COVID-19 Issues in Long-Term Care in Ontario: A Document Analysis

Oldenburger, David; Baumann, Andrea; Crea‐Arsenio, Mary; Deber, Raisa; Baba, Vishwanath V.

doi:10.12927/hcpol.2022.26854

Cited by 8 publications

(8 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Originally, LTC was experiencing crisis prior to the emergence of COVID-19, with inadequate staffing and outdated infrastructure of many facilities, 3,14 leaving it sorely unprepared for the emergence of COVID-19. While governments, public health systems, and emergency response agencies were left unprepared to respond when alarm bells rang over the state of LTC.…”

Section: Discussionmentioning

confidence: 99%

“…Previously, LTC in Ontario had experienced significant issues for over two decades that were exacerbated into a sector-wide crisis for LTC in Ontario. 14 Approximately 34% of homes experienced outbreaks in the first-wave, with over 8,500 COVID-19 cases, 1,800 deaths, 15 and critical staff shortages of up to 80% absenteeism in some facilities. 16 In response to the worsening situation in LTC, the Ontario government requested external support, and enacted emergency legislation that allowed the re-deployment of staff and transfer of 35 LTC home management to local acute care hospitals.…”

Section: Part One: Examining the Definition Of Disastermentioning

confidence: 99%

“…3 However, legacy issues in LTC disadvantaged the sector’s ability to manage the novel virus, while the pandemic’s prolonged duration quickly diminished the little existing resources. 14,15 The last aspect of resilience – the response – saw implementation of restrictive measures from government to reduce the risk of COVID-19 entering LTC, followed by the deployment of external support from acute care hospitals, the military, and Canadian Red Cross. Later, LTC residents and staff were prioritized for vaccination when they became available in the province.…”

Section: Introductionmentioning

confidence: 99%

“…As the authors note, however, response measures may also have a negative impact – as was seen with restricting front-line personnel to working at one facility and locking out family from LTC homes, hindering both the physical and psychosocial care residents received. 14…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

COVID-19 in Long-Term Care: A Two-Part Commentary

Oldenburger,

Baumann,

Crea-Arsenio

et al. 2023

Prehosp. Disaster med.

View full text Add to dashboard Cite

Part One: Examining the Definition of DisasterThe coronavirus disease 2019 (COVID-19) pandemic has had a major impact on health, economic, political, and social systems, exacerbated existing inequity, stretched systems to the point of failure, and exposed vulnerabilities globally. We will present a case study of COVID-19's impact in long-term care (LTC) in Canada's most populous province, Ontario. Originally, COVID-19 in LTC was called a crisis by politicians and mainstream media, but the situation and response were comparable to major disasters and wartime. Governments, health systems, and emergency agencies have disaster preparedness plans, however COVD-19's size and duration exposed the limits of these plans. This paper is the first of a two-part commentary that will begin by demonstrating that COVID-19 in LTC meets the definition of disaster by examining existing definitions and comparing COVID-19 in LTC to other disasters. The second paper will apply the case study of COVID-19 in LTC to a disaster framework to identify key contributing factors. The rationale of this discussion is to learn lessons from the experience of COVID-19 in LTC by expanding our perspective of what is a disaster, while identifying what factors contributed, in order to improve preparedness for all types of disaster.The word "disaster" comes from the Greek word "dis" meaning bad or ill-favored, and "aster" meaning star. 1 This coincides with the belief that disasters were from an external force, and the Judeo-Christian view as an "act of God," 2 which frames disasters as: "tragic situations over which persons, groups, or communities have no controlsituations which are imposed by an outside force too great to resist." 3(p733) However, more recently, perspectives related to the definition have shifted from event-centric to human-centric; 4 a complex interaction of environment and human agency, 5 and social phenomenaas Stallings stated: "'Social' separates disasters from tragedies that befall individuals or small groups such as a family. Disasters are collective in nature." 6(p263) Thus, the focus of disaster theory has expanded from the "what" hazard that could impact a community -or event that has occurred -to the "how" and "why" it could or did impact a community.The definition continues to evolve, shifting with dominant socio-political forces. 7-9 Similarities can be found in contemporary definitions and systems of classification. The International Federation of the Red Cross and Red Crescent Societies (Geneva, Switzerland) defines disaster as: " : : : serious disruptions to the functioning of a community that exceed its capacity to cope using its own resources. Disasters can be caused by natural,

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Part One: Examining the Definition Of Disastermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

COVID-19 in Long-Term Care: A Two-Part Commentary

Oldenburger,

Baumann,

Crea-Arsenio

et al. 2023

Prehosp. Disaster med.

View full text Add to dashboard Cite

show abstract

“…For example, Hussin et al (2021) noted several barriers to implementing non-pharmacological interventions for BPSD in LTC, including limited staff time and training [ 35 ]. Likewise, Oldenburger et al (2022) reported that, although residents require approximately 4.1 h of care time per day to meet needs, they are only receiving about 2.45 h to 3.73 h of care per day [ 36 ]. The onset of COVID-19 has further exacerbated issues in staffing and time to provide care [ 36 ].…”

Section: Mild-to-moderate Agitation And/or Aggressionmentioning

confidence: 99%

Barriers and facilitators to care for agitation and/or aggression among persons living with dementia in long-term care

Wong,

Ismail,

Watt

et al. 2024

BMC Geriatr

View full text Add to dashboard Cite

Background Agitation and/or aggression affect up to 60% of persons living with dementia in long-term care (LTC). It can be treated via non-pharmacological and pharmacological interventions, but the former are underused in clinical practice. In the literature, there is currently a lack of understanding of the challenges to caring for agitation and/or aggression among persons living with dementia in LTC. This study assesses what barriers and facilitators across the spectrum of care exist for agitation and/or aggression among people with dementia in LTC across stakeholder groups. Methods This was a qualitative study that used semi-structured interviews among persons involved in the care and/or planning of care for people with dementia in LTC. Participants were recruited via purposive and snowball sampling, with the assistance of four owner-operator models. Interviews were guided by the Theoretical Domains Framework and transcribed and analyzed using Framework Analysis. Results Eighteen interviews were conducted across 5 stakeholder groups. Key identified barriers were a lack of agitation and/or aggression diagnostic measures, limited training for managing agitation and/or aggression in LTC, an overuse of physical and chemical restraints, and an underuse of non-pharmacological interventions. Facilitators included using an interdisciplinary team to deliver care and having competent and trained healthcare providers to administer non-pharmacological interventions. Conclusions This study advances care for persons living with dementia in LTC by drawing attention to unique and systemic barriers present across local and national Canadian LTC facilities. Findings will support future implementation research endeavours to eliminate these identified barriers across the spectrum of care, thus improving care outcomes among people with dementia in LTC.

show abstract

“We have to save him”: a qualitative study on care transition decisions in Ontario’s long-term care settings during the COVID-19 pandemic

Carbone,

Berta,

Law

et al. 2023

BMC Geriatr

View full text Add to dashboard Cite

Background The COVID-19 pandemic has contributed to a global crisis in long-term care (LTC) with devastating consequences for residents, families and health professionals. In Ontario, Canada the severity of this crisis has prompted some care partners to move residents home with them for the duration or a portion of the pandemic. This type of care transition, from LTC to home care, was highly unusual pre-pandemic and arguably suboptimal for adults with complex needs. This paper presents the findings of a qualitative study to better understand how residents, care partners, and health professionals made care transition decisions in Ontario’s LTC settings during the pandemic. Methods Semi-structured interviews were conducted with 32 residents, care partners and health professionals who considered, supported or pursued a care transition in a LTC setting in Ontario during the pandemic. Crisis Decision Theory was used to structure the analysis. Results The results highlighted significant individual and group differences in how participants assessed the severity of the crisis and evaluated response options. Key factors that had an impact on decision trajectories included the individuals’ emotional responses to the pandemic, personal identities and available resources. Conclusions The findings from this study offer novel important insights regarding how individuals and groups perceive and respond to crisis events.

show abstract

COVID-19 Issues in Long-Term Care in Ontario: A Document Analysis

Cited by 8 publications

References 4 publications

COVID-19 in Long-Term Care: A Two-Part Commentary

COVID-19 in Long-Term Care: A Two-Part Commentary

Barriers and facilitators to care for agitation and/or aggression among persons living with dementia in long-term care

“We have to save him”: a qualitative study on care transition decisions in Ontario’s long-term care settings during the COVID-19 pandemic

Contact Info

Product

Resources

About