Context:The precarious work arrangements experienced by many long-term care workers have led to the creation of a "shared" workforce across residential, home, and community aging care sectors. This shared workforce was identified as a contributor to the spread of COVID-19 early in the pandemic.Objective: This analysis sought to review policy measures targeting the long-term care workforce across seven high income jurisdictions during the first year of the COVID-19 pandemic. The focus was on financial supports introduced to recognize long-term care workers for the increased risks they faced, including both (1) health risks posed by direct care provision during the pandemic and (2) economic risks associated with restrictions to multi-site work.Method: Environmental scan of publicly available policy documents and government news releases published between March 1, 2020 and March 31, 2021, across seven high income jurisdictions.Findings: While there was limited use of financial measures in the United States to compensate long-term care workers for the increased health risks they faced, these measures were widely used across Canada, as well as in Wales, Scotland, and Australia. Moreover, there was a corresponding use of financial measures to protect workers from income loss in parts of Canada, Australia and the UK.Limitations: Our analysis did not include additional policy measures such as sick pay or recruitment incentives. We also relied primarily on publicly available policy documentation. In some cases, documents had been archived or revised, making it difficult to ascertain and clarify original information and amendments.Implications: While these financial measures are temporary, they brought to light long-standing issues related to the supply of and support for workers providing care to older adults in long-term care homes.

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Despite the demonstrated effectiveness of vaccines, varying levels of hesitancy were observed among healthcare and long‐term care workers, who were prioritized in the roll out of COVID‐19 vaccines due to their high risk of exposure to SARS‐CoV‐2 transmission. However, the evidence around the measurable impact of various educational interventions to improve vaccine confidence is limited. The proposed scoping review is intended to explore any emerging research and experiences of delivering educational interventions to improve COVID‐19 vaccine confidence among health and long‐term care workforces. We aim to identify characteristics of both informal and formal educational interventions delivered during the pandemic to support COVID‐19 vaccine hesitancy. Using the guidance outlined by the Joanna Briggs Institute, we intend to search five databases including, Ovid MEDLINE and Web of Science, as well as grey literature. We will consider all study designs and reports in an effort to include a breadth of sources to ensure our review will capture preliminary evidence, as well as more exploratory experiences of COVID‐19 vaccine education delivery. Articles will be screened by three reviewers independently and the data will be charted, and results described narratively.

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ObjectivesRESPECT is a prognostic tool, developed using linked population-based data, to predict 6-month mortality in community-dwelling older adults. RESPECT is implemented and openly accessible as a web-based tool on ProjectBigLife.ca, where over 700,000 calculations have been performed to date. Our objective was to describe healthcare utilization patterns among home care (HC) users across mortality risk profiles generated from RESPECT to inform care planning for older persons who have varying mortality risks and levels of care needs as they decline. ApproachWe conducted a retrospective cohort study examining healthcare use among HC users in Ontario, Canada, who received at least one interRAI HC assessment between April 2018 and September 2019.  Using linked health administrative data at the individual level, we examined the use of acute care (hospitalizations and emergency department (ED) visits), long-term care (LTC), and palliative home care within 6-months of each assessment and prognostication using RESPECT. Mortality risk profiles from RESPECT were created based on the median survival. ResultsThe cohort comprised 247,377 community-dwelling older adults; 14.3% died within 6-months of an assessment. Among decedents, half (51.51%) of HC users with a predicted median survival of less than 3-months received at least one palliative care home visit; 39.17%, 34.82% and 13.84% visited the ED, were hospitalized, or were admitted to LTC, respectively. The proportion of assessments that received at least one palliative HC visit declined to 43.11% and 30.28% of assessments with a median survival between 3- and 6-months and those between 6-months and 12-months, respectively.  The proportion of assessments with an acute care use increases with increasing median survival. ConclusionA considerable proportion of people at the end-of-life do not receive any palliative home care and continued to be institutionalized. This may be indication that the reduced life expectancies and palliative care needs of many older adults are not being recognized, thus demonstrating the value of prognostic models like RESPECT to inform care planning  for individuals in their final years of life.