Influence of the COVID-19 pandemic on executive skills in Canadians experiencing social vulnerability: A descriptive...

The objective of this study was to describe executive skills in clients experiencing social vulnerability in the context of COVID-19 from the perspective of social service agency staff. COVID-19 has required transformational changes to livelihood and day-to-day living. Socially vulnerable individuals are likely to be disproportionally impacted because many have experienced serious early childhood adversity, which may compromise their executive skills in adulthood. Using a cross-sectional survey, we collected data between 05 May 2020 and 03 July 2020, for this mixed methods study of 53 staff in two agencies in western Canada serving clients experiencing social vulnerability. The first case of COVID-19 in this jurisdiction was identified 05 March 2020. Using investigator-designed survey items, we captured executive skills in five areas: (a) planning tasks of daily living, (b) managing time, (c) keeping track of information and appointments, (d) managing emotions, and (e) managing self-control. Staff reported their clients struggled with executive skills and these struggles increased during COVID-19, particularly in the areas of managing daily tasks and emotional regulation. COVID-19 restrictions overwhelmed clients with the decisions required to maintain health, employment, and childcare. With the loss of structure and routine, clients lost track of time and delayed completion of tasks, which further increased stress. Disrupted goals and uncertainty about the future contributed to hopelessness for clients who were trying to regain control over their lives, which made it difficult to manage emotions. Some clients acted more impulsively because of the added stressors, lack of routine and access to friends and extended family. A better understanding of the impact of COVID-19 on socially vulnerable clients will inform social service agencies about areas to focus programming to support their socially vulnerable clients.