“Living with the Times” Toolkit
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Living with the Times A mental health and psychosocial support toolkit for older adults during the COVID-19 pandemic Translations, accessible formats and adaptations Please contact the IASC Reference Group on Mental Health and Psychosocial Support (mhpss.refgroup@ gmail.com) for the coordination of translations and preferred formats. All completed translations and versions will be posted on the IASC MHPSS RG website. If you create a translation or an adaptation of this work, kindly note that: • You are not allowed to add your logo (or that of a funding agency) to the product. • In case of adaptation (i.e. changes to the text or images), the use of the IASC logo is not permitted • In any use of this work, there should be no suggestion that IASC endorses any specific organization, product or service. • You should add the following disclaimer, in the language of the translation: “This translation/ adaptation was not created by the Inter-Agency Standing Committee (IASC). The IASC is not responsible for the content or accuracy of this translation. The original English edition ‘Inter-Agency Standing Committee: Living with the Times: a mental health and psychosocial support toolkit for older adults during the COVID-19 pandemic’ shall be the binding and authentic edition.” For an overview of all completed translations and formats of Living with the Times: a mental health and psychosocial support toolkit for older adults during the COVID-19 pandemic, see: https:// interagencystandingcommittee.org/mental-health-and-psychosocial-support-resources-covid-19 Introduction Living with the Times: a mental health and psychosocial support toolkit for older adults during the COVID-19 pandemic has been developed by the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support in Emergency Settings (IASC MHPSS RG). This resource includes posters with key messages for older adults on how to take care of their well-being and how they can provide support to those around them during the COVID-19 pandemic and beyond. It includes instructions for facilitators of mental health and psychosocial support (MHPSS) on how to conduct guided conversations with older adults using these posters. The posters build upon the guidance sections for older adults in the IASC Interim Briefing Note Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak, and the IASC Guidance on Operational Considerations for Multisectoral Mental Health and Psychosocial Support Programmes during the COVID-19 Pandemic. The production of this toolkit involved an iterative and participatory development process, which began with pilot-testing to understand what style of illustrations and designs worked best for older adults. A total of 199 older adults aged between 60 and 90 years, from 51 countries, provided inputs to the design and content via an online survey and a number of focus group consultations. Based on this feedback, the IASC MHPSS RG revised the posters and developed this facilitator guide through a thematic ad hoc steering group, in close collaboration with agencies specializing in the well-being of older adults, including colleagues from the International Federation on Ageing, HelpAge International and Alzheimer’s Disease International. The process was a unique inter-agency collaboration between experts from different disciplines, including dementia, MHPSS in humanitarian settings, and ageing and disability. Through a network of country-level MHPSS Technical Working Groups, the posters were then tested with 80 older adults from a wide range of countries, based on geographical location and different income groups and contexts. This testing phase included older adults living in humanitarian settings from a total of 10 countries. The facilitator guide was reviewed based on inputs from Member Agencies of the IASC MHPSS RG. The posters with key messages require minimal reading skills, are culturally diverse and aim to engage older adults in conversations and activities. The IASC MHPSS RG collected feedback on different designs for the posters to arrive at the style you will find in this IASC product. Our sincere appreciation goes to all the older adults who guided and informed the development of this toolkit. This is a tool to be used by all COVID-19 and humanitarian responders to help treat the mental health and psychosocial well-being of older adults as a priority. Background The COVID-19 pandemic has had a stressful events and take disproportionate impact on older women and more time to recover from men, who are at a higher risk of developing stress, which can affect more severe symptoms of the disease, and both their mental and of dying as a result. This increased risk is physical health. Measures partly due to age-related changes to the put in place to contain the immune system, which make it harder to fight spread of COVID-19 and off diseases and infection. Older adults are to protect older adults also more likely to have underlying health (such as shielding) have created additional conditions, such as lung, kidney, cardiovascular economic pressures and burdens for them. or cerebrovascular disease or cancer, and to Financial worries include families facing take multiple concurrent medications that unemployment or job losses and higher out- make it harder to cope with, and recover from, of-pocket expenditure for health and social illness, including COVID-19. welfare services as resources are diverted to COVID-19 response efforts. The stress, economic hardship and social Within the group of older women and men isolation associated (“older adults”) there is a great diversity with both short- of ages and abilities. The diversity of this term and long- population, as with any age cohort, will term measures put have a determining effect on their level of in place to contain vulnerability. Gender, age, disability, ethnic COVID-19 may affect origin, sexual orientation (LGBTQI+), social psychological well- connectedness, literacy levels, poverty, work being, exacerbate opportunities and other factors will all play a underlying mental key role in the extent to which an individual is health or neurological at risk or can be a support for their community. conditions, including common conditions For example, older adults who have migrated such as depression and anxiety, and also to their current country of residence may have potentially increase the risk of worsening fewer social connections or may not have cognitive decline and/or of suicide. Older access to the main language of information adults, especially women who live alone or about the pandemic. Other older adults may have limited social contact in normal situations, be proactively supporting their friends or be or older adults living in vulnerable situations part of emergency response efforts through (e.g. poverty, refugee settings, violence and running hotline/helpline services. abuse, or frailty), may also be at higher risk of experiencing newly presented symptoms of mental health and neurological conditions. Some older adults may react more strongly to 4 Due to their health risk profile, older adults becoming infected with COVID-19 or of may be one of the last population groups infecting family and friends. Stress related to for whom lockdown measures are lifted, COVID-19 may also exacerbate pre-existing potentially resulting in more time spent in fears and anxieties related to dying or dying social isolation. If COVID-19 transmission alone. For these reasons, it is important that rates remain high, older adults may also older adults remain mentally healthy and remain at higher risk of infection once active during the pandemic. disease-related measures are lifted. Older adults may be particularly afraid of Purpose The purpose of this activity toolkit is to share recommendations with older adults on how to protect their health and well-being, as well as how they too can provide support to those around them during the COVID-19 pandemic and beyond. The toolkit contains five large poster illustrations to print out or show on a screen, each addressing one of the following questions: 1. How can I stay healthy? 2. What can I do to improve my mood? 3. How can I feel connected to my family and community? 4. Where can I get help if I need it? 5. How can I cope with grief and loss? The posters aim to provide answers to these questions in an accessible format that requires minimal reading ability. They are universal in nature, representing different cultures, settings and regions; however, discussions arising from the illustrations should take socio-cultural, economic and gender contexts into consideration. The facilitator notes for each poster expand on this point and were developed so that each poster can be discussed stand-alone. As a result the instructions may feel somewhat repetitive at times. However, this was done to allow for the separate use of each poster. The illustrations can guide conversations and invite the viewer(s) to interact with the image. Each poster can be used as an activity; older adults can spend time with them and find solutions to the five key questions by themselves or in a group setting. The activities are best facilitated by a group leader, a mental health and psychosocial support (MHPSS) worker or a volunteer who is familiar with the needs of older women and men in a specific community or context. However, older adults can also review the posters in their own time, engage in conversations with one another or use them as discussion points in social gatherings. 5 Facilitator notes Before you start, here are some generic instructions and tips for facilitating the activity: • Familiarize yourself with the content of the toolkit and the illustrations. Reflect on how to introduce the themes in the posters in relation to your specific community or context. • You can run the activity in groups or through individual sessions. Where culturally or socially indicated, the activity should be arranged in gender-segregated groups.