Background: Long-term care homes (LTCHs) restricted essential family caregivers’ (EFCs) visitations during COVID-19, and virtual visits using technology were used. Objective: To understand EFCs’ virtual visitations experiences during COVID-19 in two Canadian provinces. Methods: Seven focus groups were conducted with EFCs. Thematic analysis was used to identify themes at micro, meso, and macro levels. Results: Four themes were found: 1) a lack of technology and infrastructure; 2) barriers to scheduling visitations; 3) unsuitable technology implementation; and 4) inability of technology to adapt to residents’ needs. Discussion: Virtual visitations showcased a confluence of micro, meso, and macro factors that, in some cases, negatively impacted the EFCs, residents, and the relationship between EFCs and residents. Structural and home inequities within and beyond the LTCH impacted the quality of technology-based visitations, underscoring the need to support technology infrastructure and training to ensure residents are able to maintain relationships during visitation bans. Conclusion: EFCs’ experiences of technology-based visitations were impacted by structural vulnerabilities of the LTCH sector.
Background
During the coronavirus (COVID-19) pandemic, long-term care homes (LTCHs) imposed visitor restrictions that prevented essential family caregivers (EFCs) from entering the homes. Under these policies, EFCs had to engage in virtual, window, and outdoor visits, prior to the re-initiation of indoor visits.
Objective
To understand EFCs’ visitation experiences with LTCH residents during COVID-19.
Methods
Seven virtual focus groups with EFCs were conducted and analysed using a thematic approach.
Findings
Six themes were identified: (a) inconsistent and poor communication; (b) lack of staffing and resources; (c) increasing discord between EFCs and staff during COVID-19; (d) shock related to reunification; (e) lack of a person-centred or family-centred approach; and, (f) EFC and resident relationships as collateral damage.
Discussion
Our findings reflect how EFCs’ visitation experiences were affected by factors at the individual, LTCH, and health-system levels. Future sectoral responses and visitation guidelines should recognize EFCs as an integral part of the care team.
Family caregivers are integral to the care of long-term care (LTC) residents. COVID-19 public health policies initially restricted all essential caregivers from visiting LTC homes. In lieu of in-person visitations, caregivers were allowed technology-based visits then restrictive outdoor visits, followed by indoor visitations. This study aims to illuminate the experiences of essential caregivers’ as they visited their loved ones in LTC during COVID-19’s restrictive policies. We conducted seven caregiver focus groups (N=30) from Ontario and British Columbia, Canada. Thematic analysis and line-by-line coding were completed using NVivo. We found six themes that were common to all the visitation types: 1) “LTC Home disorganization” to facilitate visits and poor communication; 2) “Lack of staffing and resources”; 3) “Mistreatment from staff and management” as caregivers were seen as inconveniences; 4) “Shock and disbelief” when family members first saw their loved ones; 5) “Significant lack of person-centered or family-centered ethos” for example the residents’ needs were ignored such that their cognitive and physical impairments sometimes made visitations impossible, as well as the burden of multiple weekly COVID-19 tests; and, 6) “Collateral damage” in the form of trauma and irreparable harm to the relationships between residents and families. These results emphasized caregivers who ultimately felt betrayed and ignored by the broader healthcare system. Our findings provide an in-depth understanding of how COVID-19 public health policies have impacted the essential caregivers and the long-lasting impacts on residents and caregivers alike. Understanding caregiver’s experiences can inform future pandemic response policies and encourage more person-centered protocols.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.