February 23, 2021 Meeting By James Rayner
Dr. Samir Sinha – Director and Chair of Geriatrics at Mount Sinai Hospital and founder of The National Institute on Aging
[Note: For personal medical advice, please consult your physician or other health care professional.]
The guest speaker at the February 23 meeting was Dr. Samir Sinha. Rather than delivering a prepared speech, Dr. Sinha’s presentation took the form of a Question and Answer session.
Q: The member referred to Happily Ever Older, a book by Moira Welch, a Toronto Star reporter. The book discusses matters such as long-term care (LTC) and aging in place and suggests how these areas could be improved, especially for those suffering from physical deterioration as well as mental decline and Alzheimer disease. Are we getting any closer to what the book envisions?
A: (Sort of.) The required personal care for seniors in homes is currently two hours and forty-five minutes and is scheduled to increase to three hours in 2022 and four hours in 2024. There appears to be two factors in play here. The Ontario Government sets the standards and provides the funding for long-term care facilities; what the standards are seems to depend on the money available. The current staff is overworked and tired and needs to be increased. Secondly, most homes are built to economy of scale where at least 120 residents divided into units of 30 are required for the business to break even. Contrasted with this is the Greenhouse model where residents are housed in a building with 10-12 bedrooms, all with separate bathrooms, but with a communal kitchen and living/dining room. This model has been shown to be more personalized and successful than the large warehouse approach. Again, the matter hinges on the money made available by the government; it will take political will to change things and that is our job— to convince politicians to make the changes required.
Q: Should we be worried about adverse side effects from the COVID-19 vaccines?
A: There is always the possibility of side effects from any vaccine; these current vaccines have been tested on thousands of volunteers and no steps have been skipped in the testing. No deaths have been attributed to the vaccine. However, as with any vaccine, a patient may experience a sore arm or fatigue for a few days. In fact, older adults, because of their weakened immune systems, are less likely to experience a negative reaction—a rare bonus from being older!
Q: Will we need to get an annual COVID booster shot?
A. We don’t know yet. While the vaccines are about 95% effective, it is too early to know how long that effect will last or even if those vaccinated can still transmit the virus to others. We may end up requiring a booster shot (like tetanus) every ten years or an annual shot similar to the flu shot.
Q: Should someone who has had COVID get vaccinated?
A: Yes. Studies have shown that those infected with COVID had 83% immunity for five months but that is not as good as being vaccinated.
Q: Where do we get the shots?
A: Until now, the government has not been clear but we did hear that the over-80 group would be vaccinated in April; Dr. Sinha used Twitter to get the government to change its mind and move that up to March. There is to be a website where Ontarians can learn about injection procedures, although the same approach was tried in California where the same program crashed constantly. We recently heard that family doctors would be able to administer the vaccine — which would be convenient — but nobody in government thought to consult with the OMA first. And why is the government waiting until now to organize when it could have done so in December?
Q: Could you comment on the use of anti-psychotic drugs in LTC homes?
A: There seems to be an increased reliance on such drugs to calm dementia patients but recent research has shown that in LTC homes, these patients are isolated and this isolation leads to behavioural problems. So, the trend now is to keep these patients in touch with other residents and cut the amount of drugs used.
As an advocate for better treatment of seniors in long-term care, Dr. Sinha was a very much appreciated speaker. He emphasized the fact that we all should be advocating for better treatment for older citizens by urging and pressuring politicians to enact changes that will make the system more effective and more humane. For information on lobbying and on the problems of aging, consult the website of The National Institute on Aging. After all, we each have a personal interest in making the system better.
Probus Club of Kingsway-Islington 