Adult children and their parents end of life journey

 My Niece, who was in her early 50’s died almost two years ago, but the pain of her passing is still hard for the family. We were out to dinner with her Mom and Dad and their partners the other day. Because of COVID the Celebration of Life had been postponed and was held about two weeks ago.

The discussion about her end-of-life journey was uplifting and sad and was needed to help move forward. For an adult to lose a child is one of the worst things that could happen and the grieving stays with us until we pass.

What we know is that when we are ready to go, we hope that we will not be a burden on our adult children so they will not have to be there to manage our end of life, physical decline or cognitive decline but hopefully not both:

There is a study done by the Life Actuary Society on how adult children coped with their parent's end-of-life issues. They found that parents experiencing cognitive decline usually required a longer period of care, were more dependent and had less say in decisions. Cognitive decline often happened gradually, and aging parents often hid signs of impairment initially. Children did not always recognize the severity of the decline, and by the time it was dealt with, it was often quite significant.

Parents often had a triggering event that led to sudden physical declines such as a fall, a stroke or heart attack, but sometimes the decline was gradual, caused by factors such as arthritis or macular degeneration. Sometimes there were a series of incidents where parents might decline and then get better for a while. In some cases, children absorbed the need for more help and in other cases, the parent needed to move to a new type of support arrangement.

Health changes happened suddenly and some gradually. Generally, the adult children tended to react to their parents’ changing needs rather than plan for them. This tendency surfaced in some interviews among siblings who did not have strong relationships with each other; this may have exacerbated a lack of planning.

The study found that a variety of events or functional decline led adult children to increasingly take responsibility for their parents’ care including widowhood (especially when the deceased parent managed the finances); loss of the ability to drive or get around on public transportation; loss of the ability to physically maintain a residence, cook or clean; and mobility issues or other issues that required long-term care. One specific triggering event was the inability of the parent to remember to take medications. Irrespective of family dynamics, one of the factors that precluded planning was that, until they experienced it, adult children often didn’t understand the toll caring for a parent would take on them.

Adult children often helped take their parents to doctor’s appointments and consult with the doctor. In this research, it was most common for the adult children to follow the doctor’s advice without question and play an active role in making sure it was followed. However, several did get second opinions or seek geriatricians, and a few questioned the doctor’s decision later.

Stay at Home Living App

An app created by two South Surrey residents has found national success in its ability to easily keep seniors connected, entertained and healthy amid the coronavirus (COVID-19) pandemic.

 Around this time last year, Carolyn Glazier and Barry Jones watched as the pandemic kept British Columbia’s senior citizens from seeing their loved ones. Not ones to stand idly by, they created what is now the Stayhome-Living app. Now being used by seniors anywhere from B.C. to the Maritimes, the app’s rapid growth can be attributed to its simplicity and relevance to some of the country's most vulnerable people.

 Early on Barry Jones saw the isolating effect the pandemic had on his senior parents, watching how their social circles disintegrated as restrictions came down.

 “You could just sort of see that it was really impacting them in such a negative way,” Jones said. "We just realized they needed a tool to help them stay connected."

Knowing that many seniors had at least some access to technology like a laptop or tablet, the goal was to pull various technology needs under one virtual, but quite literal, “roof.” 

Working with Carolyn Glazier's father Tom Waters, a retired tech executive, they designed the app around the front of a small house. The various windows of the simple design serve as the entry points to the app’s curated content. 

Zoom, email, social media sites and other communication tools are contained within a window marked "Connect" while food delivery services can be found behind the window marked “Services.” Free streaming services like CBC Gem and HGTV can be found under the entertainment window and various games along with guided fitness classes like chair yoga are behind the “Activities” window. 

The simple and down-home feel of the app is one of its most attractive aspects to seniors Glazier says recalling a user who found comfort in the layout. 

"One of our beta testers early on actually got COVID and she was really unwell,” Glazier said. “She was really drawn to the house because it felt safe and easy to navigate."

"Now that she's getting stronger and healthier she's doing the seated yoga class three times a week and just loving it," Glazier added.

Having seen success after the beta test, the app has expanded from where it started in South Surrey and White Rock to more of the Lower Mainland and Metro Vancouver, then the Sunshine Coast and into Northern Alberta.

"We're in pretty much all the provinces," Glazier said. "That's our bigger push now is to extend the reach and have our content over a pan-Canadian nature."

As the app expanded, so did the creativity of the people using it. Some users have started doing virtual date nights through the app’s drone tours of cities around the world. A date might include taking a cooking class in the rolling hills of Tuscany, Italy and then taking a helicopter ride over New York City.

“It feels great really. Knowing just that, we are positively impacting people's lives and helping out at a time when the battle is the greatest," Jones said. "We are trying to bring technology to seniors and it doesn't come naturally, it's not second nature to a lot of them but what we're finding is they've got this fantastic sort of 'give it a go' mentality."

As for the future of Stayhome-Living, the pair says there are big plans ahead for the app and some proprietary software will be coming at a later date. Jones mentioned there could be a premium version launched that would offer more interactivity but the free version will always be available.

To download or learn more about the Stayhome-Living app you can check out the app's website.https://www.stayhome-living.com/dev/ 

Normal is still a bit away

The AARP put out some guidelines for those who have been vaccinated. The return to normal must still wait until at least 2022. 

1. You still need to wear a mask because:

2. You could still catch COVID-19.

The Pfizer-BioNTech and Moderna COVID-19 vaccines ARE about 95 percent effective in preventing symptomatic COVID-19 after two doses in clinical trials. The whole point of a vaccine is that it prevents you from dying or ending up in the hospital, but you may still get sick.”

3. You could infect someone else.

There's also a small chance that you could get infected with the virus and not even realize it, and then you could transmit it to someone who is not vaccinated. Researchers are still studying whether the vaccines prevent the asymptomatic spread of the virus, she says; early data indicates that they likely do. But the evidence is preliminary, and more research is needed.

4. You can visit friends and family,

The CDC still recommends avoiding medium-size and large gatherings.

5. You don't have to quarantine after exposure.

You do not have to quarantine or get tested after exposure to someone with the coronavirus, if you aren't experiencing any symptoms, the CDC says.

6. You should keep your vaccine record card handy.

In the future, you may need proof of vaccination to travel, work in certain industries or attend large events. Your vaccination card is a record of this. Your card may also come in handy to confirm which vaccine you received, and when you received it

7. Travel is still discouraged.

8. It's a good time to go to the doctor or dentist.

9. You may need a booster shot.

Researchers still don't know how long immunity from the vaccines will last. The current vaccines should provide some protection against the coronavirus variants circulating right now. Chances are that we will have to get some kind of COVID-19 shot on a regular basis, perhaps once every three years or every year, like the flu shot.

10. A return to normal hinges on herd immunity

Before life can get totally back to normal, experts say that first, we need to reach herd immunity. Estimates of when we will reach that point range from this summer to early 2022.

 

 

Race

I saw this the other day on Facebook and thought It interesting.

If you could fit the entire population of the world into a village consisting of 100 people, maintaining the proportions of all the people living on Earth, that village would consist of

·       57 Asians

·       21 Europeans

·       14 Americans (North, Central and South)

·       8 Africans

This is a very simple illustration used by the author of this Facebook post to point out how we are different. So, does this mean anything of value? I am not sure. What does it mean that there are 14 Americans (North Central and South)? Does that signify something of importance, I am an American, but I am Caucasian American, but I know there are Asians who live in North America, are they counted in the 57 Asians or are they counted in the 14 Americans? What about the 21 Europeans do any of them live in America, Asia, or Africa?

To me, the comparisons made above are not valid. It would have been better to perhaps divide us up by ethnic group and that was done in the early 2000s according to the Washington Post story published in 2013.

The problem is that the idea of ethnicity can change over time; the authors of the study note that this happened in Somalia, where the same people started self-identifying differently after war broke out.

Ethnicity is a social construct and that means that when we look at ethnicity people in different countries might have different bars for what constitutes a distinct ethnicity. Finally, as the study notes, "It would be wrong to interpret our ethnicity variable as reflecting racial characteristics alone." Ethnicity might partially coincide with race, but they're not the same thing.

When five economists and social scientists set out to measure ethnic diversity for a landmark 2002 paper for the Harvard Institute of Economic Research, they started by comparing data from an array of different sources: national censuses, Encyclopedia Britannica, the CIA, Minority Rights Group International and a 1998 study called "Ethnic Groups Worldwide." They looked for consistence and inconsistency in the reports to determine what data set would be most reliable and complete. Because data sources such as censuses or surveys are self-reported – in other words, people are classified how they ask to be classified – the ethnic group data reflects how people see themselves, not how they're categorized by outsiders. Those results measured 650 ethnic groups in 190 countries.

That is a lot of groups and so it does not fit easily into a simple story. The story goes on to talk about which countries were the most and least ethnically diverse, but closes with the following:

Here's the money quote on the potential political implications of ethnicity:

 In general, it does not matter for our purposes whether ethnic differences reflect physical attributes of groups (skin color, facial features) or long-lasting social conventions (language, marriage within the group, cultural norms) or simple social definition (self-identification, identification by outsiders). When people persistently identify with a particular group, they form potential interest groups that can be manipulated by political leaders, who often choose to mobilize some coalition of ethnic groups (“us”) to the exclusion of others (“them”). Politicians also sometimes can mobilize support by singling out some groups for persecution, where hatred of the minority group is complementary to some policy the politician wishes to pursue.

Some perhaps would like to divide us by race, the problem is that the early research on race, which talked about 5 or 6 different races was wrong. There is only one race. If someone talks about different races, they are using information that is not accurate and false.  The research I have seen suggests that racial categories as socially constructed, that is, race is not intrinsic to human beings but rather an identity created, often by socially dominant groups, to establish meaning in a social context. Different cultures define different racial groups, often focused on the largest groups of social relevance, and these definitions can change over time. As humans, we love to put people into categories but putting people into categories of race or ethnicity will not work. The best course of action is to treat each of us unique.

Be Kinder

As individuals, we struggle every day to cope with the restrictions that we accepted to fight the Pandemic. However, as a society, we haven’t yet come close to reckoning with the impact this new (sur)reality has had on our collective mental health, and the long-term effects on friendships and familial relationships. Some days a trip to the grocery store can bring up a generalized feeling of anxiety. The obvious discomfort I feel when I see people not physically distancing on a TV show. Spring break is coming up in our area, and I have the fear or perhaps the knowledge that the numbers of people infected daily may look very different again after these holidays when infection rates spike because people chose to ignore the rules.

I am not sure about you, but the constant need to try and anticipate the unpredictable becomes wearing. It also seems to me that there is so much anger at what we cannot control which shows up by the ease with which exchanges on social media or in general can ramp up into something much more volatile.

Layered on top of the systemic inequity that existed long before the pandemic, the intensifying public mental health crisis needs, In BC we have another health crisis with overdose deaths, caused by many reasons. This is another layer on top of the systemic inequity that existed long before the pandemic, As a society we need to recognize that public mental health crisis needs to be acknowledged, addressed, and put high on the priority list, not just prioritized. Rather than focusing exclusively on “building back better,” we need to talk, now, about the overwhelming need to build back kinder and more compassionate. This is a vital part of healthy healing for families, workplaces, and communities. There is no time to waste.

Moving to stay healthy

Staying healthy as you age is not easy, we are subject to many chronic illnesses that may prevent us from being active. I have friends who still go to the gym every day when they can. My brothers who are all also seniors are still active. One of them runs and indicated he is going to start doing marathons again. Another still plays tennis and last year one the Provincial championship for those over 70. I still walk at least 5km a day. Down from last year when I was walking 7Km a day. We are all still active and luckily we are all still healthy.

I have been active all of my life but not as active as my friends, but I know people who are not active, and it is hard to start to be active when you retire if you have not been active when you were working. So, a key to staying healthy in retirement is to be active. For those of us who have been active all of our lives, this is easy. For those individuals that have not been active all their lives, the key point to being active is to start moving. Moving does not mean that the person has to enter road races. Moving means get outside and walk your dog. Every day when I go for my walk there are many people out walking their dogs. This appears to be a very popular form of exercise.

If you don’t have a dog, maybe you can take the stairs instead of an escalator, or elevator, to the next floor level. One of the benefits of walking up and downstairs is that the extra height of the steps builds muscle strength in the legs.

 Walking is a great exercise, you get a chance to see your neighbours say, hello and stop and talk. If you know your neighbour well,  ask them to join you on a walk. Walking in a neighbourhood for several blocks lets you actually see the homes and yards that you may never appreciate driving in a car.

Doing a little yard work, like raking leaves, mowing the lawn, planting flowers, is just as beneficial as going for a walk. If you have a tree in your yard, then picking up branches is good because it helps keep you limber when you bend over. For extra benefit plant a garden, and after a month or so, you can reap the rewards of your earlier efforts.

A friend of mine has an exercise bike that he uses well he watches TV. I find exercise bikes boring so I don’t have one. However, one easy thing to do while watching television is doing a little exercise during the commercials. Have you noticed that commercial breaks are now almost five minutes long? While in five minutes you can do some simple standing up, doing some sit-ups, or pushups, or have some light hand weights to lift, can be a routine to follow for a few programs. 

When I am writing I can be sitting at my computer for long periods, which is not healthy. So what I find useful is standing up and walking around for a few minutes. The simple act of standing up and walking around for several minutes every half hour is beneficial in helping the circulation in the legs and I find that I can get back to my writing with a refreshed attitude.

The key to ageing gracefully, and enjoying yourself, is to keep moving. Growing old is not for sissy’s, all those past injuries come back to remind you that you need to slow down. The joints might not be as flexible, and the muscles are not as strong, but you can still get around. The key is don’t stop, keep moving, and by moving you will stay healthy as long as you can.

Loneliness in the Age of COVID 5 (Conclusion with Referrences)

The following is part five of an article written by a friend of mine, Ken who shared it with his community, the Tri-Cities Seniors Action Society, of which I am on the Board.

 

Conclusions

Preventing loneliness in institutionalized persons is at least as important as helping them with personal hygiene. This is especially important during the COVID-19 pandemic when residents are not allowed contact with other individuals to reduce the risk of infection. Implementation of some of the strategies listed in this article requires education of staff members and supply of required items; however, this effort can significantly improve the quality of life of residents affected by pandemic restrictions.

 

Results: What interventions/strategies might support social connection for people living in LTC homes in the context of infectious disease outbreaks like COVID-19?

 

Interventions/strategies to support social connection for people living in LTC homes in the context of COVID-19

·        Opportunities for creative expressions, like art, music or storytelling: COVID-19 Context:

•  Individualized creative activities based on the residents.

personhood; including music & art.

•  Individualized Activity Kits (14-day isolation period); using information from completed personhood tools to put together while the person remains in hospital/community.

•  Challenges: inability to share products; needing to dedicate limited supplies to one resident; the architecture of some LTC homes; staffing.

Exercise:

COVID-19 Context:

•  Using pre-recorded, freely available online videos to assist with instructing residents in one-on-one exercise (with supervision).

•  Building “activity circuits” inside residents’ rooms, incorporating multiple tasks (e.g., bean bag toss, light exercises, folding laundry, etc.).

 

·        Maintain religious and cultural practices: COVID-19 Context:

•   Using telephone or videoconference to connect with a religious community.

•  Offering residents online or pre-recorded videos of religious observances.

•  In Indigenous LTC homes, incorporating traditional wellness practices, such as residents making cedar tea as an individualized activity.

 

·        Garden, either indoors or outside COVID-19 Context:

•  In-Room gardening; use of real and artificial plants.

•  Outdoor vegetable gardening (individual activity instead of a group.

 

·        Visit with pets:

COVID-19 Context:

•  Encouraging families to bring pets to window visits.

•  Continuing community-based pet therapy programs through window visits; visits from some larger animals, like goats and horses.

•  Alternative solutions to incorporate animals: robotic pets.

 

·        Use technology to communicate: COVID-19 Context:

•  Facilitating video calls between residents and their families and friends, mostly using tablets; weekly videoconference schedules, with allocated time (e.g., 45-minutes) for each resident.

•  Creating specific email addresses for families and friends to send emails, photos and videos to residents during times where they could not visit.  Email messages were printed from inside the LTC Home and delivered to the resident and, in some cases, read aloud by LTC Team Members to the resident. Photos and videos were shared via tablets. Initiating ways for residents to use tablets to respond to emails with a short voice and/or video messages.

•   Using projectors and projection systems to engage in interactive virtual activities.

 

·        Laugh together:

COVID-19 Context:

•  Adding joy and humour to window visits, such as with a ‘kissing booth’, games (e.g., tic tac toe with dry erase markers) and parades from local organizations.

•   Using the spaces and activities within homes for fun and enjoyment, such as makeshift ice cream trucks, hallway ‘Happy Hours’ and decorated ‘Tuck Shops on Wheels’.

 

·        Reminisce about people, places and events COVID-19 Context:

•  Involving community-based programs providing virtual programming via videoconference or telephone, such as reminiscence programs on specific topics (e.g., travel, hobbies, etc.) Creating personalized tools for residents; one LTC home developed a ‘Talking Points Key Ring’ for a resident, with laminated cards containing favourite photos, artworks, sayings and conversation topics and that could spark conversations.

 

·        Communicate non-verbally:

COVID-19 Context:

•  Facilitating pen pal programs whereby residents to write to one another.

•  Encouraging letter mail exchange between residents and family and friends.

•  Supporting ‘Friendly Letter’ programs, whereby individuals outside the LTC home would exchange letters with residents, sometimes in collaboration with organizations (e.g., local Alzheimer Society).

 

References:

Strict COVID-19 protocols are leaving seniors lonely, depressed and wondering: Is it worth it? - Macleans.ca

Social connection in residents of long-term care homes: mental health impacts and strategies during COVID-19 (brainxchange.ca)

Social connection in residents of long-term care homes on Vimeo

HOME | Caregivers4Change

 

Loneliness and Isolation in Long-term Care and the COVID-19 Pandemic (nih.gov)

 

Loneliness in the Age of COVID 4

The following is part four of an article written by a friend of mine, Ken who shared it with his community, the Tri-Cities Seniors Action Society, of which I am on the Board.

The following ideas are easy to implement, with little or no cost or hiring additional staff, and can decrease the loneliness of residents in nursing homes or assisted living communities:

·       Have residents and staff wear a plain easily-readable name tag. Wearing a name tag that can easily be read helps to make a connection between the staff and residents.

·       Ask family members of residents who could operate a personal computer or iPad to purchase one to help them stay connected with each other. When the resident has a computer or iPad in his or her room, a Skype or Zoom meeting can be arranged.  These meetings can be coordinated with the activity staff, so they can help set up the computer or iPad. iN2L technology may facilitate online connections.

·       Families may not be allowed to come into the facility; however, they can stay connected in several ways. Ask families to have at least 1 family member call a resident in the morning to say, “good morning,” and another to call late in the afternoon or early evening to say, “good night.” This is assuming that residents have a phone in their rooms and can answer it. If you have residents with no active family members, you may be able to recruit volunteers to call residents.

·       Families can come to the window in the resident's room and sing to the resident or hold signs sending love to the resident. If the resident's room is not on the ground floor, the family can arrange a time convenient for the staff to take the resident to the first floor where the resident can look out a window and see his or her family.

·       Urge families to send cards and letters. Residents also love to receive “artwork” from their grandchildren or great-grandchildren. Letters can include copies of pictures from the past that residents may enjoy seeing again.

·       Group religious services have been discontinued; however, many are now on the Internet or television. The activity staff will have a social history of each resident and will know the resident's religion. If it would be comforting for the resident, staff can make sure the mass or other religious service is on the resident's television or iPad.

·       Some residents with dementia are comforted with realistic toy dogs, cats, or life-like–looking dolls. If a resident develops a fondness for any of them, the family might agree to purchase one. It seems that men particularly like dogs. They can be purchased for less than $20. Stuffed animals or dolls cannot be shared because of infection-control issues. There is also some evidence that robotic animals (robopets) may be effective in decreasing the loneliness of older adults in a residential care setting.

·       Simulated Presence Therapy is another way by which families can keep in touch with a resident. It involves the family member making a recording in which questions are asked, such as, “I remember when you lived in Williams Lake, do you remember what you did with your Girl Scout troop?” Then the recording is silent, so the resident can say something. The recording could be similar to a phone call, in which the family member can ask about pleasant experiences in the past and leave a space for the resident's answers. If the resident has dementia, the recording could be played repeatedly, because the resident will forget that she or he already listened to it. A study found that Simulated Presence Therapy enhanced the well-being of residents with dementia and decreased behavioural symptoms of dementia.

·       The Activity Department might be encouraged to have items that can be sorted, like buttons or small pieces of fabric. Residents can be asked to help sort items and put them into small bowls. The resident sorting buttons must be a person who would not try to eat one, as this would be quite dangerous. Take 3 packs of cards and mix them up and ask a resident to sort them. Make sure the packs are very distinctive, so it will be easy to decide what pack each card belongs in and thank the resident when the task is completed. Nursing home residents often feel hopeless, as rarely does anyone thank them for doing something. This is a great opportunity to have a resident feel as if he or she is needed.

 

Loneliness in the Age of COVID 3

The following is part three of an article written by a friend of mine, Ken who shared it with his community, the Tri-Cities Seniors Action Society, of which I am on the Board.

The National Institute on Aging is tracking COVID-19 and the toll it is taking on retirement homes across the country. Seniors need to be in the home to get the care they need, but for many, it may not be worth the sacrifice of giving up contact with loved ones and caregivers. Health-care providers noted increasing numbers of depression. We're seeing increasing rates of depression, loneliness, social isolation, and that actually can be even more dangerous than never having gotten the virus in the first place. Some people are saying, “Look, I know that I could get the virus and die, but I might rather have that, frankly, than not being able to be with my loved ones for the next six months”. "I think we have to remember that residents have rights," Sinha said. "Their families have rights as well."

 

It's the emotional, mental health of these residents that I think has declined. The limits on physical touch have affected all aspects of life for residents — from tables in the dining room being pushed further apart, to the staff wearing plastic shields, to the end of weekly visits from a hands-on hairdresser. Dementia has increased. Incidents of residents who stop eating while no one is monitoring them have increased.

 

Family members play a critical role in-inpatient care. Particularly in the ICU, where we're dealing with people who are seriously ill, the person themself isn't able to engage with us, so we rely heavily on family caregivers, family members to participate with us in decision making. Excluding family caregivers from that role in acute care causes a lot of problems and distress and sometimes medical errors. The medical system must take a broad view of health to include the emotional, spiritual and mental well-being of patients.

 

Social connection is an important health issue for LTC homes. Social connection is key to the quality of life in LTC homes. Social connection has specific considerations for LTC homes, e.g.,

·        Residents: mostly older adults, many with vision/hearing loss, cognitive impairment, and mobility impairment which can impact social connection;

·        Families: many provide vital social support (e.g., daily, ongoing care);

·        Staff: provide daily support to residents;

·        Homes: communal setting (e.g., meals, group activities);

·        Communities: community organizations and care professionals participate in the life of the home.

 

What mental health outcomes are associated with social connection for people living in LTC homes?

·        Depression 29 (of 35 studies)

·        Responsive behaviours 6 (of 9 studies)

·        Mood, affect and emotions 8 (of 8 studies)

·        Anxiety 2 (of 3 studies)

·        Cognitive decline 2 (of 2 studies)

·        Medication use 0 (of 3 studies)

·        Death anxiety 2 (of 2 studies)

·        Suicidal ideation 2 (of 2 studies)

·        Boredom 2 (of 2 studies)

·        Daily crying 1 (of 1 study)

·        Psychiatric morbidity 1 (of 1 study)

 

Loneliness in the age of COVID 2

The following is part two of an article written by a friend of mine, Ken who shared it with his community, the Tri-Cities Seniors Action Society, of which I am on the Board.

Loneliness has three dimensions. The first is personal loneliness, which is often related to the absence of a significant person like a spouse or partner who provides emotional support and is someone who affirms one's value as a person. The significant someone could be a pet because pet ownership decreases loneliness. The second dimension of loneliness is the absence of a sympathy group, which can include 15 to 50 people who are seen regularly. This may be a card group, bridge or canasta, or another popular game, Bingo, which many retired seniors enjoy. The third dimension is a lack of an active network group, consisting of from 150 to 1500 people, who provide support just by being together in a group. Church services, Rotary meetings and the Lions Club are good examples of these larger groups.

Geriatricians across the country are seeing the effects of months-long restrictions. In Prince Edward Island, where 56 cases of COVID were identified between March and mid-September falls among seniors living independently rose substantially, says Dr. Martha Carmichael, the province’s only geriatrician. “911 calls for falls are up dramatically, and probably just because of isolation and deconditioning that goes along with it,” she says. On the other side of the country in Vancouver, where many of Dr. Nishi Varshney’s patients live independently, the geriatrician is helping them manage mental and physical health concerns born of isolation.

Patients postponed regular home care services when their support workers couldn’t get sufficient personal protective equipment or cancelled the services outright for fear of infection from outsiders. Their visits with family and friends became less frequent, as did trips into their communities. Their health destabilized and deteriorated, she says: “You can’t just quarantine an older person. It’s definitely not healthy for the older person and the concept is not conducive to a healthy society.”

In all countries affected by COVID-19, the message that is being sent by government officials and medical experts is “stay at home” and “isolate in place.” Isolation is especially difficult for people living in nursing homes and assisted living communities. Most facilities have asked that no one enter the facilities unless they work there because there is a high risk that COVID-19 would spread rapidly once it is introduced. Group activities have been cancelled and, in many facilities, residents are eating in their rooms, as all communal dining has been stopped. Although prohibiting group activities will decrease the risk of spreading the COVID-19 infection in nursing homes, it significantly increases the isolation and resulting loneliness of residents.

Long-term care facilities also prohibit visits from outside, including visits by family members. This is especially burdensome for residents with cognitive impairment and dementia. Many family members of these residents visit often, sometimes every day, bring food, and help the residents with eating and drinking. If they cannot visit, they may be afraid that the resident will no longer recognize them.

For years, seniors’ advocacy groups have called for better supports for Canada’s seniors. They want more affordable housing options and better access to care as close to home as possible. They want more acknowledgement of caregivers, many of whom provide life-sustaining acts like feeding, bathing and transporting seniors. They want to see policies that produce truly age-friendly communities that promote the inclusion of older people as productive and engaged citizens. They want an end to the kind of ageism that deprives seniors of their rights to make informed decisions about their lives.

Loneliness in the age of COVID 1

The following was written by a friend of mine, Ken who shared it with his community, the Tri-Cities Seniors Action Society, of which I am on the Board. It is a long paper, and I will present it over the next few days as I consider it to be very interesting and useful information.

Canadians of all ages are carrying out COVID-related risk assessments on their usual activities of living, but the stakes are greater as people age. The virus is more deadly among the elderly: those in their 90s have a 25 percent risk of mortality if infected with the virus. For those in their 80s, it’s 15 percent, and eight percent for people in their 70s, according to Dr. Samir Sinha, director of geriatrics at the Sinai Health System and the University Health Network in Toronto.

At greatest risk in Canada are those living in long-term care, where the mortality rate among people infected with COVID was about 35 percent by May, according to figures from the Canadian Institute for Health Information. By June, four out of five known COVID deaths in Canada were among residents of long-term care homes, although they only accounted for 18 percent of total cases.

 But physical isolation, the mainstay of defence against the virus, comes with its own terrible list of side effects. Older adults who are socially isolated are more likely to become inactive, grow frail, become depressed, and experience advancing dementia or eat poorly. These health consequences are interrelated, with one worsening the other, and can be irreversible or even fatal.

 Social isolation (the objective state of having few social relationships or infrequent social contact with others) and loneliness (a subjective feeling of being isolated) are serious yet underappreciated public health risks that affect a significant portion of the adult population.

 Approximately one-quarter (24%) of community-dwellers aged 65 and older are considered to be socially isolated, and a significant proportion of adults report feeling lonely (35% of adults aged 45 and older and 43% of adults aged 60 and older).

 Loneliness is even more common in long-term care institutions. The prevalence of severe loneliness among older people living in care homes is at least double that of community-dwelling populations: 22% to 42%. A feeling of loneliness has increased the risk of depression, alcoholism, suicidal thoughts, aggressive behaviours, anxiety, and impulsivity. Some studies found that loneliness is also a risk factor for cognitive decline and progression of Alzheimer's disease, recurrent stroke, obesity, elevated blood pressure, and mortality. Lonely older people may be burdened by more symptoms before death and may be exposed to more intense end-of-life care compared with non-lonely people.

Health and Wellness Institute

The following is from the President of Council of Senior Citizens Organization where he talked about the Seniors Health and Wellness Institute, COSTCO. The federal charity, Seniors Health and Wellness Institute-COSCO, was established in 2007. It offers free workshops on a large variety of topics that are of particular concern to seniors, to any seniors group that asks for a workshop.

The first workshop was Falls Prevention. Additional workshops were added over the years. Currently, there are 44 workshops listed on the Society's web site involving healthy living, safety, personal planning, and legal and financial issues. Many of these workshop summaries are offered in) languages other than English. The workshop summaries are offered in Chinese, Japanese, and Punjabi.

Since the Institute was established, we have seen close to 3000 workshops conducted around the province with a total attendance of approximately 50,000 seniors. The workshops are presented by our volunteer facilitators. As a result, of the current Covid-19 virus situation, workshops are presently presented virtually and of the 44 we regularly have, 28 are offered virtually.

COSCO is involved in many other on-going advocacies such the advocacy and lobbying efforts in respect to the establishment of national standards for long term care, in-home care, and a national Pharmacare program.

The workshops now can be delivered to any senior group in Canada or other countries. Visit our webpage, Seniorshelpingseniors.ca  to learn how to book an online workshop.