Completed

Updated: September 11, 2020

What emerging practices exist to safely re-open activities in non-residential settings for seniors?

Summary

The following is a summary of evidence sources that provide high quality information on how to re-open senior centres following closures due to COVID-19. This note is a jurisdictional scan.  For additional information about each of the sources, see the Table below.

Several jurisdictions offer guidance on how to restart recreational and other services for seniors including Manitoba, Massachusetts, Vermont and Pennsylvania. Manitoba guidance on Restoring Safe Services outlined strategies including 1) providing a single entry to the site and screening all staff, volunteers, and participants for symptoms of COVID; 2) maintaining physical distance measures by practicing proper hygiene standards laid out and structuring the furniture to maintain social distancing; 3) having adequate hygiene stations available; 4) discouraging drop-in sessions and limiting the size of groups to one-on-one interactions, where possible or as small of a group as possible and preferably in outdoor settings; 5) maintaining a list of service participants for 21 days to ensure public health follow-up for individuals exposed to COVID-19; 6) providing individually wrapped meals instead of family-style servings and serving beverages by a single staff to avoid continuous touching of items; and 7) using enhanced disinfection and cleaning measures and frequently on all surfaces possible, including washrooms, if available. The guidance states that health clinics for seniors run by health care providers can resume if guidelines for primary care are followed [1]
 
The Massachusetts Councils on AgingVermont Department of Health, and Pennsylvania Department of Aging also offer recommendations for re-opening senior activities in senior centres. These include 1) creating a flexible schedule to ensure participants have access to programs, but alternating program start and end times to space out activities and stagger timing; 2) adhering to requirements of group size when transporting (i.e., participants should be spaced out in the vehicle as best as possible) and vehicles should be thoroughly cleaned and disinfected before and after transportation; 3) maintaining proper safe practices, such as face coverings, and hygiene amongst all personnel within the centre; 4) operating with up to 1 person per 113 to 200 square feet, including staff, volunteers and participants; 5) installing plexiglass in reception and other face-to-face interactions areas; 6) placing directional arrows to establish the flow of traffic; 7) setting-up and dividing supplies and/or equipment prior to programming; 8) creating and disseminating policies, procedures, and identify staff present who will serve as the Pandemic Response Person; 9) posting the resources created and safety reminders for participants throughout the facility; and 11) following other general COVID-19 guidelines provided by the major organizations such as Centers for Disease Control and Prevention [2,3,4].  

Evidence

What‘s Trending on Social Media and Media

The North York General Hospital Seniors’ Health Centre took proactive measures to successfully minimize the potential impact at the 192-bed facility. The lives of their residents were not heavily impacted by the COVID-19 outbreaks thanks to the early decisions around screening, masking, and critical changes to the visitor policy.  
 
With seniors being one of the most vulnerable populations, some provinces such as Alberta have not yet provided timelines for reopening seniors’ centres. See the article by Global news for more information.  

Review of Evidence

Resource Type/Source of Evidence Last Updated
Province of Manitoba Restoring Safe Services – Senior Centres/Clubs
— Province of Manitoba
Guidance

This guidance by the province of Manitoba recommends using the following strategies: 1) providing a single entry to the site and screening all staff, volunteers, and participants for symptoms of COVID; 2) maintaining physical distance measures by practicing proper hygiene standards laid out and structuring the furniture to maintain social distancing; 3) having adequate hygiene stations available; 4) discouraging drop-in sessions and limiting the size of groups to one-on-one interactions, where possible or as small of a group as possible and preferably in outdoor settings; 5) maintaining a list of service participants for 21 days to ensure public health follow-up for individuals exposed to COVID-19; 6) providing individually wrapped meals instead of family-style servings and serving beverages by a single staff to avoid continuous touching of items; and 7) using enhanced disinfection and cleaning measures and frequently on all surfaces possible, including washrooms, if available. The guidance states that health clinics for seniors run by health care providers can resume if guidelines for primary care are followed 

Last Updated: May 31, 2020
Massachusetts Recommendations for Reopening- Scaling Up Senior Centre Operations
— Massachusetts Councils on Aging
Guidance

This guidance is based on re-opening of services including senior centres, which recommends the following: 1) creating a flexible schedule to ensure participants have access to programs, but alternating program start and end times; 2) installing plexiglass in reception and other face-to-face interactions areas;   3) placing directional arrows to establish the flow of traffic;   4) requiring face coverings for all persons entering the center, and educating staff, volunteers and participants on how to properly use and take off masks;   5) setting-up and dividing supplies and/or equipment prior to programming; and   6) establishing a plan for employees or participants who are displaying symptoms, become ill from COVID-19 at the center or a return-to-work/programming plan. 

Last Updated: August 24, 2020
Guidance for Senior Centres in Planning for Re-Opening
— Vermont Department of Health
Guidance

The guidance by the Vermont department of health states the following: 1) The center should track all people attending the center each day in case future contact tracing is needed (records should be kept for 30 days); 2) Hand hygiene facilities should be set-up at the entrance of the senior center; 3) If the center is transporting participants, they should adhere to requirements of group size, participants should be spaced out in the vehicle as best as possible and vehicles should be thoroughly cleaned and disinfected before and after transportation; 4) The center should operate with up to 1 person per 200 square feet, including staff, volunteers and participants; and 5)  Assist participants with handwashing who cannot wash hands alone. 

Last Updated: June 16, 2020
Guidance for Reopening & Operation of Older Adult Daily Living Centers
— Pennsylvania Department of Aging
Guidance

This guidance outlines three steps on how to proceed with re-opening senior community centres (SCC). During the state’s re-opening of services including senior centres, these centres need to:   1) determine how many participants the SCC can serve and include the area needed around the senior being served (i.e., 113 square footage per individual served)  2) create resources to disseminate policies, procedures, and identify staff present who will serve as the Pandemic Response Person; and 3) post the resources created and safety reminders for participants throughout the facility.  The guidance states that it is also important to follow other general COVID-19 guidelines provided by the major organizations such as Centers for Disease Control and Prevention (CDC). 

Last Updated: June 14, 2020
Disclaimer: The summaries provided are distillations of reviews that have synthesized many individual studies. As such, summarized information may not always be applicable to every context. Each piece of evidence is hyperlinked to the original source.

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