Mental Health and Dementia during the COVID-19 Pandemic
In last month’s newsletter we discussed the effects of stress caused by the COVID-19 pandemic on the elderly who suffer from Alzheimer’s and other dementias. In this newsletter, we examine a closely related problem: mental health. As the pandemic has advanced, we have been hearing more and more about the mental health crisis that has been precipitated by the spread of the virus itself and the living conditions that have been imposed to contain the spread of the virus, such as lockdowns, isolation, and social distancing. The stress of coping with these conditions has given rise to a number of mental health issues, including fear, depression, loneliness, anxiety, panic, uncertainty, hopelessness, and grief at the loss of loved ones who have died from the infection, to mention a few.
These symptoms resulting from stress are bad enough in normally healthy people, but in the case of the elderly, especially those with dementia, the mental health effects of stress can be much worse. This is because dementia produces its own set of psychological and behavioural symptoms that are much more difficult to deal with than the ones mentioned above. Studies document that 90% of those suffering from dementia may, at some time during the course of their illness, experience one or more of the following symptoms: visual and other hallucinations, delusions, delusional misidentifications, anxiety, apathy, aggression, agitation, wandering, loss of inhibition, and other psychotic behaviors. These symptoms may be caused by several triggers, such as loneliness, depression and various other social stressors. These manifestations, which affect the patient’s emotional state and thought content, are unpredictable, and may occur individually, but most often in clusters. These behavioral and psychological symptoms are as much a part of the condition of dementia as the decline in and impairment of cognitive abilities that are generally associated with dementia. The problem is that because dementia patients suffer from cognitive impairment, they are often unable to express adequately in words what they are feeling emotionally and psychologically, and the symptoms therefore go unnoticed and undiagnosed.
At the best of times, dealing with these mental health manifestations of dementia patients put a strain on caregivers—even those who are professionally trained. However, during the current pandemic, with the added stress and the increase in the occurrence of these symptoms, caregivers in care homes and assisted living facilities are being pushed to the point of exhaustion and burnout. In the current pandemic environment, it is important to organize in-house support group for staff and caregivers, organize holiday and individual birthday celebrations for each resident, staff and caregiver to maintain a celebratory environment in the house. Announcement and preparation for such celebrations could be weaved into residents’ daily recreational activities.
There are several approaches that can be used to deal with mental health issues of dementia patients during the pandemic. The environmental approach seeks to ensure that the physical needs of the patient are being taken care of adequately, and necessary adjustments are made to accommodate the individual circumstances of each resident. The cognitive and emotion-oriented approach uses various therapies to address the patient’s emotional needs. Cognitive stimulation therapy uses mentally stimulating activities such as puzzles and handcrafts. Reminiscence therapy encourages patients to remember past events, experiences, and achievements, often in a group setting. Validation therapy uses affirmation of the emotions that the patient is experiencing and/or acknowledgment of the patient’s expressed wishes. Sensory stimulation, AlfredHouse Symphony is a unique and one of the rare facilities that has a multi-sensory therapy room. Music therapy and animal-assisted therapy have also proved to be very effective. At AlfredHouse, we are committed to providing our residents with the most appropriate care for their individual needs, including their mental health issues.