the pandemic on older people has been demonstrated in changes to mood, reduced mobility, loss of enjoyment, and exacerbation of loneliness (Mello et al., 2022; Neves et al., 2023).
Qualitative research can inform evidence-based public health responses to infectious diseases (Vindrola-Padros et al., 2020) and qualitative methods are recommended by the Centre for Disease Control in epidemiological investigation due to their capacity to provide insight into perceptions, values, opinions and community norms (Wolff et al., 2018).
Although older adults are a heterogenous group they faced specific challenges during the COVID-19 pandemic and this study aimed to explore the experiences and beliefs of older adults during the initial outbreak of the COVID-19 pandemic in the context of the Republic of Ireland.
Context
The Irish government introduced ‘cocooning’ on March 27th 2020, a measure for those over 70 years of age to minimise interactions with others by not leaving their homes, even for exercise (Kennelly et al., 2020), alongside other guidelines for the wider population. Cocooning measures stayed in place until May 5th, 2020, when older adults were allowed to go outdoors to exercise but recommended to avoid shops. Public health guidance for older adults became more flexible in subsequent waves of infection and in late 2020 “support bubbles” were encouraged to minimise isolation (Phelan et al., 2021).
An unprecedented mobilisation of community and voluntary services to support older adults and vulnerable members of communities was enacted in Ireland in March 2020. COVID-19 Community Response Forums were established in every Local Authority area in Ireland to coordinate and organise volunteer services to ensure vulnerable members of communities could access food, medicines, and meet other needs such as transport to medical appointments (Office of the Government Chief Information Officer, 2022).
Method
Design
A qualitative interpretative design was adopted to explore in-depth the experiences and beliefs of older Irish adults during the outbreak phase of the COVID-19 pandemic. Reporting is guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ) (Tong et al., 2007). The study methods are described in detail in the published protocol (Robinson et al., 2020).
Participants and Recruitment
Convenience sampling was used to recruit participants from an older adult and family carer stakeholder panel for health services research within the Ageing Research Centre (ARC) at the University of Limerick, Ireland. Recruitment for this panel has been previously reported (Conneely et al., 2020). Additionally, ARC academic members circulated an information sheet to known older adult contacts. Seventeen stakeholder panel members volunteered to participate, and an additional twenty-one participants were recruited through ARC academic member contacts. Recruitment continued until saturation was achieved. Participants are described in Table 1. Written informed consent was obtained from each participant who participated in the study.
Table 1. Participant characteristics.
Research team roles and prior experience
Interviews were conducted by AON, MC, AMM and KR. Interviews were transcribed in full and analysed by KR. Wider team members reviewed analysis at various stages. The research team members experience of qualitative research has been reported in the study protocol (Robinson et al., 2020). All members of this team were female.
Data collection
A semi-structured recorded telephone interview was conducted with recruited participants between April 13th and May 5th, 2020. The interview schedule covered four areas; participants experience since the COVID-19 outbreak, participants beliefs about COVID-19, challenges participants have faced since the COVID-19 outbreak, what has supported participants since the COVID-19 outbreak. Interviews ranged in length from 30 to 70 minutes with an average length of 48 minutes. Interviewers did not interview any of their own known contacts except in two cases.
All interviews, bar one rescheduled interview, were conducted under cocooning guidelines that restricted older adults from leaving their homes, even for exercise.
Data analysis
Interviews were transcribed and analysed using a thematic approach to analysis supported by the use of NVIVO software. Initially an interview transcript was coded by KR and JP independently and subsequently discussed. All data were subsequently coded by KR. Preliminary themes were presented to and discussed with the wider research team and a four-page summary was circulated to ARC older adult stakeholder panel members for comments / feedback.
Results
Thirty eight older adults were interviewed, see Table 1. For participant characteristics. Data analysis generated four themes.
Theme 1: Older adults experienced the pandemic in the context of diverse life experiences and circumstances and in the context of their age
While older adults’ experiences shared common elements, their accounts were also heterogenous reflecting their diverse experiences and circumstances. Some participants had recently experienced a transition or life event including retirement, a spouse moving to a nursing home, bereavement, illness in their family and receiving a new diagnosis. For many their experience of this transition was negatively compounded by the pandemic.
Some participants were family carers for a spouse or adult child, and they reported feeling unrecognised, unsupported, burdened and concerned about the future. Family carers described a hugely difficult few weeks as they adjusted to the withdrawal of day services, personal assistant services, carer support group meetings and other informal supports.
“we did have a personal assistant that was coming in, and now that person has left … I suppose that's the biggest support that's gone … and not just what the work she could do but it was the banter and the, you know, the engagement with her. She was adding life to the house, do you know what I mean? She just broke up the thing of the two of us being here on our own the whole time” (Barbra).
Older adults experienced COVID in the context of past life experiences. The restrictions and fear of COVID-19 were compared with the Foot and Mouth Disease outbreak and atomic bomb fears and their memories of other infectious diseases such as Tuberculosis, SARS, Polio, and Asian Flu.
Older adult’s perception of their age was often central to their beliefs about COVID-19. For some the pandemic had forced a new or heightened awareness of their age. Many perceived their vulnerability to COVID-19 as increased due to their age.
Few participants questioned the restrictions placed on older adults with only one wondering about the legal basis of not allowing older adults outside even to exercise. However, many older participants thought not allowing older adults go for a drive or visit outdoor sites such as graveyards was overly restrictive. Beliefs that older people would be restricted longer than other groups were common, and some older adults questioned using chronological age to determine restrictions or to decide clinical treatment and they emphasised that older people can be healthier than younger people and that old age does not begin at the same age for everyone.
“Your health would be more important than the age, I think, you see you could have bad chest and things at 50 or 60 and could be at risk. It would vary from person to person I think. You know... it isn’t just because I’m old I’m saying that, but ah, two people the same age won’t have the same health” (Joe).
While some saw themselves as healthy and fit others were anxious about their age and other health complaints in case they contracted COVID-19. A small number of older adults described feeling that time is precious for older people and COVID-19 therefore has a greater impact.
“It's funny at this stage in your life you resent the fact that you will probably lose a year out of it when you can ill afford that. There's not many years left in me that I feel like having a wasted one but there you go, you don't have a choice in these matters” (Clodagh).
Many older adults referred to recent reports of older adults aged 100 years+ who had survived COVID-19 and many said that these stories were uplifting.
Older adults themselves identified the stoicism and resilience of their generation referring to older people as ‘hardy’, having experienced a lot more challenges than younger people. Older adults referenced difficult childhoods, experiences of poverty and hardship and growing up during and post WW2.
While older adults were, in the main, appreciative of, and valued support from adult children, a few respondents described adult children as controlling them or a changed dynamic of children acting like older adults’ parents. This changed dynamic often focused on adult children admonishing older adults for going out in the community.
“Like the last time I was in town would have been the, mm, around the 12th of March I think .. and I literally had to go .. to collect something .. and my daughter ate the head off me afterwards .. various daughters on the phone like you know, ‘What were you doing?’” (Ella).
“That describes my life now and now with eight children I'm under their surveillance. I can't go out” (Mary).
Theme 2: Although older adults faced many challenges, they were slow to complain, and they minimised their difficulties
Participants described much disruption and change to their daily lives, activities and routines. They reported the loss of participation in many valued activities (most commonly; volunteering, work, minding grandchildren, leisure activities, going to mass and funerals, and shopping). Activity changes created a cascade of losses including loss of social interaction, loss of daily structure and routine, loss of independence and loss of purpose.
Descriptions of emotional difficulties were common. Participants described fear and stress, feeling low and sad, boredom/monotony, frustration, feeling that life has shrunk or that life is on pause, having bad days, struggling with uncertainty, loneliness and difficulty motivating themselves. Fear of COVID-19 was common and many participants felt at increased risk from COVID-19 because of their age and in some cases other health conditions.
“Well I suppose being, being the worst aspect I suppose I mean is the fear I suppose that you would get it Because of our age you know” (William).
Participants who had a spouse or adult child living in a residential care setting or nursing home reported the cessation of visits was upsetting and they worried about the welfare of their loved ones.
Some had not revealed their concerns to family members as they did not want to worry them. A small number of participants described an improvement over the course of the first few weeks from being very fearful or finding the restrictions difficult to cope with initially to feeling better over the course of the first few weeks.
“So you know, I have to say that I have become used to it. In the beginning I had a few bad days you know, kind of thinking, just leave me alone kind of and I want to get out and I want my life back but it's amazing how adaptable we are and I'd say my husband is the same.” (Mairead).
Most older adults reported that they wanted to avoid hospital, the Emergency Department (ED) or attending their General Practitioner due to fear of contracting COVID-19. Many described fears of the ED or hospital attendances before the pandemic and that this was now heightened;
Although older adults faced many challenges almost all were slow to complain, they frequently reframed negative impacts of the pandemic and trivialised and dismissed them.
“So you know there have been a huge amount of changes. Now having said all that, I hope you don't think I'm complaining, I'm not. Because we realise how lucky we are … we are very lucky and we very grateful for all the blessings we have in life” (Mairead).
Participants identified many reasons to be grateful including their personal characteristics, their living and social situation and their environment. They drew many comparisons with their situation and that of others, less fortunate, and expressed concern for family members and others, not known to them, in difficult circumstances. Stoical responses, such as, “we have to put up with it” and “soldier on” were common. Most participants described being grateful for the good weather making the restrictions easier as it was easier to spend time outside, gardening and the good weather was described as uplifting.
“I don't ever remember an April as lovely as this in terms of weather. Oh, didn't God send this [the weather] to us like” (Ellen).
Most participants described some disappointment about cancelled events, plans and holidays however these disappointments were often subsequently dismissed as trivial. Many were philosophical and stoical about their risk of dying if they contracted COVID-19.
“I'm not really afraid for myself, except in so far as it would affect my family if I got it, because I know if I get it it will, that will be the end of me, but look, I'm 78. I had a great life. I can't complain” (Roisin).
Participants described appreciation and admiration for those who volunteered to help older adults during the pandemic including the An Post postal collection services, people helping with grocery shopping and prescription collections. Participants also identified a new sense of community spirit and getting to know neighbours better in some cases.
Theme 3: Older adults trusted the government response, were knowledgeable about COVID-19 and took preventative action
The vast majority of participants reported that watching the news on TV and newspapers were their main sources of information on COVID-19. Other popular sources of information were adult children and the internet. The overwhelming majority reported the government issued booklet on COVID-19 was not useful as by the time it was received, they had already heard the information it contained.
“We got books out about it but sure by the time the book came we were nearly as wise as the ones that sent it” (Joe).
Many respondents reported they had to limit the amount of news they watched / read about COVID-19 as it was stressful / anxiety provoking, especially in some cases before going to bed.
“Okay, probably like everybody else, the first two or three weeks, I was constantly reading every single thing on Facebook, I would listen to the radio, you name it. But I just felt it was getting to me far more. I had my mental health, I found I was getting more anxious and more anxious, oh god, it was like the virus was going to come in the window to me. So I found that, in about the last three weeks now, only listen to the six o'clock news, you'd get everything that you need to get from that” (Aoife).
Most were knowledgeable about COVID-19 in the context of the publicly available information at that time. The vast majority reported that the virus is transmitted by droplets in the air, particularly caused by coughing and sneezing, and contaminated surfaces. The main symptoms mentioned were fever and cough. Masks were not discussed by all and those who did discuss masks raised concerns about their effectiveness.
“I sort of wondering about masks but there's so many different opinions on that, whether they actually work or whether they don't … then another programme said, oh well, the germs can go through the masks just like that with no problem, it's like putting an apple through a football net. So you don't know what to believe” (Orla).
All participants described changes in their behaviour to avoid contracting COVID including physical distancing, meeting outdoors rather than indoors, increased hand washing and sanitising and cleaning surfaces. A small group were very cautious about surface cleaning.
“I get up in the morning and I have my spray, my Dettol and I do all the handles, and there's nobody here only myself like. The switches, everything gets it. The remote control gets it, my phone gets it, everything gets it. I've completely gone over the top with it like” (Ellen).
While almost all described adhering to the restrictions many breaches were reported which participants perceived as posing minimal risk to them or others, mainly taking outdoor exercise.
While some participants mentioned distrust of reporting and data from China, only one participant explicitly mentioned fake news or conspiracy theories.
Many discussed case numbers in Ireland and internationally and a small number discussed mortality rates, vaccine development and scale-up, issues with testing and contact tracing and the concept of virus waves.
All, bar one participant described the Irish government and public response to COVID-19 in very positive terms. Many contrasted this with other countries most notably the UK and America.
The Irish Chief Medical Officer was regularly praised along with the Taoiseach and Health minister. Participants felt the government had taken appropriate and timely action, helped by being forewarned by events in Italy and Spain. Participants perceived the Irish government were listening to scientists and healthcare providers and basing their decisions on the well-being of the nation and care for citizens. While one participant was very critical of the Irish government response, most appraised the government positively and many were extremely positive about the government response. Government messaging, timing of information, and speeches were complimented. Criticisms of the government preparation in terms of PPE and lack of strategy for nursing homes were raised by many.
“I'm proud to be an Irish man because I believe we have handled this very well. I would have the utmost respect for people like Dr Tony Houlihan and so on and all of those people at the top strategy level. I think they have done a very, very, good job and I think in fairness to the politicians, they have listened to them, they have listened to the experts and they are acting on the advice, they're acting in a timely way on the advice that they are being given” (Jeff).
Theme 4: Older adults responded to the pandemic with a commitment to keep busy
Older adults responded to COVID with a commitment to re-establish routine and maintain activity participation. Older adults commonly expressed fear of being idle or bored.
“[daughters name] got me wallpaper on-line. She ordered it for me, so I'll do that now but I'm kind of waiting now for the next day or two to even start that because I want it to stretch out a bit, you know, keep myself busy” (Brigid).
They described tackling new projects and setting new goals to fill time and remain productive during the period of restrictions.
“I've set aside jobs every day. I have a big lawn. I'd normally cut it in one day but now I'm making three days of it so that I have something to do every day. You know that type of thing. I read, I read a lot and I watch television of course. So you just try to keep busy” (Tara).
Many saw daily exercise as important and walking was the most commonly reported exercise and a small few described other exercise including chair-based exercises, and an online exercise class. Many described starting walking during the restrictions to replace other activities they normally engaged in for example golf.
Many described implementing a new daily routine and stressed the importance of having a routine to structure their day following the disruption of the restrictions.
“We have a bit of a routine established in that we turn on the radio about half eight in the morning and listen to the news until about half nine. Then we make our breakfast. Then we watch mass on the streaming or whatever its on then we have our morning coffee. That’s the end of the morning (laughs) and then I’m getting the paper delivered. I'm getting the paper delivered that started yesterday. That fills up until lunchtime so to speak” (William).
The disruption to weekly routine was keenly felt with many reporting that they were having difficulty knowing what day of the week it was.
“I wake up in the morning and I'd have to think for a few minutes, what day is it today. Every day now for us is like a weekend” (Brigid).
Many new activities were adopted including online education courses, tackling household projects including gardening, yard work, clearing out, decluttering, wallpapering, and painting. Listening to mass on the tv or radio or online for the first time was common and many reported reading more, watching more tv and doing more puzzles.
“So yeah I like to have a project per day and if I don't I'm kind of ‘oh my goodness’ Which doesn't happen very often you know. You know that kind of thing. At the moment now I'm am clearing out presses and things that belonged to to (name of late husband) ” (Niamh)
Support from adult children to use technology and videocall online platforms for the first time was very commonly reported.
“My daughter got me a laptop there since this thing [COVID-19] came in just so I'm able to do a lot of things on the laptop. Cattle bought on the laptop and everything (Laughter)” (John).
While some enjoyed these new online activities multiple challenges were also described including fear of using technology, lack of familiarity, hassle and the online experience of activities such as reading the paper or shopping not equating to a real-world experience.
Discussion
This qualitative study of older adults’ experiences during the outbreak phase of the COVID-19 pandemic found that older adults experienced the pandemic in the context of diverse life experiences, circumstances and their age. Older adults faced many challenges and experienced many losses during the early weeks of the pandemic; however, they were slow to complain and minimised their difficulties. Older adults responded to the disruption of the pandemic with a commitment to keep busy and reinstate daily routine. Older adults were knowledgeable about COVID and reported adhering to restrictions in the main, this was linked with very positive evaluations of, and trust in, the Irish government response.
Participants in our study reported negative emotional experiences. These findings have also been replicated in studies nationally and internationally. Phelan and colleagues also aimed to explore older adults’ experience of cocooning in the Republic of Ireland and participants described anxiety, worry and loneliness (Phelan et al., 2021). This study however had a smaller sample size and participants opinions were sought based on their experience of cocooning throughout the year 2020 whereas this study focused on the earliest stage of the pandemic when restrictions were most inflexible for older adults. A systematic review and meta-analysis by Su and colleagues in 2023 reported significant incidence of loneliness and social isolation among older adults during the pandemic with a pooled prevalence of 28.6 per cent and 31.2 per cent respectively (Su et al., 2023).
Alongside challenges, losses and negative emotional experiences our analysis also revealed that older adults were slow to complain and adopted active approaches to coping such as re-establishing routine and engaging in activities. This reflects findings by Bellanova and colleagues who demonstrated older adults’ stoicism and described how older adults use of activity, social interactions, a positive mindset and personal attributes counteracted isolation during the pandemic (Bellanova et al., 2024). In a systematic review of qualitative studies, Ahmadi and colleagues describe the active approaches to coping by older adults during the pandemic which included maintaining social connections, meaning-based strategies, and activities for fun (Ahmadi et al., 2023). Several studies point to important age-related differences in the psychological impact of the pandemic and coping, with higher levels of psychological distress reported by younger compared to older adults (Best et al., 2023; Birditt et al., 2021; Nelson & Bergeman, 2020; Wang et al., 2020; Young et al., 2021). These differences may relate to the life experience and coping mechanisms of older adults (Young et al., 2021).
We found that older adults set goals around engagement in activities, made an active effort to re-instate daily routine and strove to be productive during the outbreak phase of the pandemic. Engagement in personally meaningful activities can play an important role in supporting adaptation and well-being during life transitions (Hammell, 2020; Jonsson et al., 2001; Trimboli et al., 2019). This was also the case for older adults in a residential setting during the pandemic. Bellanova and colleagues also identified the role activity, be that new-found and/or re-discovered, played in cultivating a sense of novelty and creating a richness of experience and opportunity that would not have been possible before the pandemic (Bellanova et al., 2024). Findings from a telephone interview study (March 28–April 20, 2020) with 76 older adults (aged 70–97) recruited from an American Midwestern region describing daily life and coping also found that staying busy, maintaining normalcy and routine, engagement in projects and setting goals operated as a coping strategy for older adults during the pandemic (Fuller & Huseth-Zosel, 2021).
Rather than emphasising their own problems older adults in our study emphasised what they are grateful for, and expressed concern for others. This is mirrored in a Canadian study which explored how older adults adjusted to life during the pandemic. Older adults were appreciative for perceived blessings such as time, their geographic location, the safety of their home circumstances and the opportunity to slow down (Brooks et al., 2022). Dispositional gratitude is moderately to strongly correlated with well-being (Portocarrero et al., 2020) and the well-being benefits of benefit finding, and optimism have also been demonstrated (Forgeard & Seligman, 2012; Helgeson et al., 2006). A significant positive association has also been reported between having positive personal character strengths and resilience in older adults (Lapierre et al., 2023). Comparisons with others in more difficult circumstances were common across the interviews and downward social comparison has benefits for individuals (Gerber et al., 2018). Participants expressed empathetic concern for others both known and not known to them during the pandemic. Mirroring our findings, an online survey of US adults (aged 60+) (n=825) experiences of pandemic stresses and joys identified concern for others as one of the most significant sources of stress during the pandemic, second only to the stress of restrictions/confinement (Whitehead & Torossian, 2021).
Caregivers in our study reported very difficult experiences during the outbreak phase of the pandemic. Similarly other studies of caregivers’ experiences during the pandemic report experiences of fear, uncertainty, and increased burden due to closure and reduction of services (Bailey et al., 2022).
Older adults trust and appraisal of the Irish government response was very positive, and they were knowledgeable about COVID-19 and its transmission. In the main, participants reported a high level of adherence with the regulations and where regulations were breached older adults perceived the associated risk was low. Similar adherence with restrictions has been reported in the literature in Ireland. Kearney and colleagues found that age was the only significant predictor of compliance behaviour in terms of restrictions with the highest levels of compliance found in the youngest and oldest age groups (Kearney et al., 2023). The Irish Longitudinal study on Ageing (TILDA) reports very high compliance with public health restrictions, estimating 80 per cent of those over the age of 60 were adhering to social distancing guidelines and 98 per cent had improved hand hygiene practices and 74 per cent reported use of PPE outside of the home (The Irish Longitudinal Study on Ageing, 2022). Contradictory findings have also been reported in the international literature. An international survey study representing 27 countries, found that older adults were not systematically more responsive to self-isolation and were not more compliant with preventative measures such as use of face coverings when compared to younger cohorts (Daoust, 2020).
The upsurge in ageism due to the pandemic has been widely discussed. In our findings older adults rejected the ageist idea that older adults are a homogenous group with an equally high risk of contracting or dying from COVID-19 (Ayalon, 2020; Ayalon et al. 2021; Maboloc & Cutillas, 2025), they emphasised that health rather than age is important in terms of COVID-19 risk. Similarly, in a qualitative study in 2021 exploring older adults perceptions and experience of ageism during the pandemic, participants protected themselves from identifying with media discourse and behaviours of ageism by focusing on alternative personal traits and life experiences (McDarby et al., 2022). Our participants also highlighted issues when their autonomy and agency were not recognised particularly by adult children. They described vigilance, admonishment and control by adult children. These experiences reflect ageist attitudes about the vulnerability of older adults and their inability to make decisions balancing risk and safety. Analysis of ageism during COVID-19 has led to calls for people to verify need, and seek consent, from older adults before engaging in helping behaviour (Vervaecke & Meisner, 2021). These findings are concerning given experimental studies have demonstrated that when confronted with negative stereotypes and ageism, older adults can experience a reduction in functional ability, cognitive performance, emotional well-being (Robertson, 2017), subjective health rating, life satisfaction (Chasteen et al., 2023) and increased loneliness (Shiovitz-Ezra et al., 2023).
Strengths
The study is strengthened by the published study protocol (Robinson et al., 2020), the adherence to standardised reporting guidelines, the prolonged engagement with the data, the attention to reflexivity, involvement of participants in data analysis and participation of multiple researchers in data analysis.
Limitations
Although the sampling strategy aimed to recruit participants with diverse demographics, we did not recruit older adults from hard-to-reach populations such as people accessing homeless services, members of the Travelling community or people from Black, Asian or Ethnic Minority communities.
Conclusion
This qualitative study of Irish older adults’ experiences of the outbreak phase of the COVD-19 pandemic reflects findings from several international studies demonstrating the active coping response of older adults’ during the COVID-19 pandemic and helps explain age-related differences in the psychological impact of the pandemic. Findings from this study reject ageist assumptions which have been prevalent in research, policy and the media during the pandemic by highlighting the heterogeneity of older adults’ experiences, and their resilience during the early outbreak phase of COVID-19.
Implications for policy and practice
This research contributes to a body of evidence that highlights the impact of the pandemic and the associated public health measures on the wellbeing of older adults thus copper fastening the importance of prioritising the psychosocial needs of older adults in a pandemic context. To progress our understanding and improve older adult outcomes for future health crisis/pandemics, research should focus on reporting the efficacy of interventions to curb the impact of public health measures. The limited number of studies completed since 2020 has focused on online/virtual methods in the main (Gabarrell-Pascuet et al., 2024; Yavuz & Şahin, 2023) or focused mainly on the wider population (Ye et al., 2022).
From a policy perspective, our findings support the need to learn from the COVID-19 pandemic and support approaches such as education in virtual communication methods tailored to the needs of older adults. Older adults’ proactive response to the pandemic supports the need for future policy makers to espouse an age-attuned approach to public health measures that acknowledges vulnerability and protects health while balancing the potentially harmful impact of social isolation.
Ethical standards
This study was approved by the Faculty of Education and Health Sciences University of Limerick, Research Ethics Committee (2020_03_51_EHS (ER) on the 24th March 2020.
Consent
Written informed consent for participation in this study was obtained from all participants involved.
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McCarthy A, Morrissey A, O'Neill A et al. A qualitative study of older adults’ experiences during the early outbreak phase of the COVID-19 pandemic [version 1; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2025, 8:51 (https://doi.org/10.12688/hrbopenres.14110.1)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Derrer-Merk E. Reviewer Report For: A qualitative study of older adults’ experiences during the early outbreak phase of the COVID-19 pandemic [version 1; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2025, 8:51 (https://doi.org/10.21956/hrbopenres.15507.r46767)
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https://hrbopenresearch.org/articles/8-51/v1#referee-response-46767
https://hrbopenresearch.org/articles/8-51/v1#referee-response-46767
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 13 Jun 2025
Approved with Reservations
VIEWS 0
�� Peer Review Feedback
Title of Manuscript: A Qualitative Study of Older Adults’ Experiences During the Early Outbreak Phase of the COVID-19 Pandemic
Dear Authors,
Thank you for your important contribution in exploring the ... Continue reading
Title of Manuscript: A Qualitative Study of Older Adults’ Experiences During the Early Outbreak Phase of the COVID-19 Pandemic
Dear Authors,
Thank you for your important contribution in exploring the ... Continue reading
CITE
HOW TO CITE THIS REPORT
Derrer-Merk E. Reviewer Report For: A qualitative study of older adults’ experiences during the early outbreak phase of the COVID-19 pandemic [version 1; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2025, 8:51 (https://doi.org/10.21956/hrbopenres.15507.r46767)
The direct URL for this report is:
https://hrbopenresearch.org/articles/8-51/v1#referee-response-46767
https://hrbopenresearch.org/articles/8-51/v1#referee-response-46767
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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1
How to cite this report:
O'Dea E. Reviewer Report For: A qualitative study of older adults’ experiences during the early outbreak phase of the COVID-19 pandemic [version 1; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2025, 8:51 (https://doi.org/10.21956/hrbopenres.15507.r46948)
The direct URL for this report is:
https://hrbopenresearch.org/articles/8-51/v1#referee-response-46948
https://hrbopenresearch.org/articles/8-51/v1#referee-response-46948
NOTE: it is important to ensure the information in square brackets after the title is included in this citation.
Reviewer Report 28 May 2025
Eireann O'Dea,
Simon Fraser University, Burnaby, Canada
Approved
VIEWS 1
This article is an interesting qualitative account of Irish older adults' experiences during the very early stages of the COVID-19 pandemic. From the findings we learn of the adaptation strategies adopted by older adults during this unprecedented time, during which
... Continue reading
CITE
HOW TO CITE THIS REPORT
O'Dea E. Reviewer Report For: A qualitative study of older adults’ experiences during the early outbreak phase of the COVID-19 pandemic [version 1; peer review: 1 approved, 1 approved with reservations]. HRB Open Res 2025, 8:51 (https://doi.org/10.21956/hrbopenres.15507.r46948)
The direct URL for this report is:
https://hrbopenresearch.org/articles/8-51/v1#referee-response-46948
https://hrbopenresearch.org/articles/8-51/v1#referee-response-46948
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Alongside their report, reviewers assign a status to the article:
Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations -
A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions
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