For one patient it didn’t take words, it only took a sound. Like many families during a time of visitor restrictions, she had a large and supportive family anxious to see her. For this patient and her family, the iPad program proved to be a major and important connection, particularly in the last days of her life.

The patient had family living in different places throughout the world, and a family member, who facilitated the FaceTime call on their end, was able to bring them all together during each iPad visit. The patient was not only missing her family, she also spoke little English and missed hearing the sounds of her first language. Having both at once appeared to be a profound blessing for her.

As care providers, our Spiritual Care and Social Work teams frequently helped facilitate these FaceTime calls, and several had the honour of holding the iPad that connected the patient with her family. As part of her care, the patient was wearing large soft mitts on her hands to protect her from pulling on lines. When the iPad was held for her, the patient would reach out for the device with her hands – and with the sides of her soft mitts, very gently hug the sides of the iPad. Together, she and I were able to non-verbally communicate where to position the iPad so she could safely hug the device (thereby virtually hugging her family) while communicating through it at the same time.

In one of her last calls with her family, the patient was able to respond to each family member with sound. As each of them joined the Facetime call, the patient would call out “oooh!”  While this may seem simple, it was profoundly moving.

At the patient’s end of life her family shared with us how comforting it was for them to be able to interact with her virtually despite the fact they were unable to be physically present. They spoke of the “ooh’s” with both smiles and tears, and with love for her life well lived.

The post A Sunnybrook patient finds comfort and connection through the iPad program appeared first on Your Health Matters.

“During crisis situations, it is important that we lean on each other for support as we are stronger as a collective than as a single individual,” says Dr. Matthew Boyle, psychiatrist. “Staying connected can also help family, friends, and those who are vulnerable, such as the elderly, feel less isolated.”

In a time when many people are consuming news about the pandemic throughout the day on various devices, Dr. Boyle says taking a break to socially connect can be beneficial to a person’s health.

“It can be hard not to always pay attention to the news during a pandemic but having some time when you can connect with others instead of focusing on the news can help from a wellness perspective,” explains Dr. Boyle. “Perhaps try spending at least one hour each day not checking news or emails, and instead, find a way to connect with friends and family. Social connections can be ways to help reduce stress – and that’s a great health benefit in a time like this.”

Here are some creative ways to connect with friends and family:

Play an online game: You can find apps to play board games, word games, or even work on jigsaw puzzles together virtually. Another way to utilize technology is to set-up video-conferencing where different households can see one another on their screens, and join in a visual game like Charades or Pictionary.

Online movie night: Find a time for friends to connect online and watch a movie together. For example, Netflix Party enables friends to watch its shows online, synchronize video playback and a group chat function. There are a variety of apps that can help you watch movies together but it may be easier to find the same movie, and for everyone to just hit ‘play’ at the same time to watch, and chat throughout the movie using text or another app. Find the app that works for you and your group, get the popcorn ready and start watching!

Write a letter: You don’t need technology with a good old-fashioned hand-written letter or card. It may not be immediate interaction, but it can be a nice way to let people know that you’re thinking about them. For those who don’t have a computer or access to technology, it is a way to keep in touch. If you’re on a short walk and the person lives nearby, you can drop the letter in their mailbox, or put a stamp on it and pop it into a nearby Canada Post box. Besides, who doesn’t enjoy getting mail that’s not a bill?

Catch up on a call:  Before video chats and texting, there was the telephone. Give a friend or family member to find out how they’re doing. You don’t always need to see each other on a screen. Sometimes it’s just nice to hear another person’s voice and have someone to talk to for a little while.

Digital coffee club: Grab a cup of java and make a virtual date with friends. While it’s not the same as meeting at your favourite coffee shop, getting cozy at home with a cup of coffee and making a plan for a video chat or phone call with friends can be something to look forward to. In a time where staying home is key, it’s a way to ‘catch up over coffee’ that can bring warmth and connection in more ways than one.

Hold a virtual social event: Technology can help bring people together to learn new things. Friends and family can get creative and hold an event online or join in over the phone. Perhaps each person in the group has a skill they can teach or demonstrate each week. Or maybe, it’s an opportunity for a group to join an online fitness group or e-learning class. “Our colleagues hold a weekly social event drop in that covers diverse topics such as yoga, karate lessons, mindfulness, sign language and beyond,” says Dr. Boyle. There are many options and ways to meet up virtually to learn together or just be social.

We are all finding new ways of connecting during the pandemic and it’s so important in maintaining our mental health and helping to reduce stress. Despite the physical distancing necessary for living in this new reality, it may be an opportunity to perhaps reconnect with loved ones on another level, and in a way, maybe even feel a little bit closer.

» Get more COVID-19 resources and updates from Sunnybrook at sunnybrook.ca/coronavirus

» Coping during the COVID-19 pandemic: mental health resources from Sunnybrook’s Department of Psychiatry

The post COVID-19: Ways to stay social despite the distance appeared first on Your Health Matters.

(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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The Gamma Knife delivers focused radiation to tumours that have spread (metastasized) to a patient’s brain. The frameless Gamma Knife Icon means the patient doesn’t have to have a frame screwed into their head to keep them still while the radiation beams carefully target their brain tumours. We are the first hospital in Canada to get this machine.

I’m passionate about this work. For a long time, patients with brain tumours and metastases were largely considered at the end of life, and using the fanciest equipment known to man was thought to be unjustified.

But as patients live longer, the focus is to make them live better, and using focused radiation can improve the ability for patients to maintain their memory and quality of life. We owe it to our patients to make their end of life as comfortable and as meaningful as we can, and that’s why technology like the Gamma Knife Icon is so important.

It means a much more comfortable journey through treatment for our patients. It means instead of a frame placed on the head with four screws going into the superficial aspect of the skull, we can now do this highly precise radiosurgery with a mask-based system. No screws.

From speaking with my patients, I know the frame is a source of stress and fear leading up to and during their treatments. When it is applied there is pain and when taken off there is pain. Sometimes there’s bleeding. As one of my patients said, “It feels like something from the medieval times.” Overall it is an invasive aspect to this non-invasive therapy. It’s pretty counterintuitive when we have the most advanced brain radiation unit in the world that we still had to have a frame to place.

The Gamma Knife Icon gives us the opportunity for the latest and most precise treatment for a variety of indications. In particular, the Gamma Knife Icon will allow us treat multiple metastases, which we would not otherwise be able to do with a regular linear accelerator. So a whole new world of brain radiation treatments will be realized.

This is a massive new area of research and development for our team. We are already doing technical research to improve image quality, and as soon as it is installed we will start testing our work and applying it to improve treatments. We received a large federal development grant for this research.

My team and our patients used to stay late into the night in order to do treatments before the Gamma Knife Icon, and we were limited as to how many tumours we could treat due to technical difficulties and the time it took. Now, we are able to treat patients with multiple metastases — 5, 10 or even 15 or more — with the Icon, and because it’s frameless we can break up the treatment into a few lesions a day instead of patients laying in the machine for 4 to 6 hours.

As we get our Icon up and running, we continue to conduct trials to see what’s best for these patients. We’ll move more and more treatments over to our Gamma Knife Icon, which we know will improve the experience of our patients.

The post Behind the research: New equipment means better patient experience appeared first on Your Health Matters.

The Answer: Once referred by a family physician, it can take a year to see a surgeon, according to Albert Yee, a spine surgeon here at Sunnybrook, who hears this question from patients all the time.

The post Spine Surgery: Why the Waits are So Long appeared first on Your Health Matters.