Pre-pregnancy / Trying to conceive

Will the vaccine impact my fertility?

Dr. Dixon: The information we know is very reassuring. There is no evidence that any of the vaccines affect fertility. I encourage everyone to get their COVID-19 vaccine when they’re eligible. This includes if you’re actively trying to have a baby or even just thinking about having a baby in the future.

I am 39 and am trying to conceive. Will the vaccination decrease my chances?

Dr. Dixon: I’ve been assuring my patients, regardless of their age, that there’s no evidence the vaccine leads to loss of fertility. While fertility was not specifically studied in the clinical trials of the vaccine, no loss of fertility has been reported among trial participants who have received the vaccines since their rollout.

Is it safe to conceive while awaiting the second dose?

Dr. Dixon: It is safe if you become pregnant at any point around your vaccine doses: immediately before or after your first dose, between your first and second doses, or immediately after your second dose. I advise my patients to get vaccinated as soon as they are eligible to ensure they do not become seriously ill from COVID-19.

Timing of vaccination during pregnancy

Is there an ideal time during pregnancy to get vaccinated? First or second or third trimester?

Dr. Ladhani: The best time to get vaccinated is when you become eligible. We know that COVID-19 in pregnancy can increase your risk of being hospitalized and also cause an increased risk of preterm delivery. Statistics suggest between eight and 11 per cent of people who are pregnant who contract COVID-19 will be admitted to hospital, and between two and four per cent will need intensive care. That’s compared to about eight per cent of all COVID-19 patients who have needed hospitalization and about 1.5 per cent who needed intensive care, so pregnancy puts you at higher risk than the general population. A recent study in the American Journal of Obstetrics and Gynecology found those who were pregnant had a strong immune response after vaccination, suggesting strong protection. The study also showed that COVID-19 antibodies were transferred to babies, and we are going to see the effects of this soon. 

I’m in my third trimester. Should I get the vaccine while pregnant or when the baby is born?

Dr. Ladhani: I would advise receiving the vaccine as soon as you can. You’ll be protecting yourself, as well as your baby, once your immune response begins to kick in (usually two weeks after vaccination). Please be sure to receive your second dose at the scheduled time. The antibodies you produce will be passed on to your baby through the umbilical cord and in the breast milk.

Pregnant and patiently waiting. Is it ever too close to the due date to get the vaccine?

Dr. Ladhani: Close to your due date is absolutely fine. You’ll be protecting two people – yourself and your baby – it’s a win-win situation.

Pregnancy & the COVID-19 vaccine

Can antibodies be passed to baby if vaccinated during pregnancy?

Dr. Ladhani: A recent study showed there was immunity transferred to babies via placenta and breast milk. This evidence points to the strength of vaccination, at any stage of pregnancy, and also for those who have delivered their baby and are breastfeeding.

What effects will the vaccine have on my baby?

Dr. Ladhani: The COVID-19 vaccines available for people who are pregnant don’t contain any live virus and do not put you at increased risk for pregnancy loss or harm to your baby. They will not give you or the baby COVID-19, and will not interact with yours or the baby’s DNA. You may develop a fever after you get the vaccine, but this will not harm the baby.

Does vaccination during pregnancy mount less of an immune response compared to non-pregnant?

Dr. Ladhani: In a recent study, COVID-19 mRNA vaccines generated strong immunity in pregnant and breastfeeding people. The immune response was the same as that observed in non-pregnant individuals. Immune responses from being vaccinated were significantly greater than if you had been infected with COVID-19.

Could post-vaccine symptoms be heightened due to pregnancy?

Dr. Ladhani: There’s no indication that if you’re pregnant you will have more severe post-vaccine symptoms. The vaccine can cause fever in some people (around 16 per cent of those vaccinated) and usually takes places following the second dose. The evidence shows there is minimal risk to your or your baby. A few hours after receiving the vaccine, if you have a fever, you can treat it with acetaminophen/Tylenol.

How do we know the vaccine is safe during pregnancy if trials have just started for that group?

Dr. Ladhani: Early clinical trials for the COVID-19 deliberately did not include people who were pregnant. It’s common practice for clinical trials to exclude those who are pregnant, with concerns about fetal development cited. However, we do know that some vaccine study participants became pregnant and to date there have been no adverse effects reported during pregnancy or related to the health of babies. The COVID-19 mRNA vaccines studied in people who were pregnant, breastfeeding and trying to conceive have been found to be safe.

I received the Tdap (Tetanus, Diphtheria, Pertussis) vaccine and Rhogam today. Do I have to wait two weeks to get the COVID vaccine?

Dr. Ladhani: There is no need to wait between vaccines. You can get both vaccines on the same day or within two weeks of each other.

Will the vaccine cause birth defects, miscarriages, or any other fertility or pregnancy complications?

Dr. Ladhani: From the data we have, there is no increased risk for miscarriage, stillbirth or congenital anomalies with the COVID-19 vaccines. I assure patients that there is no evidence that the vaccine can cause birth defects, miscarriages or fertility or pregnancy complications. This is based on the millions who have received the vaccines to date and were trying to conceive or were pregnant.

What happens if I get COVID-19 while pregnant?

Dr. Ladhani: If you begin to feel unwell with symptoms of COVID-19, please contact your obstetrician. Most people who are pregnant will have mild-to-moderate illness if they contract COVID-19. Your obstetrician will provide you with support and resources for managing COVID-19.

High-risk pregnancy & the COVID-19 vaccine

Is the vaccine right for me if I have an autoimmune disorder, asthma and recurrent losses?

Dr. Ladhani: Yes, we would recommend that you get the COVID-19 vaccine. Being pregnant and having asthma are both risk factors for moderate to severe illness with COVID-19. People with autoimmune disorders weren’t included in the vaccine trials, and so the effectiveness and safety profiles aren’t known, but NACI and the Canadian Rheumatology Association are recommending that people with autoimmune disorders are offered the vaccine. Given your risk profile, the vaccine may protect you from the severe forms of COVID-19. It may be worth discussing this more with your health-care practitioner.

I’m having a high risk pregnancy. Should I get the vaccine?

Dr. Ladhani: Yes, in most cases people who are pregnant with high or low-risk pregnancies will benefit from receiving the COVID-19 vaccine and being protected from the disease. Please speak with your high-risk obstetrician about the specific details surrounding your pregnancy to determine if you will benefit from the vaccine.

I’m expecting twins. Is it safe to get the vaccine?

Dr. Ladhani: Yes! You’ll protect yourself and potentially protect both of your babies!

I am pregnant after experiencing a pregnancy loss. Should I get the vaccine?

Dr. Ladhani: A pregnancy loss can be devastating, and it’s understandable you may feel anxious being pregnant again. I would recommend receiving the vaccine for additional peace of mind during your pregnancy, especially as contracting COVID-19 during pregnancy can put you at higher risk of hospitalization and preterm delivery. Please remember there is always support available for pregnancy and infant loss through Sunnybrook’s Pregnancy and Infant Loss (PAIL) Network.

Are there complications with heart arrhythmias?

Dr. Ladhani: COVID-19 can be dangerous for those who have an underlying heart condition. Both of the COVID-19 mRNA vaccines were tested in people with heart problems and found to be safe and effective.There is no evidence that the vaccine has worse side effects for people with underlying heart conditions, and having COVID-19 is much riskier than getting the vaccine, so we would recommend you get the vaccine.

Breastfeeding & the COVID-19 vaccine

Is the vaccine safe for both me and my baby while breastfeeding?

Dr. Ladhani: The vaccine is safe for your and for the baby. There is new data showing antibodies for COVID-19 in breast milk after vaccination. So you’re not only protecting yourself against COVID-19 with the vaccine, but also possibly passing along some immunity to your little one. A huge win!

Fertility treatments & the COVID-19 vaccine

Is the vaccine safe when undergoing fertility treatment, like IVF?

Dr. Dixon: I suggest speaking with your fertility specialist who knows your history and care plan, and can answer your questions to help you make an informed decision. Undergoing IVF can be a stressful time and your fertility team is a wonderful resource to help guide you. Your specialist may suggest waiting a few days between some treatment procedures (for example, egg collection in IVF) and vaccination, so that any symptoms, such as fever, might be attributed correctly to the vaccine or the treatment procedure. 

Is it safe to get the vaccine if you have a planned intrauterine insemination (IUI) or embryo transfer?

Dr. Dixon: We may consider postponing the start of assisted reproductive treatments – like IUI, ovarian stimulation and embryo transfer after your first or second vaccination. This allows time for the immune response from the COVID-19 vaccine to settle down – this recommendation is purely to help patients cope with potential side effects IF they occur. Please talk to your fertility specialist if you have any concerns about the timing of your vaccine with upcoming fertility treatments.

I did IVF and I’m still in my first trimester. How long should I wait to get the vaccine?

Dr. Dixon: You should take the vaccine as soon as it is made available to you. Please speak with your provider about the specifics of your case. This is consistent with the most recent fertility practice guidelines.

I got pregnant after my second IVF cycle, I’m on my fifth week. Is it safe to receive the vaccine?

Dr. Dixon: It is safe to receive the vaccine in your first trimester. The data from those women who became pregnant immediately after receiving both of the COVID-19 mRNA vaccines showed no adverse outcomes in the pregnancy and the vaccines have thus been deemed both safe and effective. Further, there is no evidence that the vaccine can cause birth defects, miscarriages or fertility or pregnancy complications.

Read more: Got your COVID-19 vaccine? What you need to know about infection prevention after getting vaccinated

The post Pregnancy, fertility and the COVID-19 vaccine: Sunnybrook experts answer your questions appeared first on Your Health Matters.

“There are different phases of a catastrophic event,” says Dr. Ari Zaretsky, Sunnybrook’s psychiatrist-in-chief in the Hurvitz Brain Sciences Program. “Early on in a crisis there is often the ‘heroic phase,’ which we saw in March and April 2020, with people coming together, rising to the challenge of the coronavirus with a sense of ‘we are all in this together,’ working as a team against this enormous adversity, and developing positive feelings and camaraderie despite the stress.”

After many months, the pandemic is taking its toll on the mental health of people everywhere.

“It’s been an emotional rollercoaster ride and that’s created a sense of burnout and frustration,” he explains. 

Coping strategies for health-care workers

In these difficult times, Dr. Zaretsky recommends that health-care workers focus on looking after their own wellness including talking to other people in your social support system and reaching out to them in various ways.

In addition to the usual tips such as getting enough regular sleep, reducing exposure to news, eating nutritious meals, and being physically active particularly outside, here are some additional suggestions for self-care and support.

Have a work buddy: It can help to have someone at work who you are comfortable talking to and who you trust. “Choose a buddy who’s going to reach out to you and see how you are doing. Sometimes asking someone, “How are you really doing?” can be an invitation and encourage them to be more authentic if they’re struggling,” says Dr. Zaretsky.

Truly ‘talk’ to people. Texting is not the same: “Speaking to someone on a device where you can see them, talking to those in your household or communicating with colleagues safely in person, is better than texting,” Dr. Zaretsky explains. “Words on a screen cannot replace the benefits of hearing, seeing, and interacting with another human being. It is very important to be safe and follow health guidelines. It is also important to keep up communication beyond texting. There is more room for laughter, compassion, and connection when we are communicating safely face-to-face even if it is from a distance, wearing masks, or through a device that enables us to see one another.”

Be genuine and acknowledge your true feelings: Try not to diminish how you are feeling. Sometimes there is a sense of guilt for being upset during the pandemic, for example, when you are healthy or still have a job at the same time that many across the world are experiencing catastrophic loss of life and economic devastation. While compassion for others is important, being compassionate with yourself is equally important.

“Recognizing your feelings is very important but often people are afraid of that because they think it will actually make them worse. If you don’t acknowledge your true feelings there is the potential danger of becoming robotic, losing compassion for patients and burning out,” says Dr. Zaretsky. “When you at least acknowledge how you are feeling, you can then get support from other people and you can be more authentic, which is very important in terms of your own self-care and receiving the social support you need.”

Mental health resources for coping during COVID-19 from Sunnybrook experts

If you need help in an emergency, please call 911 or visit your local emergency department.

If you’re feeling like you’re in crisis or need somebody to talk to, please know that help is also available through community resources:

• Find a local crisis resource at sunnybrook.ca/gethelp
• Crisis Services Canada
  • Phone: 24-hour, toll-free 1-833-456-4566
  • Text: 45645 (4:00 p.m. – midnight Eastern Time)

The post Strategies for coping on the frontlines of the COVID-19 pandemic appeared first on Your Health Matters.

“Even though people are staying close to home, physical distancing can lead to an increase in high-risk behaviours, which in turn cause the types of injuries we often end up treating here,” says Dr. Marc Jeschke, medical director of the Ross Tilley Burn Centre at Sunnybrook.

The good news is that often, a little common sense can go a long way. Below are some tips from our Ross Tilley Burn Centre (RTBC) team:

Be careful when burning brush and debris

It’s understandable that many people want to make use of their time at home to get a head start with spring maintenance around their properties. Those who live on larger properties outside of the city, however, should think twice before burning large piles of brush and debris.

“Do not pour gasoline or another igniter fluid onto a fire that’s already burning, like a bonfire. The fire can come right back up into the container you’re holding, which will then explode,” he says. The person holding the container may also react by throwing it, inadvertently spraying other people nearby with burning fuel.

There is also the risk of a sudden shift in the direction of the wind, or the potential for unknown substances to be added to barrel fires. Have a safety plan in place, which includes having a container of water nearby or a garden hose on standby before starting the fire, and make sure someone else who knows what you’re doing (and where).

“With fires, you should always remember safety, and know where the closest water supply is,” says Dr. Jeschke.

Try not to use alcohol as a coping mechanism

Tolerating isolation is difficult for many people, particularly as the pandemic drags on, but Dr. Jeschke warns against drinking more alcohol as a coping mechanism.

“People are staying at home and drinking and smoking more, putting themselves at risk,” says Dr. Jeschke.

He says many of the injuries they see in the RTBC are the result of poor judgment. Simple activities like smoking and cooking can become deadly if a person falls asleep. Dropping a lit cigarette onto the carpet or leaving a stove unattended can ignite a fire very quickly.

If you do decide to consume alcohol, enjoy responsibly.

Take care of your mental health

The past year has brought huge changes to our daily routines, significantly impacting the mental health of many people. Anne Hayward, RTBC’s social worker, says it’s important to remember that physical distancing does not equal emotional or psychological distancing.

“For many people, physical distancing increases feelings of isolation, anxiety and depression, especially in at-risk populations. This, in turn, can lead to an increase in substance misuse and self-harm,” says Hayward.

“It’s more important now than ever to keep engaged, which can include staying in contact with people by phone, text, e-mail and using virtual technology.”

Hayward also recommends limiting the amount of time spent reading, watching and listening to the news, and only using reliable sources when you do.

“There’s a balance between being informed, but not overwhelmed,” she says.

If you are feeling anxious or overwhelmed, one strategy Hayward recommends is Expressions of Gratitude.

“By asking yourself what you are grateful for, it shifts the focus away from some of the negativity and worry and helps you to focus on something positive. This could include something simple like an act of kindness, spending time with people you love, or realizing what’s important,” she says.

Take care when cooking

With stay-at-home orders in place once again, more people are preparing and cooking meals at home. Keep some simple safety tips in mind, such as not wearing loose, flowing clothing while cooking.

“With loose clothing, you turn around quickly or get too close, and the fire ignites the clothes. You then have a major injury for no reason whatsoever,” says Dr. Jeschke.

Make sure your smoke alarms are working, stay in the kitchen at all times when you’re cooking, move anything that can catch fire away from your stovetop, and keep kids away from areas where hot foods or liquids are being prepared, like stoves and microwaves.

If you do suffer a burn:

If it’s a significant burn, call 911. While waiting for help to arrive, don’t put butter, vinegar, oil or lemons on the burn.

“The best initial treatment for all burns is cool running water. Don’t soak the injured area, just let the water run over it,” says Dr. Jeschke.

Help is available

Hayward says there are many reasons for people to feel anxious or overwhelmed right now.

“People may be struggling with financial, housing, food and job insecurity concerns, new or pre-existing mental health issues. They may also have immune-compromised or senior loved ones who are at risk, or loved ones who are living in other cities, provinces or countries that they can’t get to right now,” she says.

Others may be self-isolating in abusive or volatile living situations, which can lead to scalding, contact or chemical injuries, she adds.

Help is available through a variety of organizations, including 211 Ontario, Kids Help Phone and Connex Ontario, among others. A complete listing of crisis support hotlines is available at ontario.ca/coronavirus. If you are experiencing an emergency crisis situation, please contact 911 immediately or present to your nearest emergency department. 

If you’re a former RTBC patient and feel as though you need support during this challenging time, Dr. Jeschke encourages you to get in touch with the burn centre.

“Please reach out. You are not alone, and we will assess how we can best help you,” he says.

Note: this article was originally published in April 2020 and has since been updated.

The post Staying safe during COVID-19 lockdown: tips from our burn centre appeared first on Your Health Matters.

The couple, 87 and 91, received their first dose of the COVID-19 vaccine on March 8, 2021, and decided to mark the day as their anniversary.

Mervin and Myrna on their wedding day, nearly 68 years ago.

It was nearly a year to the day since the pandemic was declared.

“On March 11, 2020 we were enjoying our time in sunny Florida when we heard the news of the pandemic and that Canada might be locked down,” Mervin recalled. “We packed our things and booked plane tickets immediately and came straight home.”

Ever since, Mervin and Myrna have been hunkered down in their Toronto condo.

It’s been a long 12 months, of course. Family dropped off groceries and supplies. And the pair used the hallways of their building as their exercise track.

“Myrna lit candles every night for dinnertime to help break up the monotony,” Mervin says.

“It was just a little something I could do to add some excitement,” Myrna added.

Myrna says getting the notification that they were able to book vaccine appointments was the “best day of the year.”

“It was so amazing,” she says. “We are so happy to have science on our side.”

Myrna and Mervin don’t yet have plans for their actual wedding anniversary in May, as they will wait to hear what the public health advice on gatherings is at that time.

“Our celebration might be a toast of champagne on Zoom, and that’s OK,” Myrna says.

Facetime and Zoom have been a wonderful way to stay connected with their three children, eight grandchildren and five great-grandchildren throughout this past year, she says.

“And the telephone,” adds Mervin. “We are so lucky to have so many ways to stay connected.

“We have just a short while longer to keep up with all the public health rules; don’t give up now. Hang in there and we will get through this.”

And Mervin’s advice for couples who are feeling cooped up as stay-at-home orders continue:

“Let things fall where they may. Don’t be demanding on each other. Myrna and I have never been demanding on each other, and it works.”

The post Couple celebrates 68th wedding anniversary by getting COVID-19 vaccines at Sunnybrook appeared first on Your Health Matters.

But all of this screen time can be tiring. ‘Zoom fatigue’ is a term coined in the COVID-19 era named after one of the video-conferencing platforms used for such meetings as people were finding themselves more exhausted than usual at the end of the workday.

Drs. Sara Mitchell, Ilana Halperin, and Philip Lam, members of Sunnybrook’s Virtual Care Taskforce weigh in on why video conferencing and virtual appointments can be exhausting and what you can do about it.

Why video chats can be exhausting

There are a number of reasons we can get worn out after a video meeting or conversation.

“Focusing on a screen for long periods can cause eye strain,” says Dr. Lam. “People are also often sitting in one position for long periods of time which can cause physical discomfort.”

On video-conferencing platforms, we can also see ourselves on screen, which can feel awkward and draining.

“When we’re looking at ourselves and speaking on a video screen, we’re observing ourselves in a way that we’re not used to in conversations,” adds Dr. Halperin. “This could also lead to self-criticism.”

Exhaustion doesn’t just happen during video calls for work. We can feel tired even when we’re meeting with family and friends on video chat.

This online, on-screen interaction is wearing us out because there’s also a lot going on in our brains.

Brain drain and video calls

“We require additional effort and sustained attention during video meetings,” says Dr. Mitchell, a neurologist at Sunnybrook. “The added strain on our attentional systems and other cognitive processes can leave us feeling exhausted.”

While communicating online can be convenient, it doesn’t come as naturally as speaking in-person and face-to-face, and that means our brains are working overtime to figure out what’s happening.

“As social beings we are well-trained to read and interpret non-verbal body language during in-person communication,” explains Dr. Mitchell. “However, when on the computer and in this two-dimensional space, we likely have to work harder to identify non-verbal cues. This can be even more difficult for people who are more reliant on non-verbal language.”

The ‘gallery’ view on-screen that displays multiple meeting participants can add to the brain drain.

“This forces our brains to have to decode and observe many people simultaneously which can be an added challenge,” says Dr. Mitchell.

Multiple alerts can also pop-up on-screen including email and messaging which adds to the strain with an added element of multi-tasking.

Technological glitches can also be source of stress.

“If the internet connection is poor the audiovisual quality may be reduced,” says Dr. Lam. “The user may have to concentrate harder on what is being heard or seen during video meetings which can be frustrating.”

“All of these challenges may be particularly difficult for individuals with cognitive or other sensory impairment, including those with certain neurological diseases,” adds Dr. Mitchell. “For instance, those with migraines and traumatic brain injury often find screens and multi-tasking particularly draining and triggering.”

Tips to help cope and combat fatigue on video meetings

Video-conferencing has its benefits, but virtual meetings don’t always have to be on-screen. Here are some steps to consider to change up your meeting and help ease the fatigue.

Turn off the computer camera: It may not always be possible to do so, but if you’re in a meeting where it is appropriate – consider turning off the computer camera.

“It may be possible that you say hello to everyone at the start of the meeting with the camera on and then if appropriate, turn the camera off while still participating and remaining online for the duration of the meeting,” says Dr. Halperin.

Alternative meetings: Instead of a video call, consider a phone call or teleconference.

“If you’re in a phone meeting, it may also be possible to go outside and take a walk while on the call,” says Dr. Halperin. “It’s a great way to get some fresh air while being productive.”

“This is also an energizing way to reduce screen time, increase exercise – which can improve mood and energy, and increase time outdoors which is also important for mental health and rejuvenation,” adds Dr. Mitchell.

Depending on the type of work you’re doing and if you’re in the workplace, going outdoors for a physically distanced walking meeting with a colleague may be possible, if safe to do so. Remember to wear a mask.

Turn-off alerts: While on a video call, turning off the pop-up alerts and notifications for emails and messages can help reduce multi-tasking and added stress. This can eliminate this distraction and help you focus on the task at hand rather than worrying about the alerts that are coming up on screen.

Take breaks: “Try to schedule in five to 10 minute breaks in-between virtual meetings or appointments,” suggests Dr. Lam. “Getting up from your chair to stretch and move can help prevent strain on your body, in addition to giving your eyes a break from the screen.”

Work-life balance: With many working from home, there can be a blurring of our personal and professional lives. It can be easy to jump onto the computer and start working a bit earlier or longer than usual. A work-life balance can help ease stress and screen time.

“Keep your personal time, for you. For example, the time you would have used to commute into the office could be used as more personal time,” suggests Dr. Halperin. “If it used to take an hour to commute into work, if possible, consider taking that hour and going for a walk, exercising or reading a book. Doing something you enjoy can help bring more of a personal balance to working from home.”

“As much as possible, try and separate work and home life to maintain boundaries,” adds Dr. Mitchell. “If available, use a separate room for working time and leave your work there when you leave,” adds Dr. Mitchell.

How taking a break from screens can help boost your brain

Going off-line has its benefits.

“Make sure you spend enough time in a day ‘device-free’ to allow your brain to recuperate and rest. Take that time to be present with those around you and observe the world, including nature to give your eyes a break from the screen,” says Dr. Mitchell.

Reducing screen time can also help to improve your quality of sleep.

“We know that blue light can suppress melatonin secretion, which is the natural hormone your body produces to regulate sleep-wake cycles,” explains Dr. Mitchell. “Turning off the screen with sufficient time before bed, up to an hour for instance, will allow for improved sleep hygiene which can improve energy levels the next day.”

The post Why am I so tired after virtual meetings? appeared first on Your Health Matters.

With the temperature drop there is the potential for more people to remain indoors and face loneliness and isolation.

“We know that at any given time, approximately 10 per cent of older adults living in the community and up to 40 per cent living in long-term care settings will have significant levels of depression,” says Dr. Damien Gallagher, geriatric psychiatrist. “Even when a patient’s mental health condition is not severe enough to be considered a major or ‘clinical depression,’ it can still impact adversely upon their ability to care for themselves, with greater risk of cognitive decline, cardiovascular events and overall mortality.”

Making plans in advance and taking preventative steps before winter arrives can help provide the elderly with support and care.

Staying connected

Staying in contact and maintaining connections with elderly friends and family members to support them will be key, especially with upcoming celebrations such as Diwali, Hanukkah and Christmas.

“Social connections are particularly important around this time of year,” says Dr. Gallagher.

These days, online visits are a helpful way to stay in contact. Family members can help an elderly family member by setting up technology in advance and practising using it together as it may take some getting used to, whether it’s a laptop, smartphone or another device.

“Ultimately family or friends will have to meet their older family members ‘where they are at’ in terms of which mode of communication or technology is most acceptable to them. Many older adults, if motivated and still cognitively able, will be able to bridge that digital divide and use new technologies.”

Dr. Gallagher adds, even in circumstances where there is cognitive impairment, it may still be possible to use virtual technologies with caregiver support.

“Many older adults have adopted video conferencing technologies or found new ways to stay cognitively and socially engaged with virtual day programs, peer support groups or online learning,” says Dr. Gallagher.

There are many simple and creative ways that family and friends can stay in touch during the holidays including sending hand-written letters or cards or a daily phone call to help keep the connection going.

How to plan ahead and support the elderly through the COVID-19 pandemic

It may be helpful to take advantage of the fall weather and take steps before the snow starts to fall to support your loved one.

Families who are caring for an aging parent at home may have to determine how to share caregiving responsibilities with their siblings.

“The challenges will be different for each family,” explains Dr. Gallagher. “The first priority is to identify areas of vulnerability or weak spots, which if not attended to, might become bigger issues as we head into the winter months. Older adults with pre-existing depression, anxiety or history of addiction will likely require more social & medical support from this perspective. Ensuring general physical needs are met with adequate caregiver support will be critical, particularly where there are mobility or cognitive concerns.”

Home safety assessments, if necessary, can help identify areas of concern that may include strategies to reduce falls risks or safe medication management with use of dose boxes or blister packs.

Some older adults may have put off medical appointments or investigations because of concern around the pandemic, but it is important that COVID-19 not deter individuals from seeking the medical help they need. Maintaining medical appointments, even if on-line or on the phone, is also important for mental and physical health. Here are some tips and a checklist for a successful virtual appointment.

Helping your loved one develop and maintain a regular routine with some kind of meaningful activity during the day will help foster a sense of purpose and help keep people cognitively and socially engaged.

Physical fitness is also a key factor in helping to improve mental health.

“It will be important to figure out ways of staying physically active whether this is outdoors or indoors as the weather gets colder. This may include going for a walk, participating in an online exercise program or even getting up and moving around during commercial breaks while watching TV,” says Dr. Gallagher. “Keeping up with physical activity can help to mitigate risk of falls, cognitive decline and depression. This is particularly important for those with some degree of frailty or cognitive impairment to help maintain mobility and independence.”

Family, friends and caregivers can all play a part to help support loved ones through the pandemic with a little planning and preparation.

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“My 86-year-old husband is in a nursing home…one long-time friend has died of the virus, and another was diagnosed and recovered,” she says. “It hits very close to home. I know I’m vulnerable and I’m taking it very seriously.”

A former nurse and clinical researcher, Mary remembers the “old days” when she was caring for a patient with tuberculosis.

“I still remember him saying, ‘If I’ve got it, you’re going to have it too,’ then he coughed right in my face,” says Mary, who is now retired. “You get some takeaway memories. I’ve become overly critical of the techniques being used to keep people safe.”

Mary admits she was worried she’d be disappointed at the hospital when she had to go to Sunnybrook Health Sciences Centre for an echocardiogram and visit with her cardiologist.

“It was a very anxious thing, and that made me even more impressed with how well they did,” she says. “You couldn’t get in without being screened – there was no way around it. It was very reassuring.”

Toronto-area hospitals have been taking extra precautions to reduce the risk of the novel coronavirus being spread from person-to-person, from entrance screening to personal protective equipment in clinical and high-traffic common areas.

Robert Kates, a seventy-seven-year-old grandfather of six (soon to be seven), says he too is “a little paranoid” about contracting COVID-19.

“At my age and with my prior history of infections, I’m overly cautious,” he says. “I wear a mask. I carry sanitizer in both my pockets. The only time I leave my house is to go out for groceries, and that’s about twice a week. I even sanitize my own car inside.”

Over the past three months, Robert has been to Sunnybrook three times to undergo tests to evaluate possible heart problems. On visiting the hospital, he says he wasn’t overly concerned: “I wondered what they were going to do. I knew they’d be taking precautions, and I was very relaxed and calm going in there.”

If you are going to hospital or out in public, infection control experts at Sunnybrook recommend you wash or sanitize your hands frequently, keep your hands away from your face, practice physical distancing, and make sure to wear your mask properly.

“Take precautions and trust in the hospital and the doctors,” advises Robert. “If you need to visit the hospital, do it. Don’t wait. It’s your life.”

Heart attacks don’t stop during a pandemic

Don’t ignore the signs of serious heart problems, especially if you have a heart condition. Call 911 if you think you are having a heart attack. Symptoms include:

• Chest pain
• Difficulty breathing
• Discomfort in your chest, arms, back, neck, shoulder or jaw

If you have questions about COVID-19 and your heart condition, or need a health visit, speak to your cardiologist or other health-care provider.

Source: Canadian Cardiovascular Society

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But for people over age 60 or people with other health conditions like diabetes or cancer, COVID-19 can have serious complications.

According to Statistics Canada, more than 6.5 million people in Canada are over age 65, and millions of Canadians live with conditions that make them more vulnerable to illness.

For these members of our communities, catching COVID-19 might mean very serious illness, hospitalization and even death.

If you get sick, even though it might not be serious, who might you pass the infection to?

Dr. Susan Deering, attending physician at Sunnybrook’s Veteran Centre, says it’s important we all continue to work to reduce the spread of the virus so that we can protect these people — our parents, grandparents, neighbours and friends.

She says that by practicing these habits, we can protect others from COVID-19 much in the same way we protect ourselves.

Stay home / physically distance from others when you must go out

By physical distancing, we can reduce the spread of COVID-19 in our community. This means reducing our number of close contacts to those who we live with, and keeping a physical distance of 2 metres from others when you must go out. Avoid non-essential trips out of the home. Go out for groceries once per week.

Remind older adults to stay home

It’s important to remind our older adult contacts that this virus continues to be a danger to them. We can help by offering to drop off groceries and essential items to their porch, or reminding them of the vulnerable person shopping hours at local grocery stores.

Check-in on relatives and neighbours

With life and routines disrupted, we are all at-risk for loneliness, and this is especially true for older adults. Give them a call, a FaceTime or send a card to let them know you are thinking of them.

If you are a caregiver:

If you are a caregiver to an older adult and thus continue to be in close contact, it’s important that you follow the tips below to help them stay safe.

Clean your hands

Our hands often carry viruses and bacteria to a virus’s port of entry – your eyes, nose or mouth. Wash every surface of your hands with soap for at least 20 seconds. Keep your hands away from your face.

Practice “respiratory hygiene”

Cover your cough. Do the sleeve sneeze. Cough or sneeze into a tissue (then throw that tissue out and wash your hands.)

Stay home when you are sick

Even if you have mild symptoms or a cold or flu, it’s best to stay home. This not only helps you rest and recover, it helps reduce the risk of spreading the virus through coughing, sneezing or touching shared surfaces with contaminated hands.

If you are supposed to visit Grandma but you aren’t feeling well, the best thing you can do for Grandma is stay home. Rebook your visit. Call or FaceTime instead.

If you have a cough or other symptoms and must provide care for your older or vulnerable loved one, please wear a mask to reduce the risk of your droplets spreading infection.

What’s in it for me?

Protecting others from viruses can save their life. If that’s not enough to motivate you, remember: reducing the spread of illnesses like COVID-19 means fewer people will need hospitalization for it, which in turn means our hospitals can still be available to you if you need your appendix removed or have a traumatic fall.

Wash your hands and keep staying home as much as you can right now: it’s a win-win (win) for you and for others (and for the healthcare system).

The post How can I protect seniors and at-risk people from COVID-19? appeared first on Your Health Matters.

While it’s important to stay informed, experts say individuals should also pay close attention to elevated feelings of stress and anxiety.

“Consuming an overwhelming amount of difficult news can have an impact on your mental health,” says Dr. Carolyn Boulos, psychiatrist. “It can fuel feelings of hopelessness, helplessness, and a sense of being unable to take control.”

What individuals can control is how much information about the pandemic that they watch or listen to each day.

“It’s okay to take a break,” explains Dr. Boulos. “This is especially important to help alleviate any stress or anxiety as we all learn to cope with the necessary changes to stay safe in our everyday lives as a result of the pandemic.”

Simple strategies to help ease information overload

Limit your time

Try limiting the amount of time spent reading or listening to new stories about the pandemic. One way to do this online is to use technology.

“It’s easy to get caught up in social media and lose track of time,” says Dr. Boulos. “There are screen time-limiting features on smartphones to alert you to the amount of time you have spent on a particular app or website. A good reminder to move on, get up and move, and get your mind on something else.”

Schedule your time

“Be mindful of when you listen to the news as it tends to be repetitive,” explains Dr. Boulos. “Perhaps select one time during the day to catch up on news headlines rather than watching or scrolling for hours on end. Consider short newscasts or a podcast.”

You can also schedule time for other things. Maybe that means spending at least one hour each day connecting with family and friends instead of checking the news. This can help people feel less isolated, especially as we practice physical distancing.

Reliable sources of information

Be careful of misinformation from unreliable sources. Choose trusted and credible organizations to get information updates on the COVID-19 pandemic such as health, government or academic organizations. Perhaps consider one credible news source for updates, rather than multiple outlets which may be reporting the same things. The information may be helpful but hearing the same update repeatedly could lead to feeling more stress than is necessary.

Other tips for disconnecting from news and social media

• Turn off notifications on your phone.
• Pick up a non-computer-based hobby.
• Do something fun like reading, listening to music or exercising.
• Don’t read the news right before bedtime to help get a better sleep.
• Establish daily routines for self-care: work, eating, chores, leisure, family-time, reaching out to your community and proper sleep time.

Information is extremely important as we learn more about the COVID-19 pandemic, but it’s also important to spend time focusing on your health and well-being and know that it’s okay to take a break from overwhelming and challenging news each day to help maintain good mental health hygiene.

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If you or someone you know is thinking about suicide or in severe emotional distress, please call 911 or visit your local emergency department. If you feel like you are in crisis or need somebody to talk to, community resources are here to help:

Crisis Services Canada

Phone: toll-free at 1-833-456-4566
Text: 45645 (available 4 p.m. – 12 a.m. EST)

The post COVID-19: How to manage information overload appeared first on Your Health Matters.

“Among the most vulnerable to COVID-19 are people living with dementia, stroke or other neurodegenerative diseases,” says Dr. Rick Swartz, neurologist. “With these conditions, changes in the brain leads to memory loss, difficulty with thinking, problem-solving, and/or movement. This could mean a person may not remember to do things like wash their hands, or they may not have the mobility they used to and require the help of a caregiver.”

» Learn more about caring for those living with dementia, stroke and neurodegenerative diseases during the COVID-19 pandemic by the Ontario Neurodegenerative Disease Research Initiative

» Find out about self-management and self-care during COVID-19 for people with stroke, heart conditions and vascular cognitive impairment from this Heart & Stroke webinar featuring Dr. Rick Swartz, Sunnybrook neurologist

Tips for hand hygiene help for a person with dementia

In a time when handwashing and taking precautions is paramount, it’s important to help those who are more vulnerable to illness during the COVID-19 pandemic, including those living with Alzheimer’s disease and other dementias. If you notice a person living with dementia is showing increased confusion, contact your health care team, as this may be a symptom of any illness.

• Explain: Give a simple description of how to wash hands to stay healthy.
• Show: Demonstrate proper hand-washing techniques, suggest humming part of a favourite tune so the individual with dementia washes their hands for an appropriate amount of time.
• Signs: Consider putting up signs near sinks as a visual reminder to wash hands. Using pictures and large font may be helpful to use in signage.
• Hand-sanitizer: If the person with dementia is not able to wash their hands easily, alcohol-based hand sanitizer with 60 per cent alcohol can be used as an alternative.

Plan ahead

From groceries to medication to alternate care, making plans in advance can help both the caregiver and the person with dementia.

• Virtual care: Talk to health care teams about the possibility of virtual care and having appointments done online or over the phone.
• Alternate care: Determine who can help provide care to the individual with dementia, if the primary caregiver becomes ill or is no longer able to assist.
• Limit trips to the pharmacy: Consider using a delivery service to fill prescriptions for medication.
• Grocery shopping options: Shopping for groceries and physical distancing is easier as many stores offer online shopping, pick-up and delivery options. Friends and family can also lend a hand by picking up groceries while at the store and dropping them off directly.
• Find resources: Learn more about resources that are available on a local, provincial and national level. Many credible organizations offer support and information online. For example, a service called 211 Ontario can help people in that province find programs and services in their community by dialing 2-1-1. There are also 211 Services outside of Ontario in some provinces and territories.

» Find more tips for caregivers from the Memory Doctor

Ways to stay connected

Health experts say while physical distancing is important to maintain during this pandemic, it’s also very important to make sure people with dementia aren’t isolated and that friends and loved ones keep in touch in a variety of ways.

• Routine calls: Schedule some time each day to contact friends and family. Go beyond just texting. In a time of physical distancing, maintain human interaction by speaking with a person on the phone or seeing them in a video chat.
• Telephone: Picking up the phone is one of the easiest ways to connect with loved ones. More people can join in if you have a conference call feature.
• Smartphones: Contact friends and family with a call, by text or by using social media app. Sharing photos and videos can help everyone feel a little closer in these times.
• Video-calling: Technology can bring friends and family altogether in groups. Not only can you speak to one another, you can see how everyone’s doing and stay connected.

Planning ahead and getting creative with communication are just some of the things that can be helpful for people living with dementia and other neurodegenerative conditions. For those who are vulnerable during the COVID-19 pandemic, having friends and family pull together to support them, their caregivers, and each other will go a long way.

The post COVID-19: Tips for supporting people with dementia appeared first on Your Health Matters.