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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(Photography by Kevin Van Paassen)

Mary Buchan Jarvis learned to drive virtually any kind of car, bus or off-road vehicle when she served as a driver in the Canadian Women’s Army Corps in the Second World War. But when her children gave her a mobile phone to help her stay in touch, Mary resisted. 

“It’s just one of those things I can’t seem to get used to,” says Mary, who has been living at Sunnybrook’s Veterans Centre for about four years. 

But when staff at the Centre announced a pilot program seeking volunteers to use an iPad-based communication app, Mary decided to give it a test drive. At the time, she didn’t even know what an iPad was.  

“The way it was described to [me] sounded like a great idea, so I said, ‘Alright, I’m up to the challenge,’” recalls Mary, who turned 95 this year. 

The mobile app, called Connections, was developed by the University of Toronto’s Technologies for Aging Gracefully Lab (TAGlab) and software company Famli.net Communications. It allows users to send text, voice, picture and video messages – all from a single interface – simply by tapping on the photos of the people they’ve added to the app. Recipients get all messages by email, regardless of whether they’re sending a text, voice memo or photo.

“We know from studies and from our work at Sunnybrook that seniors’ health, function and mood are better when they’re engaged,” says Dr. Jocelyn Charles, medical director of the Veterans Centre at Sunnybrook. “Veterans using the app are definitely more engaged, connected and enjoying a better life experience.” 

The pilot program, which started three years ago with 10 participants, was expanded last year to include 40 veterans.

Sunnybrook volunteers, most of them retirees or university students, provide one-on-one and group training sessions for the veterans on a weekly basis. The majority of participants have so far reported feeling more connected since they started using the app, Dr. Charles says. 

The Connections app is a step towards universally accessible communication for older people, says Robert Arn, chief technology officer at Toronto-based Famli.net, the mobile communications software company that worked with Sunnybrook and U of T on the pilot project. Robert points to TAGlab research that looked into the many communication challenges faced by older people. 

“The problems are multifaceted and include issues such as accessibility – for seniors with hearing and eyesight problems, for example – and in some cases also cognitive challenges and language barriers,” Robert says.  

App developers worked to create a way for people to communicate that is independent of any disabilities the users might have and that doesn’t require anyone to be particularly tech-savvy, he says. “For example, if you have poor eyesight and are sending a voice message to someone who’s hard of hearing, your message would be automatically converted to text.” 

Mary’s daughter, Karen Evans, says her mother’s ability to communicate through a device she’s comfortable with has made all the difference for the entire family. Mary is even taking photos of flowers and vegetables in the Veterans Centre garden and sending them to the youngest members of the family.  

“It used to be so hard to get in touch with her because she doesn’t like using her phone, but it’s been amazing the way she’s adopted the iPad,” Karen says. “It’s been a lifeline for me and for my brothers, but the absolute benefit has been for her grandchildren and great-grandchildren because now she’s maintaining email correspondence with them.”  

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Combine these higher risk factors for seniors with dangerous winter conditions, and you can see why it’s so important for elderly pedestrians to take some precautions. Sarah Gallsworthy, Program Coordinator at Sunnybrook’s RBC First Office for Injury Prevention, has eight simple tips to keep pedestrians, particularly elderly ones, safe this winter:

1) Stay off your phone while walking– distracted walking is dangerous!

2) Be visible to drivers day and night by wearing bright, reflective items. Add a reflective sticker or patch to your jacket and bag

3) Wear proper and well-maintained footwear to reduce your risk of falling on slippery surfaces

4) Plan your outings– try to schedule outings during daylight hours and good weather conditions. Give yourself more time when traveling during the winter, so you don’t have to dart through traffic to catch the bus!

5) Be as light as possible– avoid carrying things that could make you lose your balance while walking

6) Don’t jaywalk– only cross at intersections with traffic signals, marked crosswalks or stop signs

7) Make eye contact with drivers before stepping off the curb- slippery road conditions means it may take drivers longer than usual to stop. Wait until vehicles have come to a complete stop before starting to cross the street

8) Keep your head up! Avoid looking at something other than the direction you’re traveling in

Do you have an elderly family member or friend who could benefit from these tips? Please pass them along, and help keep pedestrians safe this winter.

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