QUALITY IMPROVEMENT
COVID-19 Brings Home the T
hat’s a powerfully healing message for everyone, from a person with cognitive impairment to a neuro-
surgeon—and one that’s vital right now. Paul D. Nussbaum, PhD, ABPP, is an ad- junct professor of neurological surgery at University of Pittsburgh School of Med- icine and president of the Brain Health Center—which offers many resources, at
brainhealthctr.com. In this conversation, he shares ideas about the importance of brain health during this pandemic and how to cultivate it. He’s speaking not only from his own expertise, but from his experience with his mother, age 96, now in care: “So I look at these issues from both sides and appreciate both.” This
interview is conversation.
Q. One of the biggest concerns, right after infection control, is the effect of increased stress or increased isolation. Can you talk about some ways to counter that potential damage? A. I'm a big advocate for provider, staff, and family not to hold it inside, to communicate. Take time periods during the day when the staff can get together. And to the extent that the residents in memory care can do so, they also need to have the opportunity to express their concerns about the masks, the screens, when people aren’t allowed to visit.
Q. What kinds of long-term effects do you see this time having on memory care? A. COVID forces us to pause and to re- flect on what we're doing. It forces you to pause and say, what are we doing? How are we managing this? And oftentimes we don't talk enough about the emotional and psychological
excerpted from a longer
implications of all this, which really are paramount. Going through this together can be very
powerful, can be very healing. And that has to be part of the culture now. Health care providers are the worst at
taking care of ourselves. We get into pro- cedures, we act like robots, we forget about ourselves. Culturally, I think this has shifted a bit, but it really needs to be pointed out on an ongoing basis for staff and families. Such as when we're talking about the
proper cleansing protocols for washing hands, it also has to include opportunities for a group setting where you can discuss how everybodyʼs feeling today: Howʼs it going at home? How are you coping? A number of people I would consider to
be very well-adjusted psychologically are having panic attacks, feeling claustrophobic, having COVID fatigue. My approach is to talk about it and to be open about it, to get it out of our heads, to be vulnerable, and to express.
Q. Have any particular approaches to memory care emerged as being stronger or more helpful in this time? A. I haven’t seen anything specific to that. What I have seen is more general. There’s a higher level of appreciation for socialization and the importance of family interaction. And that's two-fold. For example, when Iʼm not able to go into the building, someone has to fill the void. The staff have another role placed on their plate. From what I’ve seen, in the companies Iʼve interacted with, theyʼve taken on that mantle and done a very good job. That places some emotional stress on them because itʼs hard to take over the role of a child or a spouse. It’s not that we didn’t know this. But social
42 SENIOR LIVING EXECUTIVE NOVEMBER/DECEMBER 2020
Issues Around Social Isolation By Sara Wildberger
Change Agent Profile
Paul D. Nussbaum, PhD, ABPP Adjunct professor, neurological surgery, University of Pittsburgh School of Medicine President, Brain Health Center
isolation is devastating, particularly for older adults—not just for older adults, but partic- ularly for older adults. My guess is one of the things thatʼs going to change culturally is the greater appreciation of social interac- tion, family interaction. We know this, but when I tell some people
that social isolation, particularly for an older adult, is every bit as devastating as smoking, they look at me like Iʼm a little bit off. But it's true. COVID made social isolation front and center for us. All of us, in a little way or not, have ex- perienced being socially isolated now. It is just a window into what it feels like to have chronic social isolation. If thereʼs anything good that comes out
of this, it’s our attention on that across the lifespan. It’s not just older adults; the same thing happens with teenagers. We don't want them isolating. Itʼs the power of hu- man interaction and social chemistry. Itʼs not a pill; itʼs not a shot. It’s not something you can necessarily see, but itʼs something you feel when youʼre with others—and it hurts when you're not with them.
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