BY IVAN OOSTHUIZEN
On 11 March 2020, the World Health Organisation (WHO), declared the Covid-19 outbreak a global pandemic. It has since unleashed an unmatched burden of care on health care facilities and it has negatively impacted the general well being of the elderly. Besides the enormous cost’s companies, governments, and operators had to endure to initiate quarantine conditions, implement preventative and immediate treatment protocols, the daily lives, and routines of a large number of seniors have been altered forever.
The world’s big pharma companies, scientists, virologists, geneticists, universities, philanthropists, hospitals, and research teams all committed themselves to find a vaccine as a grave matter of urgency, for the sake of all human beings. We have learnt a lot about the virus since its outbreak, and it has become one of the most sought-after themes in current research proposals across many different academic disciplines. While the world holds its breath for a vaccine, hospitals, doctors, medical aids, nurses, carers, and everyone in between have been desperately playing their gruelling part in keeping patients safe, alive, comfortable, medicated and sadly, comforted during a lonely and inevitable death. The world’s care army truly tested.
Across the globe, countries are in different stages of managing the virus, and in some cases, as has just happened in the UK, second waves of infection have forced additional lock-down regulations and procedures. In other parts of the world, including South Africa, lockdown levels have slowly been eased and economies slowly been restarted while keeping a close eye on the rates of new infections.
It is only now that we are seeing the true toll of the hard lockdowns and social isolation and the impact on the health of our elders. Reports of observable deterioration include decreased mobility, weakened motor functions, reduced cognitive abilities, increased loneliness, depression, and a diminished capacity for social engagement (almost like a social anxiety, likely brought on by social distancing and the absence of typical forms of affection such as hugs, kisses and handshakes).
Is it possible that, in our pursuit of adhering to the vast array of illness management (including our own fears) protocols that we have somehow forgotten about the wellness of elderly residents?
Earlier this year in May, Andrius Baard wrote in a series, published by Ethics of Care, entitled the Corona Times (We Should Also Discuss Quality of Life) about stories from elderly people saying “…I’ve had a good life until now, I cannot and I will not go without visitors and I fully accept the risk it involves…”. Baard further says that “…not having visitors merely inflicts incisive suffering and as such is a lot worse than any risk connected to having visitors. Things could of course turn out wrong, yet receiving visitors fits in with how we wish to live our life and how we choose to relate to our fragility. Death might befall us sooner, yet it will be within a life meaningful to us.”
How do we, as custodians of the care industry, balance the burden of enforcing safety protocols against the human desire (plea) for wellness from our elders? A recent on-line SA Care Forum Conversation Hub entitled “Moving Ahead During and Post Covid19 with Healthy Ageing” (presented by guest speaker Jo Boylan, COO of Southern Cross Care in Adelaide, Australia, a global expert on healthy ageing) a range of insights were offered by Jo Boylan and the participants, on how to re-establish connection and wellness.
While we hold our breath for the release and manufacturing of a vaccine, life goes on within the safety limitations and challenges. Below is a summary of specific areas which could be useful opportunities for health care teams to explore ideas on how to refocus care efforts and improve the wellbeing of our seniors and home residents, particularly where lockdowns and restrictions have now gradually been lifted.
RESPECTING AND PROMOTING INDEPENDENCE
One of the first steps towards re-establishing wellness is to encourage and promote independence. This also means respecting every person’s right to make their own decisions and to act by their own accord. Care homes and health care centres can play a pivotal part in this process of re-engagement by encouraging residents to take small steps and to gradually build up their confidence, to take on the external world again.
Fear can quickly take hold of senior residents and be the cause of minimal or no social contact and may lead to further emotional, cognitive, and physical deterioration. It is here where, through creativity and enthusiasm, caring staff and management can play a definitive role in making sure social contact is not completely amiss within restricted care settings.
REASSURANCE AND DISPELLING FEARS AND FICTIONS
Another critically important building block towards wellness, is to make use, and create opportunities, to dispel fears and remove fictitious perceptions about the pandemic (or any other humanitarian crises for that matter). Rumours, miss-information, conspiracy theories and ridiculous end-of-the world prophecies can quickly become the breeding ground of complete despair and hopelessness. This often leads to mental health issues such as depression, anxiety, and thoughts of self-harm.
By making sure there are free support services such as weekly information sessions, on-site counselling. newsletters, WhatsApp groups, staff and carer training, webinars, and a general sense of openness to voice contentious or worrisome issues, operators, managers, nursing staff and care teams can create an open environment where fear can be addressed before it gets out of hand. Empowering residents and staff with the latest developments and information creates a confident care setting and sows the seeds of hope.
HUMANITARIAN APPROACHES IN THE MIDST OF CARE PROTOCOLS
Mahatma Gandhi once said, “The greatness of humanity is not in being human, but in being humane” and I can’t think of a more fitting quote to underscore this point. Managing the pandemic is important and applying the required health protocols is critical, but we so easily fall into a regimented almost militarised mode of care.
Once we fail to recognise each person as a unique human being, we run the risk of becoming automated, unemotional even, and simply doing for the sake of doing. As an alternative we should again remind ourselves and our care teams to marvel at the sacredness of the carer-resident relationship. How do we stay true to our humanity in a time when no one will blame us for administering care as per the public sector issued protocols? It begins by reconnecting and reminding ourselves of our own values and understanding that how we model those values to those around us, matters. Leaders in the care sector must lead by example and prevent, at all costs, a situation where staff start feeling unappreciated and under-valued. True humanity is modelled, not preached.
THE MIRACLE OF MOVEMENT
Another critical factor that influences social, emotional, and mental wellbeing is being fit and healthy. This means we should keep our seniors moving. Note that movement is not necessarily exhausting physical activity, but rather making small daily gains.
Care teams must use every opportunity to make sure movement becomes part of the daily routines. Exercises can be as simple as lifting both arms in the air for a few seconds, to standing and sitting down a few times (with due consideration for the person’s physical limitations or status of health). The point is that every engagement during the day with a resident is an opportunity for some type of physical activity.
In a lock-down or limited access scenarios, it may be difficult to take residents for daily walks or outings, but there are numerous programs (many of them offered on-line) and courses teaching activities which can also be set-up and offered in-house such as exercises, dancing, chair aerobics, drumming, brain games and crafts. All brief, yet immensely effective physical activities to keep everyone moving. Movement is energy, and energy is never wasted.
UBUNTU AND THE GREATER GOOD
There are numerous examples of paintings, theatre performances, video clips, posts on social media, movies, documentaries and many more, telling amazing stories of how people and communities have taken hands and stood by each other during this pandemic. From blocks of flats applauding at night for the efforts of nursing and caring staff to musicians playing their instruments through loudspeakers for everyone to enjoy.
How often have we not heard the saying, “umntu ngumntu ngabantu” (Xhosa) which means “I am because we are”; the African philosophical principle of Ubuntu. It is the concept of a universal bond of sharing that connects all of humanity. But have we actually seen it in action? I believe we have, and we are continuing to see it unfold in a number of ways. It is our responsibility to make sure we play our part to ensure, as humanity, that we survive this pandemic. There will be other pandemics and we need to learn as many lessons as we can.
One practical way is to create a community network consisting of volunteers offering their expertise in the name of the greater good. Community support is not simply limited to delivering food, making up parcels and providing care, but also includes other forms of support such as safety and security measures, emergency maintenance, taking care of sick pets and serenading to seniors on Christmas day. Let us all play our part in identifying our own special niche in our community and how we can do our bit to make a difference.
Our vulnerability has brazenly been laid bare by the ongoing destruction and death, caused by this pandemic. Our raw desire to feel loved and close to people who love us, has been one of the reasons why we have suffered so intensely, particularly our seniors.
What seems to be in diametrical opposition to each other, is the intergenerational differences in our value perceptions; what matters to the elderly in their senior years is quite different from what a younger generation of health care workers might deem important, especially during a pandemic.
We regularly praise ourselves for promoting quality of life when in practice (such as during this pandemic), that often means quite the opposite. Perhaps we should ask ourselves if it is not high time that the rights of the individual take centre stage, instead of continuing down a path of staged lip-service where “quality of life” is really determined by budget, timesheet, power narratives and commercial perspectives, instead of emanating from the individual.
We hold the keys, and power, to move from illness to wellness, but are we willing to make the effort?
Ivan is a freelance writer and creates custom content for digital and print media. His keen eye for detail, critical research skills and love for storytelling makes him a well read and sought-after craftsman. Ivan has more than 25 years of experience in a variety of industries including Education, Commerce, Defence, Medicine and Executive Management and he can be contacted via email at firstname.lastname@example.org.