“We are now seeing what many of us in hospitals knew would happen eventually – people would start to die,” said Dr. Samir Sinha, director of geriatrics at Sinai Health and University Health Network in Toronto .
A weakened immune system and underlying medical conditions make seniors particularly vulnerable to serious illnesses if they receive COVID-19.
But in addition to the risks to physical health, Sinha and Dr. Theresa Tam, Chief Public Health Officer of Canada, note that protective measures against the physical removal and isolation of the elderly – who are already at risk increased risk of loneliness and feelings of depression – can take a toll on their mental health.
“Staying connected has never been more important,” said Tam, encouraging Canadians to stay in touch with loved ones by phone or video conference.
COVID-19 has heightened the urgency to protect the physical and mental health of our elderly loved ones and neighbors, Sinha told CBC podcast host Dr. Brian Goldman The dose.
Here are some tips to consider:
How can we help while physically moving away?
A side effect of the COVID-19 pandemic is that, as Canadians have had to adopt an unprecedented lifestyle of isolation, they may develop empathy for the number of seniors who feel it every day.
“I think we are finally seeing what they are going through, right? Being in your house, not being able to just get up and go when you want to go, ”said Gabrielle McMillan, volunteer and former president of Life After. Fifty in Windsor, Ont.
When COVID-19 forced the nonprofit to close its recreation centers in mid-March, McMillan and other volunteers began making “telephone insurance” calls to older members to try to maintain a connection in the absence of social interaction in person.
Already, she can hear the toll of isolation “in the voices of some of the people I call,” said McMillan.
When they picked up the phone for the first time, “you can hear a little bit of depression … they are very low,” she said.
But this personal recording, even if it lasts only 10 minutes, has an effect.
“We talk a bit and they are better when I hang up,” said McMillan. “It’s amazing to see what it means and how much it can help. “
Finding “creative” ways to stay in touch is essential to helping seniors get through this time, said Sinha.
Phone calls are great, but he also recommends maintaining a face-to-face connection with seniors via Skype, FaceTime or other video chat platforms, if possible.
Some family members turn to low technology and stand in front of their elder’s window, waving signs of support and waving.
It is also important to remember that many elders do not have family members who record them – so the little gestures of the neighbors go a long way.
Leave a note outside an older neighbor’s door with your phone number, suggested Sinha, inviting them to call if they need groceries, prescriptions or just want to talk.
At a time when so many people feel “a little helpless,” he said, reaching out to an older person can be rewarding.
“It’s a two-way street,” said McMillan. “When I hang up, I smile. “
What questions should I ask a long-term care home?
In addition to an increased level of frailty or dementia that leads a person to require long-term care placement, there are a number of factors that can put people in retirement homes at increased risk.
Residents can live close to each other, especially in older settlements, where it is common to have up to four people in one room.
“This idea of social distancing, and other things that we should be trying to do, is much more difficult in these old installations,” said Sinha.
The Pinecrest Nursing Home in Bobcaygeon, Ontario, devastated by the deaths of 20 residents in a COVID-19 outbreak, is an example of such a facility, he said.
The problem is compounded by the “precarious” nature of staffing in many nursing homes, as employees often receive only part-time work, said Sinha, forcing them to accept jobs at multiple establishments or to do home care “to make ends meet. ”
This movement between establishments and homes can contribute to the spread of the coronavirus.
Reassuring good news is that most long-term care facilities have pandemic plans and infection control measures in place to deal with epidemics such as the flu, said Sinha. But COVID-19 poses a unique challenge.
“We don’t have treatments, we don’t have vaccinations,” he said. “And it’s very contagious. So once it’s entered, it can spread quickly and kill.
” [That’s] why are we trying to do our best [to] keep COVID out of a nursing home in the first place. “
Here are some questions to ask:
- Do you have enough personal protective equipment for your staff? Although there are no known cases of COVID-19 at the facility, staff should always wear at least surgical masks, said Sinha. If there are infected people in the building, they should wear N-95 masks, face shields, overalls and gloves.
- What specific infection control measures have you put in place to protect yourself against COVID-19?
- Do you feel confident in your ability to support my loved one right now?
What about removing my loved one from long term care?
Some families may not be confident in the nursing home’s efforts to minimize the risk of COVID-19 and may want to bring their loved one home, said Sinha. But this is not a decision that can be taken lightly.
” [That’s] huge, and it’s not something people can easily do, “he said. “We might not just have space. We just might not have, you know, power-person. ”
It’s important to remember that some long-term care homes have better protections than others, said Dr. Isaac Bogoch, an infectious disease specialist at the University Health Network.
Family members must also weigh the risks of bringing their elderly relative home, he said.
For example, if there are people living in the family home who come and go, it is possible that someone may be bringing COVID-19 infection, said Bogoch.
There is also the question of whether the home is a safe place and whether family members can realistically provide the level of care necessary for an elderly and frail person.
Depending on the person and the circumstances, moving them from a familiar environment to an unknown environment can also cause psychological distress, added Bogoch.
Sinha and Bogoch agree that this is an individual decision.
“Not all long-term care facilities are created equally, and all [family] the houses are created equally, “said Bogoch.
What about seniors living at home?
Because the elderly are so vulnerable to COVID-19, health officials asked people aged 70 and over to self-isolate at home.
“Their greatest risk is when people come to visit them,” said Sinha.
Family members, friends or neighbors bringing groceries, medication and meals should keep a physical distance and leave items outside the senior’s door as much as possible.
But for older people receiving home care, certain visits – including medical treatment or baths – may be essential, he said.
If personal support workers or others are to enter the home, seniors or their families must:
- Make sure caregivers wash their hands.
- Ask them to wear a mask. Social workers move from home to home – and can also work in long-term care facilities, so it is essential to do everything possible to minimize the risk of transmitting the virus even if they have no symptoms .
What other difficulties do the elderly suffer from?
While we ask people over 70 to isolate themselves at home and to prohibit all visits, except essential, to retirement and nursing homes “, elderly people already isolated enough [are] become even more isolated, “said Sinha.
The emotional toll is “the collateral damage” from efforts to protect the elderly from infection, he said.
“This is where we have to make some of these compromises in an attempt to save lives, but at what cost overall? “
For older adults with dementia, the restrictions can be particularly devastating, as they may not understand what’s going on – and why.
“They’re getting more and more distressed because the people in their lives are trying to stay away from them and they don’t remember trying to stay away from them to protect them,” said Sinha.
Many seniors also do not have people to rely on to bring essential supplies to their doorstep – and cannot afford store delivery services.
These are areas that nonprofits are trying to address. The federal government has pledged $ 9 million to the United Way – which funds community charities across the country – to help vulnerable seniors during the COVID-19 pandemic.
The money will be used to fund supports to help seniors “safely isolate themselves”, with a focus on those living in precarious or low-income housing, said the spokesperson for the United Way. Anita Khanna in an email to CBC News.
Services will include delivery of groceries, pickup and return of prescriptions, transportation to medical appointments and “phone calls with friendly registration,” she said.
Seniors can also call 211 in most parts of Canada to access information and support.