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9 BEST QUESTIONS ANSWERED

Here are some of the most common questions caregivers have asked during the pandemic. We hope these experts, answers will help you.

Q: Is it safe for me and my children to visit older adults in our family during this time?

Everyone should be aiming to interact closely with as few vulnerable adults as possible to be on the safe side. Make your “bubble” of a few people and stick with it. Reducing the number of people an older adult comes into contact with reduces the risk. However, the goal isn’t to isolate your older adult either. You may want to arrange short social distancing visits, one person at a time, keep up regular phone or video calls and continue shopping for them. Check out this helpful guide: https://files.ontario.ca/moh-how-to-build-your-social-circle-en-2020-06-12.pdf

Q: What precautions should I take when I’m visiting an older adult’s home?

Bring as little as possible into the house and practice good hygiene.

  • Wear a mask and gloves at all times and change regularly if you are providing physical care/assistance.
  • Wash your face, hands, and forearms and wash your hands regularly during your visit (remove jewellery).
  • Remove your shoes and wear indoor slippers.
  • Clean your cell phone with a 70 per cent alcohol wipe or put it away.
  • Leave your belongings in the car or near the door, limiting their contact with the rest of the home and shower/change your clothing if you feel your adult is at risk.
  • Pull back your hair to reduce the likelihood that you’ll need to touch it or that it would brush against your older adult.
  • Avoid physical contact and stay two metres apart.
  • If possible, conduct the visit outdoors (porch, yard). If not possible open some windows to improve air circulation.
  • Sanitize before leaving the car and upon re-entering the car.
  • If possible, limit the duration of the visit to 15-30 minutes (guideline for visits to MD offices is currently to keep them under 15 mins).

Q: Do I need to sanitize food and supplies before putting them away or using them?

Items from stores have been touched by many people and could potentially carry the virus, which can live for up to 3 days on surfaces like plastic and steel. Items that have been packed or delivered by grocery services have also been handled by other people. Later at home, lingering germs could be transferred to your hands.

This article from Consumer Reports contains useful information from infectious disease experts and specific suggestions on how to clean and disinfect groceries and other household goods that you’ve purchased or had delivered. For most items and surfaces, washing with soap and water can break apart the COVID-19 virus’ cell walls and kills it.

Q: What’s the proper technique for washing my hands to reduce the spread of infection?

  • Step 1: Wet hands with warm water.
  • Step 2: Apply soap.
  • Step 3: Wash hands for at least 20 seconds (including your palms, back of each hand, between fingers, thumbs and under nails).
  • Step 4: Rinse well.
  • Step 5: Dry hands well with paper towel.
  • Step 6: Turn off tap using paper towel.

Source: https://www.canada.ca/en/public-health/services/publications/ diseases-conditions/reduce-spread-covid-19-wash-your-hands.html

Q: How do I disinfect my older adult’s home to prevent the spread of viruses?

Coronaviruses are one of the easiest types of viruses to kill with the appropriate disinfectant product when used according to the label directions. Health Canada has published a list of hard surface disinfectants that are likely to be effective for use against COVID-19.

Although they do not claim to kill COVID-19, cleaners can play a role in limiting the transfer of microorganisms. Health Canada recommends cleaning high-touch hard surfaces often, using either regular household cleaners or diluted bleach according to the label directions.

These surfaces include: toilets, phones, electronics, door handles, bedside tables and television remotes. This bleach solution should be prepared according to the instructions on the label or in a ratio of 250 mL (1 cup) of water per 5 mL (1 teaspoon) of bleach. Directions are based on bleach that is 5% sodium hypochlorite, to give a 0.1% sodium hypochlorite solution. Never mix bleach with other chemical products and use it in a well-ventilated area. Special precautions must be used when cleaning with bleach to avoid serious incidents.

Q: When I go out to shop for food, can I take advantage of special services?

Yes. A lot of grocery stores have created special shopping times for seniors and people with underlying health conditions that compromise their immune system. However, whenever possible, utilize home delivery or instacart pick-up. A lot of stores have implemented both shopping and delivery services to help their customers stay safe.

Q: Do I have to wear a face mask when I go out?

Yes, you should wear a homemade mask or cloth face covering when you are in public. This is in addition to maintaining a six-foot (two metre) distance from other people, another essential step in slowing the spread of coronavirus. Many areas are now making wearing a mask mandatory in public places. Check your local rules but err on the side of caution and wear one anyway.

Q: Should grandparents be visiting with grandchildren right now?

Create your bubble and stay in it. For many families this is including kids and seniors. However, many doctors and other medical professionals are recom- mending that grandparents who are vulnerable shouldn’t visit with their grandchildren right now. Remember many people show no symptoms and older adults are at high risk of becoming severely ill if infected with COVID-19.

Q: My dad is quite ill and has an in-home caregiver who goes to care for him every day. What kind of precautions should they be taking?

It’s a scary time because older adults are at higher risk for developing severe illness if they’re infected with COVID-19. But they also need a
great deal of personal care in order to get through the day. Staying six feet (two metres) away or avoiding personal contact is simply impossible.

Every care situation is different, so what makes sense for one may not work for another. Reduce risk by following Canada.ca’s recommendations for high-risk individuals. Take time to learn the facts and take time to prepare. Educate staff about ways to prevent the spread of COVID-19 by:

  • Washing hands often with soap and water for at least 20 seconds, especially after using the washroom and when preparing food. Use alcohol- based hand sanitizer if soap and water are not available.
  • Increasing access to hand hygiene and cough etiquette supplies (e.g., alcohol-based hand rub, soap, paper towels, tissues, waste containers).
  • Cleaning frequently used spaces, surfaces and objects (kitchens, common areas, dining areas, desks, shared sleeping spaces, doorknobs, and faucets).
  • Maintain physical distancing, keeping at least two metres from other people.
  • Staying home when sick.

SELF-CARE FOR CAREGIVERS

BY CRYSTAL GONDER

At the best of times, caregiving, while rewarding, is also a difficult, stressful, exhausting and often thankless job.

As COVID-19 has turned all of our lives upside down, caregivers can feel more isolated than ever before and without access to many of the resources they depend on. From caregivers with aging parents and children at home, to essential workers worried about exposing vulnerable loved ones, to families overwhelmed in quarantine, the coronavirus is stretching our carer community thin.

If you’re a caregiver tackling daily demands during this pandemic, it’s likely that you are at the very bottom of your priority list. It is always a challenge to find the time and energy for self-care, but when your needs are taken care of, the person you are caring for will benefit as well. Here are a few tips to help you feel a little more calm, healthy and in control during the pandemic:

Stay connected

While we must be physically apart, social distancing does not mean being alone. In moderation, Instagram, Facebook, Twitter and other social media sites can be positive ways to stay in touch, and video conferencing apps like FaceTime, Zoom and Skype may provide the face-to-face connection we are all craving. Use these platforms to play games, listen to music, watch a movie, eat a meal or even have a dance party together with someone outside of your home. If you feel overwhelmed by these technologies, there are a lot of easy-to-follow tutorials online that can help. Checking in on a neighbour or another parent or two from a safe distance, sending a hand-written note or making a phone call are other ways to create a sense
of connectedness.

Limit information overload

The constant media coverage of the coronavirus may be adding to your anxiety and distress. As a caregiver, staying informed and up-to-date
is important to help keep your family safe, but it’s a good idea to set boundaries. Rely on a few trusted sources like canada.ca/coronavirus, your provincial health department or health professional, read updates only once a day and aim to limit social media.

Prioritize your health

The worry and lack of structure that we are all experiencing can make healthy choices difficult. Try your best to eat balanced meals, get lots of sleep and be active every day. Going for walks, exploring free online workouts, taking long baths or meditating will help boost your mood and reduce stress. You can still binge watch your favourite TV show and eat too much ice cream, but be thoughtful and intentional about how you are treating your body.

Find your joy

During this quarantine, if you find you have a little extra time, consider taking up hobbies and activities you enjoy or are interested in. Get out a puzzle, learn to bake bread, finish that knitting project, listen to podcasts, do crosswords or paint a watercolour. Even in short bursts these activities can help take you away from daily concerns. There’s also exciting content online like the Vancouver Aquarium or Calgary Zoo live cams, The AGO from Home online collection or Stratford Festival plays to help you escape the confines of your home. But, don’t feel any pressure to use this time to learn new things and improve yourself—you may just be in survival mode and that’s okay too!

Unite with parents

Whether you connected with a support group prior to the pandemic or not, it’s more important than ever to find people who understand what you are going through. The Ontario Caregiver Organization and Canadian Caregiver Network both offer online caregiving communities to remind you that we are all in this together. Similarly, reaching out to other carers in your life to
talk openly about how the virus has affected you can create both a support system and human connection.

Get help

If you are isolating with your loved ones—while you may be the primary caregiver—there are ways for family and friends to help. Ask someone to pick up groceries, medications or run errands, organize drive-by visits and accept any offers for meal drop offs. This is an extraordinary situation and really tough, so be honest with yourself about how you are doing. If you are struggling, teletherapy is now covered by most extended health plans. Otherwise, there are many free, online mental health services available including: Big White Wall, The Canadian Mental Health Association’s BounceBack and Anxiety Canada’s app Mindshift.

No one knows for sure how long this will last, and the uncertainty may be the hardest part of the COVID-19 crisis. During these difficult times, take things one day at a time, set realistic expectations, be kind to yourself and try to focus on what matters.

Crystal Gonder is the Communications Consultant for VHA Home HealthCare.

LOVE DURING ADVERSITY

IS A POWERFUL COMBINATION

BY AL ETMANSKI

I’ve noticed three different states of mind related to COVID-19.

  1. OMG this is a disaster. Somebody, anybody, please do something.
  2. The people in authority are best positioned to tell us what to do.
  3. The situation is unprecedented. No one is completely sure what to do. We are all in the same boat.

It’s easy to spend too much time inside the first mindset, to get stuck in the bog of fear, panic and desperation and to spin one’s wheels. Rationing your media is a good idea.

The second is both true and not true. It’s important to pay attention to what the experts and scientists say. Their advice is indispensable. However they,
like everyone, are in a state of active learning. The ground is constantly shifting. New discoveries are emerging daily.

The third response requires us to keep our thinking caps on, to exercise our own good judgement, to spot the gaps, to pay attention to who and what is being ignored, to join with like-minded others; and to act. To act with confidence and courage. Even though we are not completely certain we are doing the right thing. It’s risky. That’s why acting alongside caring for others is critical. It makes us smarter.

Here is a key finding from those involved in previous outbreaks, and crises (ebola, SARS and forest fires). Every encouragement should be given to local, creative, adaptive problem solving. Authorities should listen carefully to information from below about what would help to make a difference. Love and adversity is a powerful combination.

To illustrate, here is an excerpt from my new book, The Power of Disability. I titled it, Breathing Love into Zika: In the lead-up to Brazil’s 2016 Summer Olympics and Paralympics, the world’s gaze was fixated on what the media described as the horror and tragedy of congenital Zika syndrome (CZS). They portrayed Brazilian parents and their babies as grieving victims. They used the images as a backdrop to discuss the herculean challenge that Western science has to over- come to eradicate the virus. In doing so, the journalists missed another gaze—the look of love in these same parents as they fussed over their babies.

They also missed the determination of Brazilian parents, particularly moms, to rise to the occasion. These parents consider their children a blessing even though they face tough challenges and strains, including the demonization of their babies. They know that science and technology can’t solve every problem, and that they distract attention and deflect resources that should be available to support these families.

Brazilians with disabilities and their families receive limited government support. So a group of mothers who have had babies with CZS created United Mothers of Angels (UMA) to share information, referrals, and treatment, and to make sure their children are not forgotten. They call each other guerreiras (warriors). Germana Soares is their leader.

“We are protesting so that this generation of special needs children will not be rendered invisible. Our babies are citizens, they have rights, and while they cannot speak we are their voice,” she said in an interview. Germana’s son Guilherme has already exceeded the predictions of doctors. He is starting to speak. “He has a really strong personality, he is very strong-willed,” said Soares. “He knows what he wants and when it’s a no, it’s a no. Debora Diniz, a Brazilian anthropologist and lawyer, and author of Zika: From the Brazilian Backlands to Global Threat, described these mothers in an interview as “the domestic scientists who have been key in advancing our understanding of CZS.” She said they are guiding the “white coats and
biomedical groups.”

Stay Home. Stay Connected. Stay Cheerful. And if you are looking for something to read…

Photo of Al Etmanski.

Al Etmanski is the co-chair of Minister Qualtrough’s Advisory Group, a writer, community organizer and social entrepreneur.

IN THE NEWS

BY JEN GIANG

HELP FOR EVERYONE EXCEPT US

Findings from a COVID-19 survey by Independent Living Canada done in May of 2020 focused on the concerns of people with disabilities, staff and volunteers at 24 Independent Living Centres across Canada. Most of the 325 respondents, (50% PWD’s), had grave concerns for personal well being and managing their financial obligations.

The PWD’s were twice as worried about health threats and social isolation. 91% were concerned about transmission and 2/3 felt they were at risk
of not being able obtain grocery supplies or having enough money for food and rent. Within the 80 percentiles of those who expressed concern, over 2/3 were very concerned about:

  • Not having access to PPE.
  • Not having the right or ability to be immediately tested.
  • Not receiving the same level of medical treatment if they were to be hospitalized for COVID-19.
  • Not being consulted like others about being treated for COVID-19.
  • If a choice had to be made, they would be chosen to die.
  • 81% feared not being about to visit the doctor or obtain a normal supply of prescription drugs, thus increasing both co-pay and pharmacy visits.

Full findings: partickcurran@ilc-vac.ca

Cartoon of a toilet.

FLUSHING ISN’T THE ONLY RISK

Before answering nature’s call, experts suggest that you should know your risks and take precautions. According to author Sarah Gibbens, in her recent article, using a public toilet may place you at increased risk given research that suggests that toilet plumes launch germy droplets into the air.

Citing a June study released by from researchers in China who talk about coronavirus-laden particles which are “flung into the air by the watery vortex inside a toilet bowl”, Gibbens suggests that many questions remain about the ‘toilet plume effect.’ Some experts she spoke to believe that there is indeed a likelihood that COVID-19 can be spread by bowel movements leading to accidental consumption of virus particles, a process called fecal-oral transmission.

Alongside a discussion about the real riskiness of restrooms, Gibbens is thoughtfully suggests what readers can do to protect themselves venturing into expert advice that includes: improved public washroom ventilation
with exhaust fans that are always running, more rigorous personal hygiene hand-washing techniques, wearing a mask in the restroom, install lids on toilets and even the recommendation for a new toilet design where the lid is automatically put down before the toilet begins flushing.

Source: National Geographic.

Man with a huge smile holding one arm out to his side and the other hand making the “okay” sign.

FINE BUT CRAVING CONNECTION

Canadians are anxious and crave real connection but in true Canadian nice-guy style, they still say they are doing fine.

Despite the fact that they are feeling more negative emotions than positive ones these days, (63% negative to 37% positive), when asked, “how they are?” 77% of those questions, say, “they’re doing fine.” According to Canadian Mental Health Association data, released to mark Mental Health Week, Canadians feel more isolated than ever, up eight points in just one month, and 2/3 crave real, meaningful social interactions in their daily life.

The materials presented suggest that even prior to the global pandemic, loneliness was already a major problem and a public health concern. “Most people want more social connection yet they are reluctant to have the kind of honest, open conversations that build the connections they crave says Margaret Eaton, national CEO of CMHA. “In our society it’s a culture norm to ask people how they are doing but not to expect, nor provide a truthful answer. This mental health week it’s time to get real about how we feel. Its clear we need each other more than ever”, she says. “Social connection
will help us recover.”

Source: Cmha.ca

FAMILY CAREGIVERS

RETURNING TO THE WORKPLACE DURING COVID-19

BY CRYSTAL GONDER

Following months of quarantine, with regions across the province entering a new phase of re-opening, many family caregivers are experiencing increased fear and anxiety as restrictions ease.

If you are a primary caregiver returning to the workplace or looking for employment, potentially exposing your vulnerable, aging, or ill loved one to the virus can be very distressing. Similarly, if you put in-home services on hold, or your loved one’s care needs have changed, you may be reluctant to welcome home care providers—nurses, personal support workers, rehab therapists—into your (or your loved one’s) home.

We spoke to VHA Home HealthCare to learn more about what home care organizations are doing to keep their staff, service providers, clients and families safe, to help you confidently decide what is best for you and your family.

VHA Home HealthCare (VHA) has been closely monitoring the COVID-19 situation and is carefully following the guidance of Public Health Ontario, including the regularly updated Infection Prevention and Control (IPAC) standards for home care. VHA cannot speak on behalf of other home health care organizations. The information below reflects the procedures in place for VHA Home HealthCare and its staff and service providers.

Home health-care as an essential service

Long-term care facilities and other congregate living settings have been hit particularly hard by the COVID-19 pandemic. Recent data from the National Institute on Aging shows that 82 per cent of corona- virus deaths in Canada have occurred in nursing and long-term care homes. The safest setting to receive care is often in one’s own home and this is even more true now as older adults and those with chronic health conditions are more vulnerable to COVID-19.

The top priority for home care organizations is keeping clients, families, staff and service providers protected. Infection prevention and control measures are a critical part of regular procedures, and like all health and community care providers, home care has adjusted to meet the need for even stricter health and safety measures and to quickly respond to public health recommendations during this time.

The safest setting to receive care is often in one’s own home and this is even more true now as older adults and those with chronic health conditions are more vulnerable to COVID-19.

What can I expect from my care provider?

Physical distancing is particularly challenging in home care, with many tasks that require close contact such as bathing, grooming and feeding. To continue to provide these services and also keep everyone safe, staff and service providers are required to:

  • Self-screen for symptoms every day and stay home if they are sick.
  • Screen clients prior to every visit.
  • Perform frequent and careful hand hygiene.
  • Keep a distance of two metres or six feet from others, whenever possible.
  • Wear a mask when they are providing care and can’t physically distance. Many care providers also wear a face shield when providing close care.
  • Use full personal protective equipment including gloves, gown, mask and face shield when providing care for anyone who has any symptoms of COVID-19.

Some home care services can also now be provided virtually, by phone, or by videoconference. Talk to your service provider to see if this is available in your situation.

An illustration of grocery store shoppers practicing social distancing.

What can I do to protect my family during and after visits?

Infection prevention and control is a joint responsibility and we all play an important role. It is a good idea to question and screen everyone that comes into your home. You are also welcome to ask your service provider about their organization’s infection control protocol—they should be happy to review these efforts with you.

Practicing good hand hygiene is the most important thing we can all do to keep ourselves safe. Wash your hands often with soap and water for a duration of 20 seconds. You can also use alcohol-based hand sanitizer if hands are not visibly soiled. It is also a good idea to regularly clean and disinfect frequently touched areas such as phones, light switches, door knobs, appliance handles, keyboards, toilets and sinks.

Can I ask my service provider to have a COVID-19 test?

Many home care organizations support testing as an important strategy to fight the spread of COVID-19 and have been involved in advocating to make testing widely available. Testing is currently available for:

  • All people with at least one COVID symptom, even if it is mild.
  • People who are concerned that they have been exposed to COVID-19.
  • People who are at risk of exposure to COVID-19 through their employment, including essential home care workers.

Currently, testing is voluntary and an individual’s test result is confidential personal health information that is shared only at the discretion of the individual. Workers do not have to share personal health information with their clients. It is also important to know that testing provides a “one-point-in-time result” and what a test shows today may not be the status tomorrow or the next day. While testing is a crucial part of limiting community spread, infection prevention and control education, symptom screening,
physical distancing, environmental cleaning and especially good hand
hygiene are also important ways to prevent transmission.

Can I request that my home care worker wear a mask?

Clinical evidence indicates thatCOVID-19 is contact/droplet spread, which means it is spread through direct and indirect contact and through respiratory droplets from actions such as sneezing and coughing. While physical distancing assists in controlling spread, keeping six feet or two metres apart can be difficult due to the nature of health care work.

For this reason, the use of personal protective equipment is important for staff and client protection and to minimize anxiety. Many home care organizations require service providers to always wear a mask when they are providing close client care (within six feet or two metres) and the use of face shields is also recommended. You and your loved one are also welcome to wear masks during your home care services.

Illustration of and older woman and an older black man holding a cane. Both are wearing masks.

Can I request that we only have one service provider?

Due to the nature of home care and the shortage of home care workers, it is often not possible for home care organizations to have only one service provider visit each client. Efforts are made to have the same workers regularly visit clients as this has many benefits, but the complexity of travel, caseloads, childcare demands and individual care needs can make this challenging.

What can I do to protect the person I am caring for if I am no longer able to isolate at home?

It can be overwhelming to resume travel on public transportation, share a workspace and be in regular contact with other people, especially when you are caring for a vulnerable loved one. These precautions will help minimize your risk of exposure:

  • Monitor your health and watch for symptoms of COVID-19 including:
    • Fever
    • Cough
    • Shortness of breath
    • Unexplained fatigue
    • Headache
    • Difficulty swallowing
    • Unexplained runny nose
    • Unexplained nasal congestion
    • Sore throat
    • Diarrhea
    • Chills
    • Conjunctivitis (or pink eye)
    • Decreased smell or taste
    • Nausea or vomiting
    • Abdominal pain
    • Sudden non-itchy rashes (in children).
  • If you have symptoms, self- isolate and stay home. Call Telehealth, your local public health unit or primary health care provider.
  • Practice good hand hygiene. Wash your hands often with soap and water for a duration of 20 seconds. You can also use alcohol-based hand sanitizer if your hands aren’t visibly soiled.
  • Continue to practice physical distancing as much as possible during your commute and in the workplace.
  • Wear a mask when keeping your distance from other people is a challenge (follow guidelines).
  • Avoid touching your face.
  • Practice proper respiratory etiquette. Sneeze or cough into a tissue or the bend of your elbow.
  • Practice good environmental cleaning. Clean and disinfect frequently touched surfaces regularly, including phones and keyboards.
  • If possible, aim for one person at a time in elevators, bathrooms, kitchens and common areas, or allow for at least six feet of distance while in motion.
  • Wait on stair landings for safe passing in stairwells and avoid hallway meetings/chats.

As recommendations continue to change rapidly, your home health care organization and care provider will keep you updated if there are
any changes to infection prevention
and control practices.

Crystal Gonder is the Communications Consultant for VHA Home HealthCare.

COPING IN DIFFICULT TIMES

It is moments like these when we need all the resilience we can muster to lighten up our hearts and minds, maintain our core values and keep moving forward during COVID-19 return to work. Our editors have pulled together a few ideas from experts that we hope will help you avoid the hurdles and keep your chin up:

1. Don’t get knocked down: There’s a thing called negativity bias that sets in before we know it. A single newscast or critical comment can knock the wind out of us very quickly.

Wise advice: Pause and refocus. Take a moment to appreciate something calming, sweet or beautiful. Try a morning photo of someone or something that makes you laugh or smile.

Result: By refocusing your attention it helps you shift away from negative stressful thoughts.

2. Avoid going it alone: Hard to do while social distancing, but isolating yourself is a surefire way for most of us to start feeling blue.

Wise advice: Reach out to others. But, rather than comparing and despairing start and finish conversa- tions on a positive note. Greet a person with a positive comment. Say something happy, grateful, friendly or funny to set the tone and energy of your conversation.

Result: When you stay in the moment and carry optimistic messages you’re more likely to excel and feel more energetic.

3. Feel like time’s a-wasting? Right now it might feel like we’re spinning our wheels or going in the wrong direction.


Wise advice: Topple this hurdle by finding a purpose. Think carefully about how you’re spending your time, what drives you and develop a multi- faceted home/work/relationship to-do list that helps you prioritize and find balance.

Result: Your self-esteem will remain intact because you’ll feel worthwhile, even if the task list is different than normal.

4. Too much change to deal with? Right now things are somewhat chaotic and it’s hard to stay grounded.

Wise advice: Set aside time to disconnect from social, email, telephone, even if its just for ten minutes. Practice 5-3-1-1. At any time of day:
take five deep breaths, think of three things you’re grateful for, smile one real smile and set one new intention.

Result: A calmer, less anxious you who’s ready willing and able to handle what life is dishing out.

FYI

WHAT YOU NEED TO KNOW

Rules to care by

  • Be a good listener. Try to stop what you are doing, no matter how important it is, and listen to what your love one says. Talking may be your loved one’s greatest need at the moment.
  • Be trustworthy. Do not gossip about your loved one with the rest of your family or friends. Respect your loved one’s privacy.
  • Be dependable. Do what you say you are going to do, when you say you will do it.
  • Don’t be fooled by anger. Remember your loved one may be angry at their illness not at you. Don’t take anger personally or let it affect your caregiving.
  • Manage your emotions. Arrange a break if you are tired or grumpy. Talk to a family member, friend or your doctor to recommend counselling.
Two doctors in PPE looking over an older female patient with a respirator.

Alarming triage protocols

ARCH Disability Law Centre recently raised significant concerns about a draft document called the Clinical Triage Protocol for Major Surge in COVID-19 Pandemic, from Ontario Health. This document first released in March is meant to help doctors make difficult decisions about who will receive critical health care during the COVID-19 pandemic if there are not enough medical resources. ARCH has been working closely with disability rights groups in different ways to ensure that if such a document is ever needed, that persons with disabilities will not be disproportionately and discriminatorily impacted.

archdisabilitylaw.ca

Career Re-boot?

Stylish man with dwarfism in a wheelchair.

After months of maneuvering through the coronavirus crisis, nearly half of 500 office employees surveyed are rethinking their careers. Online interviews also showed that employees in this group:

  • Were 60 per cent more motivated to work for a firm that values its staff during unpredictable times.
  • Almost 50 per cent more likely to prioritize. their personal life over their job in the future.
  • 1/3 more likely to look for a more meaningful or fulfilling position.

COVID-19 True or False?

A near-constant stream of news, sometimes contradictory, can cause anyone to feel lost and distressed. Make sure to use reliable sources such as
the UNICEF and the World Health Organization’s sites to get information, or to check any information you might be getting through less reliable channels or visit: www.canada.ca/covid-19/coronavirus

Source: Robert Half

Virus image.

GOOD TO “GO”

BY STEPHEN TRUMPER

Let’s face it…we’re more than pumped to get back to work and life before quarantine. Keeping in mind that a vaccine is probably months away, however, all of us still need to be mindful of the risks. The need to be cautious is particularly relevant to those of us in the disability community, many of whom are deemed to be at greater risk due to underlying medical conditions. On a daily basis we need to carefully weigh the personal risks associated with leaving our homes or inviting others into them, of taking public transit, of visiting a grocery store, a restaurant or a place of worship. What might work for some people in the general population may not work for us.

What follows are some essential tips, guidelines and helpful advice that I’ve collected to help you keep this dastardly virus at bay while you go about your business at work, at play and at school.

Preparing for medical appointments to reduce anxiety and confusion

Whether it be a doctor, dentist, chiropractor, therapist or physio, expect your office and lab appointments to look a little different these days.

  • Phone ahead to find out what the office’s safety protocols are, and what you need to know in advance, including what time they want you to show up and where you should wait.
  • Wear a mask or cloth covering.
  • Wash your hands on arrival.
  • Use disinfectant wipes to wash down anything that needs it to satisfy yourself that surfaces and other things are clean and hygienic.
Multiethnic group of people, cleaning together in public park, saving the environment.

Back into the workplace

Heading back may be daunting. Think of the shortest route you can use to get to your office/desk and make sure you understand the company protocols.

  • Make sure all desks and working spaces in an office allow for social distancing or are separated by Plexiglas barriers or equivalent.
  • Elevators–given space restrictions and turning requirements, wheelchair, scooter users should request solitary use of the elevator. Be prepared to ask and also be prepared to catch the next lift.
  • Use disinfectant wipes to clean desk tops, office phones, seating and any objects that are kept on your desk or working surface.
  • Wash your hands frequently, taking care to make sure you wipe surfaces in a shared bathroom or kitchen /coffee/ water cooler areas. Beware the fridge and microwave door handles.
  • Encourage your organization to make sure any sick employees stay home until they fully recover.
  • Discuss an immediate operational Plan B with your team in case COVID-19 cases return.
  • If you use a wheelchair or any other mobility aids, ask your colleagues not to touch them during the day.
  • Check that your workplace has a robust ventilation system that moves the air around.
A woman in a wheelchair sitting at a conference table.

The safety basics

Before you do anything else, make sure you travel light (only essentials), have planned your excursion and know where you’re going before venturing out.

  • Get a supply of disinfectant wipes, a box of gloves and good quality masks and be sure you have an easy way to re-order as needed.
  • Know where to get a COVID-19 test if necessary and if you’ve had one, keep the results handy.
  • Regardless of your circumstances, figure out how best to keep distance between yourself and others (within about 6 feet, or 2 meters). Keep in mind some people may have COVID-19 and spread it to others, even if they don’t have symptoms or don’t know they have the virus.
  • Find a way to wash your hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer that contains at least 60 per cent alcohol.
  • Cover your face with a mask or cloth in public spaces, such as the grocery store, where it’s difficult to avoid close contact with others. Only use non–medical cloth masks—surgical masks and N95 respirators should be reserved for healthcare providers or, perhaps, if you live with or regularly visit somebody with an ongoing and underlying respiratory condition.
  • Avoid touching your eyes, nose and mouth and if you cough or sneeze, cover your mouth and nose with your elbow or a tissue, and try to turn away.
  • Clean and disinfect high-touch surfaces regularly.
  • Stay home from work, school, public transportation and shops if you are feeling unwell.
A male grocery store worker wearing a mask and standing in front of vegetables.

Out for lunch or shopping

Not everyone is following the guidelines below. You’re on your own:

  • Always wear a mask or cloth covering.
  • Order food delivery when you can.
  • Shop online rather than in person.
  • Take hand sanitizers or wipes with you when venturing out.
  • Practice social distancing at counters and in line-ups.
  • Be aware of and follow floor markings and directional arrows.
  • Use a credit or debit card rather than cash. l Favour stores with special hours/services for persons with disabilities and seniors.
  • Choose locations with good safety protocols, Plexiglas barriers, and mandatory staff and customer facial covering.
  • Pick places where you can access fresh air or where there are robust ventilation systems.
  • Phone ahead to find out the store’s hours, number of people permitted at any given time, wheelchair access and special services.
A man with down syndrome smiling at work.

Hiring PSWs, attendants or other caregivers

Work with people you can trust to keep you safe and make sure your PSWs and other caregivers have the necessary personal protective equipment (PPE) for your care and their safety when they are out and about in the community or caring for others. If they are not wearing the appropriate equipment they could actually be spreading the virus to you and to others, which you want to avoid at all costs.

  • Know where to get supplies. If you are running short of PPE, check with your healthcare providers.
  • Make sure your caregivers are tested regularly for COVID-19, and that you are made aware of their status at all times.
  • Have a back-up plan for when caregivers cannot come to work.
  • Work with any agency or organization you use regularly to provide that back up, or, if you hire your caregivers independently, with the individuals themselves.
  • If for any reason your assigned caregivers are not wearing the PPE they should be wearing while providing your care, mention it to them but also notify the organizations they are associated with.

SAFER AND SMARTER


BY PAT IRWIN

Reducing risk for PWDs and vulnerable adults

The 2020 COVID-19 Pandemic has created the biggest social experience of our time; quarantine and self-isolation. Spending this much time alone or with our immediate families, we have learned a lot about ourselves, our family members, essential work and our society. Our challenge is to take that learning, apply it to improve our own lives and the greater good, and to take that learning into the future as our world begins to open up again.

What have we learned?

We have heard wonderful stories about those on the front lines of healthcare. We have heard heart-wrenching stories of loss and wonderful tales of communities helping each other and sewing face masks. We’ve also heard distressing stories about the treatment of our most vulnerable citizens— the elderly and people living with disabilities.

Together, we’ve learned alternate ways of working; a recent Angus Reid poll reports only 36 per cent of Canadians plan to go back to the office permanently. How will they integrate working and family life into the long term?

Let’s look at the experience of several Canadian families and how they’re coping with the new normal that the pandemic has introduced:

ALEXIS’ FAMILY

A young adult woman.

Alexis is a labour lawyer whose husband, Bob’s, stroke five years ago rendered him paraplegic. They managed with a jigsaw of care from social services and a private agency. When she got home in the evening, Alexis would take over. Working from home during quarantine, Alexis developed a new routine: she would get up at 6 a.m. and work for a few hours until the visiting personal support worker (PSW) came to help her husband. She realized that taking a break for a few hours meant she could spend time with her husband, have a daily workout, and make and eat dinner together. Alexis and Bob re-arranged for the same PSW to cover dinner clean-up and bedtime prep while Alexis worked a few more
hours in the evening.

Quarantining taught Alexis a few things:

  1. That she could indeed effectively work from home and that adjusting Bob’s care schedule could actually enhance their lives.
  2. She realized that she could still make time for herself and had extra time and energy without her daily commute.
  3. She enjoyed spending additional time with her husband during the day and being able to walk their little dog.
  4. The couple agreed to cancel their weekly cleaning service as a precaution and bought a robot vacuum that Bob could operate.
  5. Bob was ready, willing and able to assume additional responsibilities and felt good about doing more.

Bob was actively involved in all new decisions and was comfortable with suggestions related to the revised plan. He agreed to manage grocery orders by phone and online for delivery, switched all of his routine medical appointments to online tele-health appoint- ments and arranged for his medications and personal care items to be delivered by the local pharmacy.

Alexis had also reviewed the hygiene protocols for themselves and any agency caregiver coming to the house to make sure everyone, including herself, was safe. She ensured they followed the caregiver guidelines outlined by the provincial Ministry of Health. These include:

  • Care providers should wear surgical/procedure masks at all times during the home visit.
  • Personal protective equipment (PPE) should be supplied by the client and used, and properly discarded, at the client’s home after use in a contactless, lined receptacle.
  • Hand hygiene is to be performed before putting on and, after removing masks.
  • If a client has a suspected or confirmed case of COVID-19, care providers should delay care if possible and only provide essential nursing, therapies and personal support services.

She has also asked the agency to provide her with regular updates and notify her of any staffing changes so she could be ready to re-orient new care providers herself.

After March and April, the couple both agreed it was achieving an even better work/life balance than before the quarantine and Alexis plans to discuss modified work from home with her law firm partners as things open up again.

An African American woman.

NINA’S FAMILY

Nina has been a surgical nurse at the local hospital for 25 years. Lately she had been working very long shifts at a local COVID-19 assessment centre. Hearing media coverage about COVID-19 outbreaks in nursing homes convinced her to relocate her 86-year-old mum from long-term care into her own home. It only took a few weeks to realize that her mom missed the activity, her table-mates and friends. And, she found it hard to be alone for 12-14 hours while Nina was at work. Despite the risk, Nina and her mum decided to ask about returning to the home after a couple of months, but her mum’s bed had been re-assigned and she would have to start again on a waiting list.

They researched some options until mum’s turn came. Social services advised that lists will be even longer post-COVID-19 but that she qualified for a visiting PSW for daily personal care. As government funded care was limited a top up would likely be necessary from mum’s pension (usually needed to pay her nursing home fees), Nina and her mum got creative.

  • They analysed exactly the care that mum needed— personal care a few times a day, toileting every few hours and administering medication were the main items.
  • In fact, Nina’s mum was alright for a few hours after the PSW’s visits, as long as she was near her commode, with the cell phone and TV remote nearby.
  • A personal emergency response device that mum could wear around her neck gave her the ability to call either Nina or the monitoring centre if she needed emergency help.
  • All groceries and drug store items would be delivered to the house to avoid the risks associated with shopping now and in the future (it saved time and turned out it wasn’t more expensive).

In addition, Nina approached her human resources department, asking to do assessments via home visits for split shifts, for the same number of hours. This allowed Nina to work in the neighbourhood from nine a.m. till noon, come home and give her mum lunch and her medication, and return to work for the afternoon. Nina’s husband, who managed to come home from work early or work from home, was able to help with dinner.

All of them were concerned, but as a nurse, Nina knew what she had to do. First, was consult the Ministry of Health’s public health website and also the guidelines from her employer. She also implemented additional precautionary measures because of her mum, who was in good health but still more vulnerable given her age:

STEP 1: Nina created her own ‘hot-spot’ in the garage where she removed her scrubs and her husband removed his work clothes and put them directly into the washing machine. They both changed into fresh clothes before entering their home environment.

STEP 2: They also immediately entered the adjacent bathroom to wash their hands with soap and water for at least 20 seconds.

STEP 3: Nina has instructed her mum on prevention techniques such as:

  • Cough or sneeze into a tissue or the bend of your arm, not your hand.
  • Dispose of any tissues you have used as soon as possible in a lined waste basket and wash your hands afterwards.
  • Avoid touching your eyes, nose, or mouth with unwashed hands.

STEP 4: At least twice a day, she sanitizes surfaces such as toilets, phones, electronics, television remotes and kitchen surfaces.

STEP 5: All deliveries are wiped down and staged for a few hours before being brought into the house.

Nina also reviewed the PSW agency’s protocols to make sure she was comfortable and insisted that her mum and the care provider wear masks, practice distancing where possible and also wash their hands frequently. Nina and her mum have agreed to try this arrangement for six months, ideally adding a day program and friendly visiting when public health allows. If her mum is still lonely, they will accept a nursing home bed when it’s offered.

BRIAN’S FAMILY

A middle-aged Asian man wearing a face mask.

Brian is a project manager in a bank’s IT department. His son David, 16, has a developmental disability; his daughter Laurel, 14, has been off school and is self- isolating at home.

David has always been restless and reacts poorly to supervision, so Brian has enrolled him in various after-school programs to keep him busy; all of which are cancelled at present. Brian is struggling to get his work team motivated to finish a major project deadline and is itching to get back to the office. His spouse is also working from home.

However, interesting things have emerged during their time at home together. When a kitten appeared at the back door one chilly March evening, David not only brought him inside and bonded with him but started to tenderly care for him. Laurel is also keen on the kitten and has become more kind that usual to her brother. Together, they plan marathon video game sessions. By spending time at home with them, Brian is realizing that both his son and daughter have become more confident and self-sufficient. Could they actually leave David at home alone for a few hours each day after school rather than forcing him to attend after school programs that he doesn’t always enjoy?

What do Brian and his spouse need to know about going back to work and David and Laurel’s safety in going back to school?

As schools reopen, the family should make sure that their children’s school is following local recommendations for cleaning and disinfecting. In David’s case, a sense of routine and predictability is the key to success. He’s shown enthusiasm for pet care and keen interest in video gaming and can be proud of what he’s achieved during the quarantine period. Perhaps he’d like to decide which after-school programs he wishes to pursue for his own interests.

What can Brian expect as he returns to his downtown office? Again, each provincial Ministry of Health has guidelines.

None of these families who’s stories I’ve shared are strangers to adversity; they have learned over time to live with medical concerns and vulnerability. They have also had the wisdom to keep on learning, and by example, help all of us to learn as well.

Illustration of a man and woman social distancing while sitting at a table.

Guidelines to share with employers

Each provincial ministry has guidelines for return to work during COVID-19. Here are Ontario’s as an example:

  • Provide access to hand-washing and have available alcohol-based hand sanitizers at multiple, prominent locations, with non-touch, lined waste disposal receptacles.
  • Implement physical distancing, maintaining a distance of at least 2 metres from other people.
  • Use telephone, video or online conferencing instead of in-person meetings.
  • Permit flexible hours and stagger start times, breaks, and lunches or stagger days that workers are in the workplace.
  • Provide physical barriers, such as plexiglass dividers, between workstations.
  • Mark out a distance of two metres between seats and seating areas to ensure physical distancing in common or shared spaces and lines (i.e., reception areas, meeting rooms, waiting rooms, kitchenettes, elevators, offices and other workspaces).
  • When physical distancing cannot be maintained, employers may implement the use of face coverings as source control (e.g., non-medical masks or cloth masks).
  • In addition to routine cleaning, surfaces that have frequent contact with hands should be cleaned and disinfected twice per day and when visibly dirty. Special attention should be paid to commonly touched surfaces in the workplace such as doorknobs, elevator buttons, light switches, toilet handles, counters, handrails, touch-screen surfaces, and shared materials, equipment, workstations, keypads, etc.
  • Place clear, visible signage at all entrances and within the workplace reminding workers and customers about the signs and symptoms of COVID-19, what to do if they feel unwell and how to protect themselves (e.g., hand hygiene, etc.).
  • ALSO: Be mindful of the needs of persons with disabilities (PWD) who are employees and customers.
Picture of Pat Irwin.

Pat M. Irwin, BA, AICB, CPCA, is president of ElderCareCanada, offering expert opinions, eldercare mediation, options for housing and care, moving and house clearing, and care management—eldercarecanada.ca/patirwin@eldercarecanada.ca

WORKPLACE FLEXIBILITY

BY KEVIN SPURGAITIS

What employers need to know about bringing people back to work, including employees with disabilities.

As Canadians continue to address the great challenges of COVID-19, many employers are working to remove the barriers that affect the employees who are among the one in five Canadians living with a disability, many of whom are at a higher risk of contracting the coronavirus.

But, according to the federal government, mitigating the impact of COVID-19 on Canadians and businesses will be a “step–by–step process that could be as long as 18 to 24 months.”

In our “new normal,” experts agree organizations should focus on “workplace flexibility,” a way of thinking that benefits both the company and all employees. Ultimately, in this time of crisis, the country has an unexpected opportunity to make lasting changes that respect the rights and dignity of people with disabilities. As well, we have the chance to improve overall working life during—and after—the pandemic.

In a statement, the Chartered Professionals in Human Resources (CPHR Canada) says that employers, in fact, have a statutory duty of care— not to mention a “moral responsibility”—for people’s health and safety during the COVID-19 crisis.

CPHR continues by suggesting a number of ways for employers to do the “right” things.

  1. Employers must keep up to date with the latest public health advice.
  2. Managers should be prepared to refer employees who are concerned about infection to official and expert medical sources.
  3. Companies would be wise to reassure employees who have COVID-19 concerns by utilizing an internal communication strategy to keep management and workers well informed of organizational policies to keep them safe, and contingency plans for employees who have been in contact with an infected person or get sick themselves.
A hair dresser wearing a mask and face shield cutting a man's hair.

CPHR’s guidance also includes encouraging employers to, “Understand that some people may have real concerns about catching the virus, while others may have worries about family or friends stranded abroad or working on the frontlines, such as healthcare workers. It’s important to strike the balance between your organization and its people being prepared for the spread of the virus while discouraging irrational panic with relevant information.” Of course, there’s always a chance the virus will continue to spread and prompt a “second wave,” so the association also suggests that businesses should prepare to “step up the level of support you provide to staff and adjust your resourcing plans accordingly.”

All employers are also advised by CPHR to evaluate their sick policies and provide guidance to employees and managers on how these will be applied to COVID-19 scenarios: “Ensure that line managers are regularly informed about the organization’s contingency plans and how to discuss the situation with any concerned employees, and where to direct people for further advice or support, including employee assistance programs or counselling if they are anxious. If your operations are severely affected, consider introducing a voluntary special leave policy on a temporary basis whereby individuals can opt to take paid or unpaid leave.”

In addition, CPHR’s pandemic recommendations remind employers to address the needs of specific groups of employees who may be more vulnerable as a result of a disability, pre-existing health condition or their role in caring for others. Today, more than 20 per cent of the Canadian population over the age of 15 has at least one disability, which means that a sizeable portion of each organization’s workforce will include individuals who may be at increased risk should they contract the virus.

Similarly, the Institute for Work & Health (IWH) has been advocating for an inclusive and equitable response to the pandemic, suggesting the financial hardship of the pandemic has had gradations of severity, particularly for people with disabilities, their caregivers and their families. “[COVID-19] has put a light onto a lot of issues in our society…and there’s a concern, in general, that disparities might increase,” says Dr. Emile Tompa, a senior scientist at the IWH and the head of the Centre for Research on Work Disability Policy (CRWDP).

Recently, Tompa hosted a federal-provincial policy roundtable related to the Disability and Work in Canada Strategy, which the CRWDP played a significant role in developing. He also chaired the technical committee behind the recently released CSA Group Work Disability Management Systems Standard. The standard also addresses issues like COVID-19, as it relates to accessibility planning and work accommodation.

Tompa says he is pleased with governments and organizations that have been trying to put disability into everything they do: “It’s about building up management systems within organizations to help them do a better job in accommodating workers’ health needs as they arise,” Tompa explains. “It’s also important that they be cognizant of workforce needs beyond the front end of the [opening up, recruiting, hiring and onboarding] process, right over the life course of a person’s engagement in the labor market.” He also insists that there’s not a lot of time and hard costs involved with making most accommodations, even when solutions are “customized” and deployed on a “case-by-case basis.” Take flexible work schedules, for instance, he says: “They cost nothing. With good planning and communication, employees can be creative in how they engage with their work. Everything doesn’t need to be on site.”

COVID-19 does, according to Tompa, have an upside. It has introduced Canadians to what many people with disabilities must confront every single day and encouraged new learning and new flexibility. Workplace measures accommodating people who have disabilities, who are immunocompromised, or who live with a mental illness may have been dismissed as too cumbersome or costly in the past. But facilitating the inclusion of people with different expertise and perspectives is now considered the most ethical and economical way to do business.

Tompa is now leading a COVID-19 impact study, which is in its early stages of development in partnership with disability community organizations. His final tip for employers in both the private and non-profit sectors is to be patient, “creative” about solutions and open to more “learning.”

“[COVID-19] broadens the obligations of employers, and that’s scary when they’re already struggling to survive in a globalized competitive economy,” he suggests. “But it’s the only way to go. … If you have an open mind today, you’ll be stronger for it at the end [of the pandemic].”

A woman in a wheelchair pushing an elevator button.

Greater risk

COVID-19 leads to a respiratory type infection that is mild for roughly 80 per cent of the population. But it can be more severe for older adults or those with chronic underlying conditions. Some people with a disability may not have a high risk of getting COVID-19 or becoming severely ill if they do contract the virus. However, experts suggest they might be at
a higher risk of infection or severe illness because of their age; underlying medical conditions, like diabetes, asthma and chronic lung disease; or their disability, itself, which could place them at greater risk of being exposed and acquiring the infection.

An Asian woman wearing a mask standing behind a cafe counter.

Case Study #1: Variety Village

Reopening plans are no less thorough for Karen Stintz, Variety Village’s president and CEO. As a social enterprise, Variety Village offers a number of life skills and integrated sports programs that support children and adults living with disabilities.

Prior to being shut down on March 15 by the pandemic, Variety Village, a 179,000-square–foot recreation facility, had 6,000 members and operated programs throughout the day for a variety of constituency groups. For example: In the morning, throughout the day and in the evenings VV offered programs aimed at young adults with intellectual disabilities and individuals in rehabilitation, as well as older adults and elite athletes from a local high school. In the evening, it offered recreational programs focussed on children with disabilities and athlete training.

Stintz and her board are moving cautiously. “We are continuing to plan our day camps for children under 16 in July. During a typical summer, we would have at least 200 children per week. Unfortunately, this year, we are planning camps to half of that number of children. For our first week of camp, only 30 children are currently registered. It’s a big change for us as we normally have a full house with lots of activities and a cleaning company that cleans the building after hours. However, without the facility open we can’t afford the monthly fee for that service [$25,000] this summer so our management team will take on cleaning and disinfecting tasks as part of our duties.”

Staff will also be implementing protocols for social distancing and screening. Variety Village is also making personal protective equipment (PPE) available and requiring all employees who have interaction with the public to wear it at all times. Stinz tells us that staff have the option of using protective shields instead of facemasks if they feel it will help them communicate more easily with the children in their programs.

She also underscores the need for non-profit organizations to make accommodations for employees and counsellors during this time—even if the “the numbers of individuals who are being served will be quite low.”

Fifty per cent of children with a disability say they have no friends so, “It is very important that we are able to offer services for those who rely on Variety Village for social connections and activities, says Stinz, who adds that, “The self-isolation that we have all experienced for a few months is a regular state of being for many children living with a disability and their families. So, while its critical that organizations that serve those with a disability be permitted to reopen, we have a responsibility to make sure it is safe. Most of the children and adults coming to Variety Village are a high–needs constituency before COVID-19. Their personal challenges have stayed the same but now their potential health risks have increased.”

A business woman wearing a mask looking at her phone while holding her credit card.

Case Study #2: Royal Bank

The health and safety of employees and clients has been our “top priority throughout the pandemic,” according to a spokesperson for RBC. During the lockdown, the organization supported employees in a number of creative ways, including enabling more than 75,000 of them to handle diverse roles through technology solutions, allowing them to work from home. Communication specialists set up a centralized hub online to distribute COVID-19 updates, FAQs, and advisories, as well as helpful resources and support programs for working from home. In addition to conducting a series of employee well-being surveys, HR organized a series of virtual town halls with RBC’s CEO and senior leaders to keep staff across the country in the loop.

As a precursor to welcoming back its workforce, the bank has created new onboarding and training programs that are 100 per cent digital for the 1,400 summer students who are taking on roles across the company. Moving forward, each location will continue to undertake extra sanitation and cleaning measures, while ensuring physical distancing, for all employees working in central and regional offices as well as branch locations.

Kevin Spurgaitis is a Toronto-based writer interested in ethics and public health issues.

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