Who’s in the House? Staffing in Long-Term Care Homes Before and During COVID-19 Pandemic

Abstract

Critical gaps exist in our knowledge on how best to provide quality person-centered care to long-term care (LTC) home residents which is closely tied to not knowing what the ideal staff is complement in the home. A survey was created on staffing in LTC homes before and during the COVID-19 pandemic to determine how the staff complement changed. Perspectives were garnered from researchers, clinicians, and policy experts in eight countries and the data provides a first approximation of staffing before and during the pandemic. Five broad categories of staff working in LTC homes were as follows: (1) those responsible for personal and support care, (2) nursing care, (3) medical care, (4) rehabilitation and recreational care, and (5) others. There is limited availability of data related to measuring staff complement in the home and those with similar roles had different titles making it difficult to compare between countries. Nevertheless, the survey results highlight that some categories of staff were either absent or deemed non-essential during the pandemic. We require standardized high-quality workforce data to design better decision-making tools for staffing and planning, which are in line with the complex care needs of the residents and prevent precarious work conditions for staff.

Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review

“…The first wave of the pandemic greatly exacerbated those problems as several members of staff had to be absent due to restrictions. Added to that, some managers had to work from their own homes, there were quarantine requirements, physicians were absent and only available via telephone or video, and more staff were needed to meet the residents’ needs for more comprehensive care [ 51 ]. Hospitals generally have more resources and larger staffs of physicians, nurses, and other relevant staff members in addition to access to on-site services, such as laboratory- and X-ray departments [ 14 ].…”

“…From another point-of-view, NHs are both the homes and health institutions for their residents. When the pandemic broke out, it was exceptionally demanding for NH employees to manage the intensified care needs of their residents brought about by COVID-19 [ 51 ]. Determining whether a NH resident should be admitted to hospital may also be partly based on the resident’s preferences in relation to treatment.…”

“…Despite those findings and to our knowledge studies that have described the medical and pharmacological treatment received by NH residents confirmed to have COVID-19 are scarce. Medical and pharmacological treatment require the close follow-up of patients; however, the staffing situation in NHs has continued to be strained [ 51 , 52 ]. It is therefore possible that not all NHs provide equal opportunities for medical and pharmacological treatment, especially not treatment for the consequences of COVID-19.…”

The Canadian Long-Term Care Sector Collapse from COVID-19: Innovations to Support People in the Workforce

“…Also, the increase in patients transferred from acute care led to an increase in outbreaks in LTC and burdened the staff because of the care required by additional residents. Furthermore, because of public health restrictions aimed at preventing the spread of the COVID-19 virus, several categories of staff were deemed non-essential to LTC, thus compromising the delivery of day-to-day recreational, rehabilitative, primary, acute, episodic and palliative care to residents (Vellani et al 2022).…”

Palliative Approach to Care Education for Multidisciplinary Staff of Long-Term Care Homes: A Pretest Post-Test Study

“…These conversations are relevant for all adults regardless of their age or stage of the disease ( Sudore et al, 2017 ). ACP is a critical component to implementing a palliative approach to care in long-term care (LTC) homes; it allows residents and their care partners such as family members or friends to be better prepared for end-of-life (EOL) care and decision-making ( Gilissen et al, 2018 ; Sudore et al, 2017 ; Vellani, Zuniga et al, 2022 ). However, many LTC residents are not offered opportunities to participate in ACP discussions prior to or upon their admission to LTC ( Hunter et al, 2020 ; Sussman et al, 2020 ; Sussman, Kaasalainen et al., 2021 ).…”