The Telehealth Intervention Program for Isolated Older Adults (TIP-OA) has been introduced to help elderly individuals, who are likelier to experience anxiety and depression as a result of the lockdown during the coronavirus (COVID-19) pandemic.
“We know that older adults are disproportionately affected by this crisis because they are already prone to isolation,” says Dr. Blanca Vacaflor, a geriatric psychiatry resident at the JGH.
“Moreover, they are at the highest risk of mortality from COVID-19. With these factors in mind, we initiated a unique clinical trial to help alleviate the stress on this population.”
The program is directed by Dr. Syeda Bukhari, a postdoctoral fellow, and Dr. Soham Rej, a Geriatric Psychiatrist at the JGH and a researcher at the Lady Davis Institute.
Since CIUSSS West-Central Montreal is home to the largest number of seniors in Quebec, the CIUSSS is the ideal venue for a data-driven assessment of new methods for delivering mental health services to the elderly.
Clients who are referred to TIP-OA receive supportive weekly telephone calls from volunteers, who provide a comforting ear and an encouraging voice.
The volunteers, many of whom have been recruited through the JGH Foundation, are not psychiatric professionals, nor is it their function to offer clinical advice. Rather, they relieve the client’s loneliness with a friendly chat, and they help determine whether the client’s basic needs—such as access to medicine, food and health care—are being met.
“Before the pandemic, vulnerable older adults could get out to exercise, shop and participate in community events,” explains Dr. Vacaflor. “But now they are told to self-isolate and to cut themselves off from caregivers and loved ones, in order to safeguard their physical health.
“So what becomes of their mental health? This is where we believe our volunteer outreach can be of service. Since the threat to older adults from the virus won’t diminish in the near future, we expect TIP-OA to continue after the pandemic subsides.”
Currently, participation will be through referrals by clinicians throughout the CIUSSS—for example, COVID-positive units, other JGH inpatient units, long-term care facilities and CLSCs.
However, the plan is to expand the project to allow for self-referral by anyone— potentially in other parts Montreal—who feels they could benefit. Volunteers are carefully paired with clients, based upon their aptitude and experience, so that more sensitive cases are assigned to those who are best equipped to assist. The program aim to reach at least 1,000 older adults, and more if funding increases.
“The objective is to provide a sense of connection that goes beyond clinical care,” says Dr. Vacaflor. “It’s crucial for their well-being and quality of life that these older adults realize they are not alone and the community is interested in their welfare.”
The JGH Division of Geriatric Psychiatry is also planning to pilot therapy for groups of up to a dozen participants using Zoom video-conferencing. Group therapy would be provided/chaired by a clinician and adapted from in-person versions of evidence-based interventions, including mindfulness-based cognitive therapy, life skills groups, problem-solving therapy, and/or supportive psychosocial groups.
The expectation is that telehealth interventions will result in expanded access to mental health services above and beyond the demands of the current pandemic.