Dietitians Working in Continuing Care Facilities in Nova Scotia: Pre- and Post-COVID-19 First Wave

Abstract

Continuing care (CC) facilities have been impacted by a growing demand for services, insufficient resources for the provision of quality food and nutrition care, and, most recently, the COVID-19 pandemic. This study explored the roles and responsibilities of dietitians working in CC facilities in Nova Scotia (NS) before and after the COVID-19 first wave. Using ethics-approved questionnaires, the estimated 75 dietitians working in CC facilities in NS were surveyed in Fall 2019 and Fall 2020 about their roles and responsibilities. Twenty responded to the first questionnaire and 15 to the second. Analysis of data included simple statistical and qualitative description methods. The findings highlighted the complexities and challenges faced by these dietitians in the provision of resident nutrition care, overseeing foodservices, training staff and dietetic interns, and contributing to facility specific care committees before and after the COVID-19 first wave. There is a need to advocate for minimum standards for dietetic and foodservice funding in CC facilities based on higher acuity and complex care needs of residents and considering the multifaceted roles of dietitians in CC. Efforts to improve awareness about the roles of dietitians working in CC among resident families, other dietitians, and dietetic interns are also needed.

Factors associated with dietitian referrals to support long‐term care residents advancing towards the end of life

“…LTC dietitian responsibilities are increasing due to frailer residents with more complex needs as well as additional expectations for non-clinical involvement within the home 18 ; these challenges have persisted and even increased since the COVID-19 pandemic. 48 Interestingly, the top three reasons cited for increasing time demands among dietitians, according to a Canadian survey, 18 were increased frailty and acuity of residents, higher resident turnover and more referrals for nutrition-related concerns, all of which were reflected in our findings. Given the shortening length of stay of residents, most of whom die in residence, the demands on dietitians' time resulting from end-of-life-related challenges are also increasing.…”

“…This study's findings represent a potential inefficiency in dietitian engagement for residents with severe and complex challenges. LTC dietitian responsibilities are increasing due to frailer residents with more complex needs as well as additional expectations for non‐clinical involvement within the home 18 ; these challenges have persisted and even increased since the COVID‐19 pandemic 48 . Interestingly, the top three reasons cited for increasing time demands among dietitians, according to a Canadian survey, 18 were increased frailty and acuity of residents, higher resident turnover and more referrals for nutrition‐related concerns, all of which were reflected in our findings.…”