British Columbia

Why treating COVID-19 in dementia units can be especially challenging

Dr. Maria Chung says the main problems with caring for people with COVID-19 who also have significant dementia is you cannot reason with them and you cannot correct their behaviour — so getting them to follow public health advice like physical distancing becomes very challenging.

'It’s very, very difficult to stay in quarantine with people with dementia,' says UBC's Dr. Maria Chung

It is particularly difficult to care for dementia patients during the COVID-19 pandemic, says Dr. Maria Chung, a UBC professor and physician specializing in geriatric care.  (Alexander Raths/Shutterstock)

The COVID-19 pandemic has made caring for people with dementia especially challenging, says a UBC professor and physician specializing in geriatric care. 

Dr. Maria Chung says the main problems with caring for people with COVID-19 who also have significant dementia is you cannot reason with them and you cannot correct their behaviour — so getting them to follow public health advice like physical distancing becomes very challenging.

"They will do what they do. Even if they agree for a second or a minute with what you're saying, they'll forget it within minutes," Chung said to host Gloria Macarenko, host of CBC's On The Coast.

The pandemic has been especially deadly for the elderly in the population, particularly those in long-term care homes across the country. In B.C., 93 residents of long-term care homes have died from the disease as of Thursday.

One such care home, the Langley Lodge, has been particularly hard hit. As of Thursday, 22 residents had died. The response has been especially complicated by the fact some residents have dementia. 

Chung says dementia units themselves are not built for physical distancing or quarantine conditions.

"The dementia care unit is specifically for people who are having more problematic behaviours, so things like wandering, where they go in and out of other people's rooms," she said. 

"The unit is designed so they can wander freely but not really get out of the building. Sometimes they have a little outdoor garden that they can wander into."

The Langley Lodge has had the highest coronavirus death toll of any long-term care home in the province. (Ben Nelms/CBC)

However, this means residents often go into each other's rooms or pay no attention to what they've touched, making it easier for a virus to spread.

"You cannot possibly expect them to respect physical distancing, to practise proper hand hygiene. They cough and sneeze wherever," she said. "It's very, very difficult to stay in quarantine with people with dementia."

Other factors that have been introduced to mitigate the risk of coronavirus have added a layer of complication. The restriction on family visits and external activities or programming can be stressful for patients. 

The one thing that can really be effective, she says, is one-to-one care. But with staffing shortages, that can be difficult.

If you do have a family member in a dementia care unit, Chung says, it's important to keep in touch with staff and try to talk to your relative if possible. 

"People say, why should I do that? They won't even remember. But they will have some comfort in that minute or so you are in contact with them," she said. "It may provide some comfort to you as well."

She also says it's important to be realistic but also have hope.

"I've had patients who have had COVID and they're in their 90s, and they do survive. It's not common, but it is possible. We just have to hope the best."

Listen to the segment on CBC's On The Coast:

May 28, 2020 The Langley Lodge care home has become the single deadliest site for COVID-19 in BC. 22 residents have died from the disease. One of the most affected units is a dementia unit. Dr. Maria Chung is a UBC associate professor of geriatric medicine. 8:55

If you have a COVID-19-related story we should pursue that affects British Columbians, please email us at impact@cbc.ca. 

With files from On The Coast

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