Executing and assessing programme for mental well-being in an old age home during the COVID-19 pandemic by a homoeopathic institution: Challenges and outcomes

Abstract

Objective: COVID-19 pandemic has affected the provision of psychiatric care across the world and the elderly have been the most disadvantaged. Psychological stress in them is not only due to excess mortality risk but also due to restrictions instituted to mitigate the chances of contracting COVID. The current pandemic is likely to lead to substantial changes in the health-care services as it has shown the need for improved multidisciplinary and community- centered care. The purpose of this paper is to address the challenges faced while implementing a multidisciplinary structured programme for the mental well-being in residents of old age home and assess the role played by the sustainable multidisciplinary structured interventions to alleviate the psychological suffering. The old age home in the study is situated in a remote area of Palghar district. Availing of required medical health-care facility during a pandemic was a challenge in itself, where delivering the multidisciplinary intervention for mental well-being was a much needed and never tested in such a setup. Material and Methods: Primary screening and knowledge of acute and chronic stressors revealed the current status of emotional wounds and hence the emotional sensitivity of the group. Scales (generalised anxiety disorder [GAD-7], patient health questionnaires [PHQ-2] and dementia assessment by rapid test [DART]) were employed to evaluate intensity of anxiety, depressive symptoms and dementia. Techniques to deal with distress demonstrated in each session were based on action learning principles. Structured group interventions were done through relevant videos, group discussions, relaxation techniques, meditation and physical exercise by the team of homoeopathic physicians, psychologist and physiotherapist. Results were subjected to statistical analysis. Results: There was a statistically significant reduction in anxiety following intervention, z = −3.886, P < 0.001, with a large effect size (r =.57). The median score on the anxiety decreased from 10 to 4 in a span of 10 months. No significant improvement was found in physical health and cognitive impairment.