The Impact of the COVID-19 Pandemic in Long-Term Care in Canada

Abstract

The COVID-19 pandemic has disproportionately affected Canada's long-term care (LTC) sector, with residents of LTC and retirement homes accounting for 67% of all COVID-19-related deaths as of February 15, 2021. This study investigated the impact of the COVID-19 pandemic on LTC residents across Canada during the first six months of the pandemic, including how care changed for residents, using data from the Canadian Institute for Health Information's LTC and acute care databases. The results suggest that LTC residents received less medical care, with fewer physician visits and hospital transfers compared with the same period in 2019. They also had less contact with family/friends compared with the same period in 2019, which was associated with higher levels of depression. In provinces where it could be measured, the number of LTC resident deaths from all causes was higher than pre-pandemic years during the peak of the first wave, even in jurisdictions with few COVID-19related deaths in LTC.* Excess LTC resident deaths is determined by comparing the number of deaths that occurred between March 1 and June 30, 2020, with the average number of deaths that occurred during the same period in the previous five years (2015 to 2019). Deaths include death from all causes and represent the LTC residents who died in the LTC home or in a hospital.

Focus on Liability of Residences for Elderly and Sick People: A Case Series and Medico-Legal Issues

“…The impact of the pandemic associated with coronavirus disease 2019 in the longterm care (LTC) services has been particularly acute related to the large numbers of older people dependent on care falling ill and because LTC workers are particularly exposed to the infection. As underlined by international epidemiological studies, the LTCF residents are at greater risk of COVID-19 and adverse consequences such as hospitalization and death [54][55][56][57][58][59]. The increasing trend of COVID-19-related mortality worldwide has led the political and health authorities to take urgent responses to contain and mitigate the pandemic diffusion in LTC, including the adoption of telemedicine in nursing homes [54][55][56][57][58][59].…”

“…As underlined by international epidemiological studies, the LTCF residents are at greater risk of COVID-19 and adverse consequences such as hospitalization and death [54][55][56][57][58][59]. The increasing trend of COVID-19-related mortality worldwide has led the political and health authorities to take urgent responses to contain and mitigate the pandemic diffusion in LTC, including the adoption of telemedicine in nursing homes [54][55][56][57][58][59]. Although people in all facilities are mostly older adults with high degrees of frailty and medical complexity, residents of long-term care homes show markedly higher needs [41].…”

Promising Best Practices Implemented in Long- Term Care Facilities During the COVID-19 Pandemic to Address Social Isolation and Loneliness: A Scoping Review

“…During the COVID-19 pandemic, LTCFs' residents had less contact with family/friends (Betini, Milicic, & Lawand, 2021) while group or one-to-one leisure activities (activity, support, internet training, home visiting, service provision) shown to reduce SIL (Dickens, Richards, Greaves, & Campbell, 2011;Windle, Francis, & Coomber, 2011) were interrupted. Only some of these activities were able to be adapted to a virtual format.…”

COVID-19 in Ontario Long-term Care Facilities Project, a manually curated and validated database

“…Long-term care facilities, including nursing homes, residential aged care facilities, retirement homes, skilled nursing facilities and assisted living communities, among others, have represented and still represent healthcare settings particularly vulnerable to the COVID-19 spread (1). For instance, in Canada, residents living in these facilities, being elderly and particularly frail, often with many co-morbidities, have been disproportionately hit by the pandemic, contributing to approximately two thirds (67%) of the entire total toll of deaths (2).…”