75 The COVID-19 pandemic and social frailty: an evaluation of Occupational Therapy practice in a day hospital

Abstract

Abstract Background Restrictions imposed to limit transmission of COVID-19 and to protect vulnerable persons led to loss of roles and routines, social isolation, sedentary lifestyles, increased anxiety, depression, and increased frailty among older people. In Occupational Therapy (OT) literature, ‘occupational deprivation’ describes this state of enforced disengagement in meaningful occupations which negatively impacts wellbeing. Clients attending a Day Hospital for Comprehensive Geriatric Assessment (CGA) reported residual elements of occupational deprivation and negative effects of COVID-19 restrictions with associated social frailty. OT practice was evaluated to determine the extent of services offered to remediate or improve social frailty and overall wellbeing. Methods During CGA, OTs assess clients’ occupational performance including cognition, mood, mobility, social environment and engagement in meaningful occupations. Routine (quantitative) data collected to evaluate the service was inputted and analysed using Microsoft Excel. OTs logged numbers of clients referred to services to remediate social frailty including day centres, social prescribing and an OT-led anxiety management group in the Day Hospital. Six months of data in 2023 was analysed. Results 288 clients received CGA by OT. The average age was 83. 33% were referred to Memory Technology Resource Rooms. 6% were referred to Day Centres or Active Retirement. 7% were referred to OT anxiety management group in the Day Hospital. 3% were referred to ALONE befriending. As part of routine OT practice, almost all clients were advised to continue with or to re-engage with previously enjoyed (meaningful) occupations such as attending mass, playing bridge, and visiting friends. Conclusion Occupational deprivation experienced by older adults during the COVID-19 pandemic contributes to increased social frailty. Older adults attending a Day Hospital received routine OT intervention focusing on enhancing their wellbeing and reversing social frailty associated with the COVID-19 restrictions. Assessment and management of social frailty is vital to understand the effects of the pandemic on older people and provide appropriate services.