The promise of transformed long-term care homes: Evidence from the pandemic

Power, G.; Carson, Jennifer

doi:10.1177/08404704211037794

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…Shifting focus from recommendations to what is needed to carry recommendations forward into meaningful change in LTRC, our findings support thinking of future pandemic preparedness, resident quality of life, and workforce mental health as connected concepts that can be supported through greater emphasis on relational and social dimensions of care in LTRC (Lowndes & Struthers, 2017;Power & Carson, 2022). This emphasis aligns with the person-centered approach in LTRC, which is defined as a standard of care that upholds the person at the center of care by integrating values of relationship, individualism, holism, respect, and empowerment (McCormack et al, 2017).…”

Section: Centering Workers In Ltrc Reformsupporting

confidence: 57%

Canadian Long-Term Residential Care Staff Recommendations for Pandemic Preparedness and Workforce Mental Health

Boettcher,

Celis,

Lashewicz

2023

Journal of Long Term Care

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The impacts of Covid-19 pandemic conditions in Canada's long-term residential care (LTRC) sector have demonstrated that future pandemic preparedness necessitates not only recovery but deeper sectoral transformation of longstanding vulnerabilities. Improving workforce mental health and resilience is central to these transformative efforts.Objective: This study presents a content analysis of staff recommendations for pandemic preparedness and employee mental health in LTRC.Methods: Qualitative data were gathered through semi-structured interviews conducted with 50 LTRC staff members from 12 organizations. The interviews aimed to gain insights into supporting worker mental health in the first wave of the Covid-19 pandemic. Participant responses to a question seeking recommendations for future pandemic preparedness were extracted and analyzed using qualitative content analysis.Findings: Our findings encompass staff recommendations organized into seven categories: 1) Risk reduction and compensation, 2) Staffing reappraisal, 3) Opportunities for relief, 4) Spaces to be heard, 5) Improved communication, 6) Cultivating responsive leadership, and 7) Redefining public accountability. Limitations:The data primarily relied on interviews with LTRC workers from western Canada.Implications: Recommendations are situated within existing policy and research for worker mental health and staffing. We discuss how supporting and listening to LTRC workers can strengthen pandemic preparedness, workforce mental health, and delivery of quality person-centered care. We position the increased presence of worker voices in knowledge generation and policymaking as vital for realizing the sectoral transformations needed in LTRC.

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Section: Centering Workers In Ltrc Reformsupporting

confidence: 57%

Canadian Long-Term Residential Care Staff Recommendations for Pandemic Preparedness and Workforce Mental Health

Boettcher,

Celis,

Lashewicz

2023

Journal of Long Term Care

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“…Finding solutions to staff shortages, especially for LPN, appears to be a crucial step to prevent COVID‐19 mortality, and may also improve the overall quality of care. Smaller facilities on a more human scale, such as the Green House Project in the United States 54 and Dementia Villages in the Netherlands, 55 would have the double advantage of decreasing occupancy density and enhancing staff ratios, among other benefits. As the threat of new variants and future pandemics looms ahead, the potential avenues identified in this study may contribute to better protect the vulnerable LTCF population in the short and long term.…”

Section: Discussionmentioning

confidence: 99%

Institutional, therapeutic, and individual factors associated with 30‐day mortality after COVID‐19 diagnosis in Canadian long‐term care facilities

Zhang

Charland²,

Quach

et al. 2022

J American Geriatrics Society

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Background Canadian long‐term care facility (LTCF) residents experienced higher death rates compared to other countries during the first wave of the COVID‐19 pandemic. This cohort study analyzes the individual, therapeutic, and institutional factors associated with death in LTCFs. Methods Institutional data for 17 LTCFs in Montreal, Canada were obtained from local administrative registries. Individual data for 1197 residents infected by SARS‐CoV‐2 between February 23 and July 11, 2020 were obtained through chart reviews. A multivariable modified Poisson regression model, which accounted for LTCF clustering, was used to identify resident and facility covariates associated with 30‐day mortality after COVID‐19 diagnosis. Results Severe shortage of licensed practical nurses (RR 2.60 95% CI 1.20–5.61) and medium‐sized facilities compared to smaller‐sized facilities (RR 2.73 95% CI 1.23–6.07) were associated with 30‐day mortality. Later COVID‐19 diagnosis (RR 0.98 95% CI 0.97–0.99 per additional day) was associated with survival. Individual risk factors for death included age (RR 1.33 95% CI 1.23–1.45 per additional 10 years), male sex (RR 1.46 95% CI 1.24–1.71), functional impairment (RR 1.08 95% CI 1.04–1.12 per unit increase of SMAF), as well as a diagnosis of congestive heart failure (RR 1.31 95% CI 1.04–1.66) and neurocognitive disorder (RR 1.31 95% CI 1.01–1.70). Among severe cases, anticoagulation was associated with survival (RR 0.70 95% CI 0.51–0.96). Conclusions This study identified practical nurse shortages and facility size as institutional risk factors for COVID‐19 death. Anticoagulation was associated with survival among severe cases.

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“…Isolation practices in particular need to be mitigated by design decisions such as enlarged resident rooms and cohorting in small groups such as households where small group activities can continue with appropriate social distancing. Such a model offers more psychosocial benefits, more direct staff support, more appropriately distanced socialization and family visits and overall quality of life benefits (Power & Carson, 2021).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in Long-Term Care: The Built Environment Impact on Infection Control

Benbow¹

2022

HERD

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Purpose: The purpose of this article is to review available literature for evidence-based impact of the built environment upon the prevention and management of COVID-19 with a view to emphasizing lessons learned for future infection control of pandemics. Background: This is urgently needed given the devastation brought upon long-term care residents worldwide. Long-term care (LTC) facilities face a battle to protect their residents. Previous studies of infection control design issues have focused generally on Fomites: that is, contaminated objects and surfaces. As COVID-19 has been shown to be largely spread through the air, this article will broaden the focus to include engineering controls that effect this type of transmission. Method: A literature search was conducted using key words such as long-term care facilities, built environment, COVID-19, infection control, and nursing homes. Results: Results were sorted using an engineering controls pyramid developed by the author to stratify approaches to LTC infrastructure. Basically, six elements were supported: ventilation, spatial separation, physical barriers, hand hygiene stations, resident room zones, and private rooms. Implications: Conclusions were that the built environment has a major impact on infection control that can be deleterious or beneficial. Substantial changes need to be made to protect the very vulnerable LTC population from future pandemics and infectious diseases.

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The promise of transformed long-term care homes: Evidence from the pandemic

Cited by 6 publications

References 14 publications

Canadian Long-Term Residential Care Staff Recommendations for Pandemic Preparedness and Workforce Mental Health

Canadian Long-Term Residential Care Staff Recommendations for Pandemic Preparedness and Workforce Mental Health

Institutional, therapeutic, and individual factors associated with 30‐day mortality after COVID‐19 diagnosis in Canadian long‐term care facilities

COVID-19 in Long-Term Care: The Built Environment Impact on Infection Control

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