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President's Message

IPA Bulletin: VOLUME 37, NO. 1 • JUNE 2020

William Reichman, IPA President

Dear Colleagues and IPA members,

Life in a Pandemic

Across the world, the COVID-19 pandemic has physically distanced us, but it has also brought us even closer together through a shared sense of angst, bewilderment, apprehension and fear.  The personal and work-related demands that so many of you have been facing must at times feel overwhelming. You understandably have concerns for your own welfare and safety and for the wellbeing of your families, friends and similarly devoted colleagues at work. Most certainly, we individually and collectively have been doing our best to support the physical, cognitive and psychological wellbeing for those especially vulnerable older patients we have dedicated our careers to serve. Many of us work in healthcare settings that are experiencing tremendous operating, staffing and financial pressures as we do all possible to prevent and contain outbreaks of illness. There are also the financial uncertainties that so many will face with the effect of this pandemic on our local, national and global economies.

One thing remains clear to me; this comparatively difficult time in our personal and professional lives will get better. Depending on where we live and work, it could be a matter of weeks, or some months, or even a year, before things start to feel more normal again. Most of us will ultimately return to the safety and comforts of our prior lives; others to the pre-pandemic personal and work-related stresses they were already living under. However, each of us, in our own way, will go on and continue to make the most of what we have and what we can contribute to the greater good of society. This is what moved us to pursue the life work we chose as clinicians, researchers and educators—to help others.

Another thing is clear to me; in many places around the world, the pandemic has exposed with great clarity, the particular vulnerabilities of the older adults we serve and striking weaknesses in the existing societal approaches that have been applied to support their needs. While we have known that social isolation with resultant loneliness undermines the physical, cognitive and emotional health of too many older adults, this has been remarkably intensified by the forced physical distancing measures implemented across the world to prevent COVID-19 transmission. Great numbers of older adults have been cut off from their families and their communities. Access to senior-friendly transportation to secure food, medications, social supports, healthcare and other essentials is a chronic problem in many societies. It has been made especially worse by the restrictions imposed to address the pandemic.  In graphic display, especially here in North America, the failures of our long-term care system have revealed some gruesome truths. Congregate senior care settings, such as nursing homes, have proven to be the most vulnerable settings for disease outbreak. They are the epicentres for pandemic related deaths. That this has occurred in long-term care facilities reflects the particular vulnerability of frail older adults to succumb to infectious disease threats. We have been confronted with the very real hazard of transmission when such individuals live in close quarters to one another. We must face the harsh reality, which in too many of these congregate care settings, there is an inexcusable lack of sophistication in infection prevention and control (IPAC) policies and procedures, poor access to personal protective equipment, and inadequate numbers of suitably trained staff.  The physical environment of care facilitates disease transmission. The impact of the pandemic has been especially challenging in the care of older adults with dementia and has heightened the great burden so many family and professional caregivers’ experience. Social distancing measures have made it very difficult to provide community-based in-home dementia and related day care, and have led to an increasing sense of isolation and boredom for patients and their care providers. In congregate residential care and hospital settings, being able to protect staff and patients from viral exposure has been especially difficult in the care of individuals with dementia.

As a result of the challenges the pandemic has highlighted, there will likely be, in many jurisdictions around the world, a more fervent call for re-examining a host of issues that could impact our field and daily work. Here in Canada, where I work and reside, the pandemic has greatly accelerated our efforts to provide virtual health care and technology-enabled social supports. In my own organization, Baycrest, due to public health social distancing mandates, families have been largely physically unable to visit their elderly loved ones in our residential settings or our hospital. As a result, we have rapidly deployed technology to enable “e-visits” with family and friends and have substantially enhanced our ability to deliver virtual healthcare services across practice settings. Additionally, we have invested much more effort in providing our older adult patients and our long-term care residents’ access to internet-based, virtual congregate and individual recreational and social programming. In the pre-pandemic period, we talked about doing these desirable things to enhance the wellbeing of those we serve. But, the substantial restrictions imposed by the pandemic made these new efforts immediately mandatory. While the pandemic has clearly caused us problems, we sought positive opportunities to exploit. As an organization, we are uniquely fortunate to have had some access to funding to quickly build up this capacity. Too few others around the world have such capabilities, but they should.

I am hopeful that our experience of the pandemic will lead to a more serious and productive conversation at policy tables around the world to combat ageism, and to provide more creative and effective approaches to meeting the needs of frail and vulnerable older adults, in part, by the broader adoption of more virtual care and related technologies. I am also hopeful that in many societies, especially here in North America, we will devote many more resources to support community-based care, lessen our reliance on large congregate care settings such as nursing homes, and commit to improved training and remuneration for those who dedicate their careers to the care of older adults.  As we contemplate the construction of new residential and healthcare facilities, I suspect we will see much more emphasis on environmental designs that support more virtual support and are better equipped to contain communicable disease outbreaks.  Lastly, across the world, I suspect we will reconsider our pandemic planning efforts to strengthen our responsiveness when another similar event occurs.

During this pandemic, IPA has stayed focused on providing our members with updated web resources to assist you in your work. In addition to an IPA COVID-19 webinar, we have also been working on a very special pandemic related issue of our journal, International Psychogeriatrics.  As you have likely heard, our next IPA Congress will be a virtual live meeting over two days in October. For those unable to participate during the live sessions, the meeting’s contents will be recorded and available online and can be accessed for CME credit at the time of your choosing. I urge you to continue to support IPA through your membership and participation in our varied activities so that IPA can best assist you.

I wish each of you and your families, friends and colleagues the very best health and wellbeing during these unmatched times in our professional and personal lives. Of course, I wish the same for your patients. Let’s learn all we can from our experience with the pandemic and commit ourselves to applying its lessons in the future to improve how we deliver healthcare to our older adults and best support their families. As always, please feel free to reach out to me via email with your comments, concerns or suggestions.

Please accept my Best Wishes and Kindest Regards,

William Reichman

Acknowledgements

Acadia Pharmaceuticals Otsuka Pharmaceuticals Cambridge University Press Avanir Pharmaceuticals
CORPORATE COUNCILS