COVID-19 Resources

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

IPAC+ Resource Library

IPAC+ Resource Library

A resource library to support the implementation of infection prevention and control (IPAC) practices in long-term care facilities (LTCFs) and retirement homes (RHs). IPAC+ is an initiative led by the Knowledge Translation Program at St. Michael’s Hospital, Unity Health Toronto, in partnership with 20 organizations including the Ontario Ministry of Health and Long-Term Care.

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.

Virtual Care

Virtual care resources for members of the public

Canadian Patient Safety Institute

Virtual Care Playbook

Canadian Medical Association

University of Toronto Virtual Care Resources

University of Toronto

Sinai Health – Virtual Care Visits

Sinai Health

Empathy in Virtual Visits

Cleveland Clinic

Recommendations for Senior Friendly Virtual Care pdf [155.66 KB]

Senior Friendly Care is proactive care. Preparation is the key to creating a virtual care environment that is suitable for older adults with frailty. Consider the following recommendations in this document as you develop and refine your virtual care processes.

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.

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

Clinical Education

E-Learning for clinicians

The e-learning format is free, and learners can self-enroll and complete modules at their own pace. Click here to enroll in e-learning on the Canvas e-learning platform, and enter join code KYPFHJ. Returning learners can login anytime from the Canvas login page.

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.

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.

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.

Pallium Canada – Free, Online Modules

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

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.

Ethics and Advocacy

sfCare OHT Policy Brief pdf [618.08 KB]

Addressing the unique needs of older adults through specifically tailored approaches across an Ontario Health Team (OHT) is key to improving health outcomes. Our policy brief offers guidance on 8 important steps for OHTs to take now.

sfCare Hospital Policy Brief pdf [161.67 KB]

Our evidence-informed brief provides guidance to hospital leaders in the steps they can take now to embed sfCare within their organizations to improve outcomes for older adults. Addressing the unique needs of older adults through specifically tailored approaches is key to reducing lengths of stay (LOS) and alternate level of care (ALC) pressures and improving patient flow.

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.

Assessment and Management

Clinical management of patients with COVID-19: Second interim guidance

A guidance has been adapted for Canadian use from the WHO document entitled Clinical management of COVID-19: interim guidance, 27 May 2020.

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.

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.

NICE COVID-19 rapid guideline: critical care pdf [131.44 KB]

A critical message from NICE to about assessing for frailty, irrespective of age, by using the Clinical Frailty Scale.

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

Important advice from the Geriatric Emergency Department Collaborative

Providing Care in Long-Term Care

Dementia Isolation Toolkit

Toolkit developed by Dr. Andrea Iaboni that includes ethical guidance, worksheets and signs.

Housekeeping Tip Sheet: Caring for Residents with Cognitive Impairment in Long-Term Care pdf [653.36 KB]

This document provides person-centered communication and interaction strategies to support housekeeping staff (redeployed from other settings) in developing effective and positive relationships with persons living in long-term care. A joint release from the RGP of Toronto’s PRC Program and the Toronto Coordinating Office of Behaviour Supports Ontario.

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.

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.

Virtual Family 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.

Delirium

E-Learning for clinicians

The e-learning format is free, and learners can self-enroll and complete modules at their own pace. Click here to enroll in e-learning on the Canvas e-learning platform, and enter join code KYPFHJ. Returning learners can login anytime from the Canvas login page.

How to provide senior friendly care during COVID-19 – spotlight on delirium pdf [610.56 KB]

IPAC measures have changed the way care is provided. This 2-page, practical resource applies the sfCare Framework to the challenge of optimizing delirium care COVID-19.

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.

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

E-Learning for clinicians

The e-learning format is free, and learners can self-enroll and complete modules at their own pace. Click here to enroll in e-learning on the Canvas e-learning platform, and enter join code KYPFHJ. Returning learners can login anytime from the Canvas login page.

How to provide senior friendly care during COVID-19 — spotlight on mobilization pdf [302.29 KB]

Using the sfCare Framework to design solutions for the challenge of promoting mobilization in older adults. A 2-page, practical resource.

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.

Stretch Lift or Tap (SLoT): How Older Adults Can Stay Active at Home 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 While Protecting Ourselves

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

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.

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.

Cognition

E-Learning for clinicians

The e-learning format is free, and learners can self-enroll and complete modules at their own pace. Click here to enroll in e-learning on the Canvas e-learning platform, and enter join code KYPFHJ. Returning learners can login anytime from the Canvas login page.

Continence

E-Learning for clinicians

The e-learning format is free, and learners can self-enroll and complete modules at their own pace. Click here to enroll in e-learning on the Canvas e-learning platform, and enter join code KYPFHJ. Returning learners can login anytime from the Canvas login page.

Nutrition

E-Learning for clinicians

The e-learning format is free, and learners can self-enroll and complete modules at their own pace. Click here to enroll in e-learning on the Canvas e-learning platform, and enter join code KYPFHJ. Returning learners can login anytime from the Canvas login page.

Pain

E-Learning for clinicians

The e-learning format is free, and learners can self-enroll and complete modules at their own pace. Click here to enroll in e-learning on the Canvas e-learning platform, and enter join code KYPFHJ. Returning learners can login anytime from the Canvas login page.

Polypharmacy

E-Learning for clinicians

The e-learning format is free, and learners can self-enroll and complete modules at their own pace. Click here to enroll in e-learning on the Canvas e-learning platform, and enter join code KYPFHJ. Returning learners can login anytime from the Canvas login page.

Loneliness

E-Learning for clinicians

The e-learning format is free, and learners can self-enroll and complete modules at their own pace. Click here to enroll in e-learning on the Canvas e-learning platform, and enter join code KYPFHJ. Returning learners can login anytime from the Canvas login page.

Helpful Links

GeriMedRisk

GeriMedRisk is an interdisciplinary telemedicine consultation and education service for doctors, nurse practitioners and pharmacists in Ontario.

COVID-19 Rapid Evidence Access Link (REAL)

Concise, easy to digest, summaries of best available evidence. Based on requests from health systems leaders, policy and decision-makers, and the public.

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.

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.