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Tuesday, September 22, 2020

For hospitals, addressing mental health of Covid patients part of treatment

Addressing emotional trauma has become an essential part of treatment of Covid-19 patients, specially senior citizens, who spend days or sometimes even a month in isolation wards.

Written by Tabassum Barnagarwala , Abha Goradia | Mumbai | July 9, 2020 2:27:25 am
coronavirus in mumbaui, mumbai hospitals, covid-19 patients in mumbai hospitals, covid patients mental health, covid pateints mental health process of treatment, indian express news Hospital staffers are still wary of infection risk, but some hospitals are now training their staff to address the mental health of patients. (Representational)

Nurse Jaya Sankar (31) remembers the confused expression of an elderly woman after she regained consciousness in Bhatia hospital’s ICU. She was on a ventilator, had undergone tracheostomy and a month-long hospitalisation. Overwhelmed, she cried. Sankar told her he is like her son, held her hands in his gloved hands and she hugged the PPE-clad nurse. She cried, and he consoled.

Addressing emotional trauma has become an essential part of treatment of Covid-19 patients, specially senior citizens, who spend days or sometimes even a month in isolation wards. Hospital staffers are still wary of infection risk, but some hospitals are now training their staff to address the mental health of patients.

Last month, a 69-year-old breathless man refused to be put on non-invasive ventilator in Bhatia hospital. Sankar stood by his bed for 45 minutes. “He thought he would die, he was depressed. And that is why he didn’t want to co-operate. I stood at his bedside so that he could trust me,” the nurse said. The senior citizen eventually agreed to the ventilator. He was discharged last Friday after being hospitalised for 15 days.

Senior citizens are more prone to mental anxiety during long hospital stays, but the Covid-19 pandemic has equally worried younger patients about job security, family and social stigma.

For its 220 moderately to severely ill Covid-19 patients, St George’s hospital is the first in the city to start ‘therapeutic community’. Each ward with its 30 patients are encouraged to help each other to the toilet or take their medicines. The idea, a brainchild of Dr Prakhar Jain, includes showing patients movies, motivational videos in the morning and evening, and disabusing Covid-19 myths.

“Two psychologists and two psychiatrists visit every day for individual and group counselling. We started this a month ago and we can see it has made a huge difference in patients,” Jain said.

When Jain first visited the isolation ward, patients were hassled. They asked for their test reports, and about their families. Patients were scared of each other. “Nights were specially lonely for them. An NGO agreed to donate a TV. We provided WiFi in one ward to allow them to watch movies. It is a hit, we are trying to get five more TVs,” Jain said. The hospital is also planning to install WiFi to have smart TVs in all Covid wards.

In Bhabha Bandra hospital, a long ward has a door with a tiny glass window at one end. A resident doctor said she has started allowing the kin of patients to come up to the doorway. “We are seeing a difference in the mood of patients through this simple exercise. Seeing their family from a distance reassures them. They feel happy,” she said.

A team of 30 MBBS students from Seth GS Medical College have begun an initiative to help ease anxiety, doubts and stress among new Covid patients at MGM hospital, Parel, and Ruparel College through WhatsApp groups. The first day of institutional quarantine for a 38-year-old Lalbaug resident was harrowing. On being admitted to MGM hospital, he worried whether he had infected his mother, a cancer patient.

“I had to send my wife and child to her maternal home. I was upset that the family was separated like this because of me,” he said. He then received a call from an MBBS student asking how he was doing. Soon, he was added to a WhatsApp group called “dost”, on which he began receiving videos on meditation, yoga and positive approaches.

“There was so much free time at the hospital that I began practising yoga ten times a day for a week,” he says, adding that this could be a reason why he recovered and was discharged within a week instead of 14 days.

In the past month and half, the group has reached about 213 patients through its efforts. The group, consisting of students and involving students of physiotherapy and occupational therapy, now plans to engage on a bigger scale by collaborating with NGOs.

“With the passing of time, we began to find that the collective panic among new patients has considerably reduced. We are looking to collaborate with the administration to further pursue impactful interventions,” said volunteer Madhu Choudhary.

Intensivist Dr Gunjan Chanchalani said steroids used during Covid-19 treatment can have mental side-effects in some patients. “We have to be careful to provide treatment for mental health for these patients,” she said.

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