A Social Worker On How To Support Our Most Vulnerable During COVID-19

Laura* was walking across the street on her lunch break from her job as a social worker in a downtown Toronto hospital when she saw a woman pick up a discarded face mask from the ground, intent on using it for herself. Luckily, Laura, who works in the heart and vascular program providing counselling to patients and their families, had an extra surgical mask in her purse. “I just said, ‘I know it's so hard, but you don't know who used that,’ and I handed her the mask,” she tells Refinery29. “It was a reminder that there are folks who can't afford to buy masks or have resources to get a homemade one."

It’s also a reminder of COVID-19's devastating toll on the country’s most-vulnerable communities, including the homeless, elderly, and people struggling with their mental health. Laura sees this firsthand daily as she interacts with people without resources for the simple things many of us take for granted in this pandemic, like masks, sure, but also access to safe spaces, and even the ability to keep in touch with family members. Social workers are facing unprecedented challenges as hospitals restrict visitors (some of these restrictions are slowly lifting) and many shelters remain closed around the country.

Here, Laura talks about the difficulty of comforting people through a mask, how survivors of domestic abuse are even more at risk during the pandemic, and what we can do to help. 

The people who come to our units have had heart attacks, cardiac arrests, and some go on to have open-heart surgery. Even under regular circumstances, that can be an upsetting, tumultuous time for people. I help people adjust to change — whether that’s the patient or the family. With COVID-19 visitor restrictions, families are even more anxious. Like many acute care hospitals right now, we aren't able to allow visitors except for a few very clear exceptions. You can only do so much with Zoom. One of my patients has a visual impairment and he said to me, "I don't know if I can do that Zoom thing. I don't know if my vision is going to allow me to do that." So, that’s another thing we have to take into consideration. 

I also deal with people with a whole array of mental-health issues from addictions to alcohol dependence to psychiatric illness. Some people believe that just by being in the hospital, they're going to get COVID. "No, I don't want to go to rehab. That's another hospital,” they say. I think it’s important to know that, despite everything going on, we are going to try to access [the help] these people need. That's what social work is known for. We're problem solvers. It’s about asking questions like, “How do we take care of people, especially the ones with the least amount of people in their corner?”

Yes, we are so vigilant around our PPE. I find wearing a mask challenging because I am talking with people about very private, personal things in their lives. And in terms of building trust, I use all of me to do that. Wearing a mask, I find, detracts from being able to express myself. You can still use your voice to show empathy, but it's really challenging.

It’s so hard. We have compassion fatigue. It’s so difficult to be on the phone with someone and have to be the person who says, "I'm sorry, you can't come in to see your sick loved one." I'm find I'm sending a lot more emails. For families, it's mostly by phone, and then I’m seeing patients in person as needed.

It’s also been hard interacting with my colleagues. They have been going through major things in their life, and I can't hug them. A nurse who's had a recent breast cancer diagnosis, another colleague whose father has bladder cancer. That same colleague's husband was in the lineup at the LCBO, and in trying to break up a scuffle between two people, was spit at by a random person. We are turning to each other since we're the only ones who know what it feels like right now to be coming into a hospital to work. We're carrying around these losses and the emotions of our patients. 

So many vulnerable communities have been affected by COVID. It's important to remember that not everyone has access to virtual solutions. We had a patient who didn't have a phone but had email. He could only use the internet at the library and because libraries were closed, we didn't have a way to contact him after he was discharged. And that was also his way of keeping in touch with his family who were out in Alberta. It’s a ripple effect.

People in vulnerable situations don't have places to wash their hands. There aren't places to go to the washroom. They don’t have access to masks. The city has done its best to try and create shelters for people who actually have COVID. But I think this pandemic has shone a light on where things weren't working. 

I feel really guilty and anxiety-ridden all the time because of the fear of transmission. My granddaughter was born in January and I felt guilty even doing a socially distant Mother’s Day thing where we brought our own food and stayed six feet apart. My husband is an older guy — he's going to be 70 this year — and given that I'm taking the TTC and I'm going into a hospital, we feel more comfortable not to have any physical contact. It’s been really hard. But we try to stay close through other ways of showing affection. 

I think it depends on how that abuse manifests. Let’s say a woman is already really isolated because of the dynamics between her and her abuser. She could be convinced that she can’t tell her partner that she’s gone to meet her sister for coffee, because her sister will say, "He's a bad guy. You need to leave him." Now, she’s not able to hear that at all. There’s an additional piece of isolation that happens when a person can’t have those conversations. When a woman is contemplating whether she wants to leave, she is building a plan to leave. And it has to be the right timing for her to do that. Obviously, now is an impossible time. In times like these it’s even more important to support women's shelters which have had to accommodate so much change in order to help these women get to safety. 

Donate to food banks. There’s a great need for food, not just for those who were already clients, but people who have been financially affected by COVID-19. There are also so many other places in your communities to donate, whether it is a women’s shelter, or agencies serving new Canadians and people with addiction or mental-health challenges. Finally, reserve judgement about those who have disadvantages. Help decrease stigma with education and compassion; one person at a time.