Social Engagement and Distress Among Home Care Recipients During the COVID-19 Pandemic in Ontario, Canada: A Retrospective Cohort Study.

This is an observational cohort, so the associations do not prove that the pandemic, frailty, depression, living alone, or caregiver contact caused changes in social engagement or distress. The outcomes were assessor-judged categories based on self-report, caregiver report, provider information, and chart review, not outcomes from a tested intervention. Formal care was a combined measure of many services, so any association with formal care cannot be attributed to physical therapy, occupational therapy, speech-language pathology and audiology, nursing, homemaking, or psychological therapy alone. Recipients with a Cognitive Performance Scale score of 4 or higher were excluded, so the findings may not apply to people who cannot reliably report distress. During the pandemic, assessments shifted to virtual methods and service volumes changed, so the study cannot separate real change in health or social status from prioritisation of more complex recipients. The supplied text reports higher proportions during the pandemic, but the counts and percentages shown for distressing social decline are inconsistent.

Do not conclude that receiving more formal care reduced social distress or withdrawal. Formal care was a combined measure that included personal support worker or home health aide, home nurse, homemaking services, physical therapy, occupational therapy, speech-language pathology and audiology services, and psychological therapy, so the study cannot separate the contribution of any one service.