When Canada first went into lockdown in March of 2020, there was a collective experience of fear and anxiety. Mundane tasks such as going to the grocery store suddenly felt risky. With the emergence of the novel coronavirus, we all felt vulnerable and isolated. However, confinement at home has also allowed us to realize that, prior to the pandemic, we took a lot of things for granted. Undoubtedly, the social isolation that came with COVID-19 has taken a toll on our mental health. Simple errands leave us questioning whether we were exposed to a virus, which unfortunately is a regular concern for those with a weakened immune system during the usual flu season. Visits with friends and family are now rare treasures, which was not an unfamiliar feeling for those in long-term care or hospice before the pandemic. Both positive and negative, the yin and yang: the COVID-19 pandemic has given us a new perspective - it has allowed us to better understand the experience of those who may regularly be in isolation due to their health or age.
For someone with a weakened immune system, the typical cold and flu season brings fear and anxiety. However, now they have an additional concern since they are considered high-risk for worse outcomes should they contract COVID-19.1 Lately, we can all relate to this feeling, which was normally reserved for those who were ‘vulnerable’ prior to the pandemic. We can now appreciate the concept of ‘risk’ when visiting a family member or friend. Hand sanitizer has become a staple in our pockets and purses, much like it was for an immunocompromised individual before the pandemic. Choosing friends for our COVID bubble is a routine challenge for someone who is vulnerable and needs to limit their contact during cold and flu season. If the COVID-19 pandemic has had an upside, it is that we now have a greater understanding of the fear, anxiety, and worry that accompanies simple activities for at-risk populations. This first-hand experience allows us to empathize with people who are dealing with chronic illnesses on a daily basis, and we can now recognize and acknowledge the compassion they deserve.
The elderly are also considered a vulnerable population to COVID-19 and have subsequently been isolated from their loved ones, particularly those living in long-term care.1 Even prior to COVID-19, older adults living in long-term care centres were more likely to experience loneliness than those living in the community.2 Since March 2020, we have experienced social isolation that is comparable to what seniors in long-term care often lived through on a daily basis even prior to the pandemic. For many residents, visits with family or friends are a treasured rarity. A precious hour-long visit has the power to restore their mood and improve their quality of life. This is now relatable for all of us as we have come to recognize the importance of social interaction and truly cherish time spent with our loved ones.
The pandemic has only further isolated residents in long-term care and assisted living centres. These facilities had no choice but to restrict visitors, cancel group activities, and in some cases even cancel group mealtimes, essentially confining residents to their rooms in order to prevent COVID-19 outbreaks.3 A recent survey of residents and their families in British Columbia revealed the harsh impact of these restrictions.4 The perspectives of residents in the survey suggested that many seniors fear loneliness more than they fear COVID-19. Restricting visitors may have been the only option at the start of the pandemic but it simply cannot continue due to the insurmountable harm to the quality of life of long- term care residents. With our new empathetic perspective, we can better understand this need for social interaction and the impact that it has on the residents’ overall well-being.
Similarly, hospices had to limit visitors at the beginning of the pandemic. In some cases, only one designated visitor was allowed per patient.5 Preventing someone who is dying from being with their loved ones seems, quite frankly, inhumane. People with life-limiting illnesses deserve to spend their final moments surrounded by family and friends. Not only is this important for the person who is ill, but it is essential for their loved ones to positively cope with the grieving process. Although there are necessary precautions required to reduce the risk of a COVID-19 outbreak within healthcare centres, there is no doubt that restricting visitors in hospice is detrimental to the well- being and mental health of patients and their loved ones. The Canadian Hospice Palliative Care Association has requested a more compassionate approach.6 Implementing safety measures and COVID-19 screening at hospices, in order to allow more visitors, is a necessary solution to save families from irreparable heartache. While this new compassionate strategy may be more cumbersome than the current approach, our own pandemic experiences of social distancing and isolation should demonstrate its immense value.
We cannot deny that the government guidelines have been effective at flattening the curve and preventing a more dire situation. Yet these restrictions have had unintended consequences on our mental health and well-being. It may seem reassuring that we are all in this together, yet it is clear that the pandemic has impacted everyone in unique ways. No two experiences are alike. A popular post on twitter by writer Damian Barr exemplifies this concept:
“We are not all in the same boat.
We are all in the same storm.
Some are on super-yachts.
Some have just the one oar.”
Barr’s full poem, published in The Wall Street Journal,7 emphasizes the importance of perspective during the pandemic. We have been given a brief insight into the daily challenges of those with a chronic illness, or the elderly living in long-term care centres. We now understand the positive impact social interactions have on our mental health. There are many simple acts of kindness, such as a virtual visit with your immunocompromised friend, or running an errand for your elderly neighbour that could provide them with the support they need during isolation. Moving forward, we can choose to use this new perspective provided by the COVID-19 pandemic and live with more empathy and compassion for others.
References:
1. Public Health Agency of Canada. Vulnerable populations and COVID-19 [Internet]. 2020. Available from: https://www.canada.ca/en/ public-health/services/publications/ diseases-conditions/vulnerable- populations-covid-19.html
2. Victor CR. Loneliness in care homes: a neglected area of research? Aging Health. 2012;8(6):637–46.
3. Centers for Disease Control and Prevention (CDC). Preparing for COVID-19 in Nursing Homes [Internet]. Coronavirus Disease 2019 Infection Control. 2020 [cited 2020 Nov 13]. Available from: https:// www.cdc.gov/coronavirus/2019- ncov/hcp/long-term-care.html
4. Office of the Seniors Advocate British Columbia. Staying Apart to Stay Safe: The Impact of Visit Restrictions on LongTerm Care and Assisted Living Survey [Internet]. 2020. Available from: https://www.seniorsadvocatebc. ca/app/uploads/sites/4/2020/11/ StayingApartToStaySafe-Report.pdf
5. Weidner J. COVID-19 restrictions in hospice change feeling of home. Waterloo Region Record. 2020 Apr 28;
6. Canadian Hospice Palliative Care Association. Canadian Hospice Palliative Care Association calls for more compassionate visitation protocols during COVID-19 pandemic. 2020 May 21;
7. Noonan P. What Comes After the Coronavirus Storm? Wall Street Journal [Internet]. 2020; Available from: https://www.wsj.com/articles/ what-comes-after-the-coronavirus- storm-11587684752
Edited by Emily Vecchiarelli & Emily Mastragostino