COVID-19 Resources

Clinical guidance, tools, and links for health providers caring for older adults during the COVID-19 Pandemic.

Assessment and Management

COVID-19 Primer – Virtual Patient Simulation

Educational primer from the New England Journal of Medicine. Introduces clinicians to some of the basic concepts of managing floor patients suspected or confirmed of having COVID-19. Includes a case of an 84 year old man with multiple comorbidities.

Tip Sheet for Care Providers Conducting Nasal and Throat Swabs with Clients with Cognitive Impairments pdf [205.53 KB]

Key considerations and practical strategies. Developed by the RGP of Toronto with input from an expert panel. Available in French

Emergency Department Discharge of Older Adults with Viral Syndrome

Discharge instructions for older adults and/or their families on discharge from the ED with a viral syndrome. From The Geriatric Emergency Department Collaborative (GEDC).

Managing Respiratory and End-of-life Symptoms for Frail Elderly Patients with COVID-19 pdf [157.51 KB]

Resource adapted by Baycrest and University of Toronto with permission from BC Centre for Palliative Care Guidelines. Available in French.

Telephone-based screening tools for mild cognitive impairment and dementia

This review from Frontiers in Aging Neuroscience highlights some of the existing instruments with particular focus on data validation, cognitive domains assessed, administration time and instrument limitations and advantages.

COVID-19 in Older Adults pdf [155.34 KB]

Summary of atypical presentations of COVID-19 in older adults. Prepared by University of Toronto and University of Calgary. Last updated April 2 2020. Available in French

Pandemic palliative care: beyond ventilators and saving lives

Practical article from CMAJ. Includes symptom management kit, triage tool for referral to specialist, and conversation templates for physicians.

Top 5 Things to Know about Lopinavir/Ritonavir and Older Adults

A resource from GeriMedRisk – a service that connects physicians, nurse practitioners, and pharmacists through telephone and eConsult to an interdisciplinary team to troubleshoot complex physical and mental health conditions in older adults.

Preventing and Managing Delirium in Older ED Patients

10 key messages about preventing and managing delirium in older ED patients during the COVID-19 pandemic. A resource from the Geriatric Emergency Department Collaborative.

COVID-19 in Older Adults: Key Points for Emergency Department Providers

Important advice from the Geriatric Emergency Department Collaborative

WHO Clinical Management of COVID-19

Helpful resource developed by Toronto physicians. Includes recommendations for older patients that emphasize being person-centred, including caregivers in management planning, reviewing for polypharmacy and multidisciplinary team approach.

Providing Care in Long-Term Care

The Person Behind the Mask: Communicating with Clients Living with Dementia in Long Term Care While Protecting Ourselves pdf [753.84 KB]

For providers in long term care settings. Developed by the Mississauga Halton Behavioural Supports Ontario and the Alzheimer Society of Peel.

Communication Tip Sheet for Redeployed Staff Working with Residents with Cognitive Impairment pdf [79.88 KB]

Practical suggestions and communication do’s and don’ts developed by experts from the Toronto Central BSO Coordinating office, the Psychogeriatric Resource Consultation Program of Toronto and the Regional Geriatric Program of Toronto.

Orientation for Teams Redeployed to LTC

The Ontario COVID-19 Education Task Force, in partnership with the Ontario Centres for Learning, Research and Innovation in Long-Term Care and the Baycrest Centre for Education, have developed an online training for providers being redeployed for COVID-19 care. Learners need an access code provided by their hospital, LTC facility, professional association, or other source. Email covideducation@uhn.ca for more information.

Ethical guidance for people who work in long-term care: What is the right thing to do in a pandemic?

12 PG resource developed by the Dementia Isolation Toolkit Working Group lead by Dr. Andrea Iaboni.

Management of Residents with COVID-19 in Long-Term Care Settings

Recorded webinar from the LTC+ Virtual Care Support for Long Term Care Homes in Toronto. Speakers include physicians from infectious diseases, long term care, palliative care, internal medicine, and geriatrics. Download slides.

Tip Sheet for Care Providers Conducting Nasal and Throat Swabs with Clients with Cognitive Impairments pdf [205.53 KB]

Key considerations and practical strategies. Developed by the RGP of Toronto with input from an expert panel. Available in French

Ethical considerations for managing residents who lack the cognitive ability to adhere to IPAC protocols pdf [631.58 KB]

3 PG practical summary of key ethical values and their application in the COVID-19 pandemic and a suggested step by step process for decision making. Lead by Sally Bean and GTA Ethicists.

Should I or my family member go to live with family or stay in the long-term care or nursing home?

6-step decision aid for older adults and families. Developed by the Ottawa Hospital Research Institute and National Institute on Aging. Includes personal rating exercise of harms and benefits.

Guidance for Supporting Clients Who Wander and Require Physical Isolation pdf [184.31 KB]

Suggestions for non-pharmacological strategies that care teams can consider and implement when supporting older adults with dementia who are at risk due to wandering behaviour. Developed by the Toronto Central BSO Coordinating office and the Regional Geriatric Program of Toronto. Available in French.

Activities for Older Adults Living with Dementia

A guide to online resources for those providing care for people with dementia. Developed by Health Innovation Network South London. May provide inspiration for staff in LTC.

Messaging Boards – Memory Supports – for Dementia

This document from DementiAbility includes a variety of messages for individuals living with dementia. Includes templates that can be modified for your organization.

Ontario CLRI Supports for LTC Teams

Mental health supports for LTC teams, resources for residents, compassionate communication modules, and more from the Ontario Centres for Learning, Research, & Innovation (CLRI) in LTC.

Virtual Visits Toolkit

Toolkit for any long-term care team attempting to set up scheduled video calls between older adults and their loved ones. Developed by Family Councils Ontario, the Ontario Association of Residents’ Councils, and Tech Coaches Inc.

ABCs of COVID-19 in Long-Term Care

Four steps LTC homes can take now: recognize atypical presentations, initiate behaviours to clinically manage infections, prepare for and prevent spread, and remain informed about changes in policies/guidelines. (D’Adamo H  2020 Mar 25)

Preparing for COVID-19 In Long-Term Care

National Collaborating Centre for Infectious Diseases speaks with Dr. David Strang, a geriatrician and co-founding member of the Long Term Care Medical Directors Association of Canada.

Managing the COVID-19 pandemic in care homes

Good practice guide from the British Geriatric Society developed to help care home staff and NHS staff who work with them to support residents through the pandemic.

Delirium

HELP COVID-19 Delirium Prevention Toolkit

Instructions on creating a patient “toolkit” to prevent functional decline in hospitalized older adults. Developed by the Hospital Elder Life Program (HELP).

COVID-19 in Older Adults pdf [155.34 KB]

Summary of atypical presentations of COVID-19 in older adults. Prepared by University of Toronto and University of Calgary. Last updated April 2 2020. Available in French

Communication tips for clinicians caring for older adults experiencing delirium pdf [193.49 KB]

Single-page resource which includes general tips, and ready-to use scripts for people experiencing confusion or agitation. Available in French.

How to prevent and support delirium in an older adult when you can’t visit in person pdf [198.38 KB]

Single-page resource which includes general tips, and ready-to use scripts.

Prevention and management of delirium in older adults across the care continuum pdf [329.49 KB]

2-page resource which includes evidence-based recommendations for quality delirium care accompanied by special considerations for the pandemic context.

British Geriatric Society statement on delirium in COVID patients

A general statement and mostly reinforces the usual approaches to delirium.

Preventing and Managing Delirium in Older ED Patients

10 key messages about preventing and managing delirium in older ED patients during the COVID-19 pandemic. A resource from the Geriatric Emergency Department Collaborative.

Mobility

Sunnybrook Specialized Geriatric Services Exercise Videos

A series of 5 instructional videos to help older adults with frailty remain active at home during COVID-19. The videos include seated, standing, and upper body strengthening exercises. Created by physiotherapists Ingrid Otten and Leslie Corrigan.

#everyBODYmoves COVID-19 Resources

Free resources from Johns Hopkins to help you foster a culture of mobility in your institution during COVID-19. Includes mobility evaluation tools and posters available for download and use under a creative commons license.

Mobilization in Older Adults Living with Frailty pdf [167.47 KB]

Evidence-based recommendations and resources for maximizing mobility in older adults who are unable to leave their current living space.

How Older Adults Can Stay Active During the COVID-19 Pandemic pdf [1.43 MB]

Ideas for how to Stretch, Lift, or Tap (SLoT) during activities of daily living. Includes mobility games such as virtual charades!

Maximizing mobility in older people when isolated with COVID-19

Rapid review from University of Oxford COVID-19 Evidence Service Team

Communication

The Person Behind the Mask: Communicating with Clients Living with Dementia in Long Term Care While Protecting Ourselves pdf [753.84 KB]

For providers in long term care settings. Developed by the Mississauga Halton Behavioural Supports Ontario and the Alzheimer Society of Peel.

The Person Behind the Mask: Communicating with Clients Living with Dementia While Protecting Ourselves

A resource for providers in the community. Developed by the Mississauga Halton Behavioural Supports Ontario and the Alzheimer Society of Peel.

Tip Sheet for Care Providers Conducting Nasal and Throat Swabs with Clients with Cognitive Impairments pdf [205.53 KB]

Key considerations and practical strategies. Developed by the RGP of Toronto with input from an expert panel. Available in French

Maintaining Our Humanity Through the Mask: Mindful Communication During COVID-19

3 tips for communication for clinicians caring for persons with dementia: Attend mindfully. Behave calmly. Communicate clearly. (Schlögl M 2020 Apr 13)

Speak Up Ontario Conversation Guides

5 goals of care conversation guides from Speak Up Ontario for clinicians speaking to older adults with frailty and COVID-19 infection.

Messaging Boards – Memory Supports – for Dementia

This document from DementiAbility includes a variety of messages for individuals living with dementia. Includes templates that can be modified for your organization.

Support Toolkit for LTC homes, housing and other seniors’ living facilities

Developed by AdvantAge Ontario. Includes communication templates, suggest list of key contacts, and a situation management checklist.

Communication tips for clinicians caring for older adults experiencing delirium pdf [193.49 KB]

Single-page resource which includes general tips, and ready-to use scripts for people experiencing confusion or agitation. Available in French.

How to prevent and support delirium in an older adult when you can’t visit in person pdf [198.38 KB]

Single-page resource which includes general tips, and ready-to use scripts.

COVID Ready Communication Playbook

Resource from VitalTalk – a nonprofit dedicated to making clinician communication tools for serious illness. Includes advice on what to say when screening, triaging, admitting, deciding, and much more.

Virtual Care

Virtual Approaches to Cognitive Screening During Pandemics

A list of cognitive assessment instruments that can be administered by telephone or videoconference. Includes feedback from geriatric outreach clinicians.

Telephone-based screening tools for mild cognitive impairment and dementia

This review from Frontiers in Aging Neuroscience highlights some of the existing instruments with particular focus on data validation, cognitive domains assessed, administration time and instrument limitations and advantages.

Virtual Visits Toolkit

Toolkit for any long-term care team attempting to set up scheduled video calls between older adults and their loved ones. Developed by Family Councils Ontario, the Ontario Association of Residents’ Councils, and Tech Coaches Inc.

ZOOM Instructions for New Users pdf [144.93 KB]

Using Zoom to connect virtually with patients during the COVID-19 crisis.

Virtual Comprehensive Geriatric Assessment pdf [418.53 KB]

Developed by Dr. Shelley Veinish and Baycrest team

Social Distancing & Infection Control

Should I or my family member go to live with family or stay in the long-term care or nursing home?

6-step decision aid for older adults and families. Developed by the Ottawa Hospital Research Institute and National Institute on Aging. Includes personal rating exercise of harms and benefits.

Should I go to live with family/friend or stay in my retirement/assisted living home?

5-step decision aid for older adults. Developed by the Ottawa Hospital Research Institute and National Institute on Aging. Includes personal rating exercise of harms and benefits.

COVID19 Prevention Tips for Personal Support Workers and Caregivers pdf [69.75 KB]

One-page poster for display in the home. Can be distributed through primary care and customized with the phone number of a family physician or nurse practitioner.

COVID-19 Health Literacy Project

Factsheets in 30+ languages designed help all patients know when, and how, to seek care. Created in partnership with Harvard Health Publishing.

Social Distancing – YES. Social Isolation – NO. png [374.17 KB]

Infographic on how to care for those living with dementia, stroke, and neurodegenerative disease during the COVID-19 pandemic. Developed by the Ontario Neurodegenerative Diseases Research Initiative (ONDRI).

Other

The Geriatric Emergency Department Collaborative – COVID-19 Links & Resources

Resources for emergency departments, long-term care, post-acute care, palliative care, intensive care, and much more.

American Geriatrics Society – COVID-19 Information Hub

A “one-stop-shop” for select tools and guidance relevant to care for older people in the United States.

Canadian Geriatrics Society – COVID-19 Resources

A list of helpful links.

Pallium Canada – Free, Online Modules

Enhance your knowledge, skills, and practice in providing high-quality palliative care with these free, self-directed modules.

British Geriatric Society – Coronavirus & Older People Page

This resource series brings together current advice from experts within the BGS relating to older people and the current COVID-19 pandemic.