Health Equity Implications of the COVID-19 Lockdown and Visitation Strategies in Long-Term Care Homes in Ontario: A Mixed Method Study

Abstract

The COVID-19 pandemic has negatively impacted the lives and well-being of long-term care home residents. This mixed-method study examined the health equity implications of the COVID-19 lockdown and visitation strategies in long-term care homes in Ontario. We recruited long-term care home residents, their family members and designated caregivers, as well as healthcare workers from 235 homes in Ontario, Canada. We used online surveys and virtual interviews to assess the priority, feasibility, and acceptability of visitation strategies, and to explore the lived experiences of participants under the lockdown and thereafter. A total of n = 201 participants completed a survey and a purposive sample of n = 15 long-term care home residents and their family members completed an interview. The initial lockdown deteriorated residents’ physical, mental, and cognitive well-being, and disrupted family and community ties. Transitional visitation strategies, such as virtual visits, were criticised for lack of emotional value and limited feasibility. Designated caregiver programs emerged as a prioritised and highly acceptable strategy, one that residents and family members demanded continuous and unconditional access to. Our findings suggest a series of equity implications that highlight a person-centred approach to visitation strategies and promote emotional connection between residents and their loved ones.

Telepresence Robots in Long-Term Care Settings in British Columbia During the COVID-19 Pandemic: Analyzing the Experiences of Residents and Family Members

“…However, LTC residents face challenges during video calls with families via tablets/computers ( Hardy et al., 2022 ; Ickert et al., 2020 ). Many LTC homes have poor Internet connections and limited devices, which restricts the opportunity for virtual visits ( Chu et al, 2022 ; Saad et al, 2022 ). Physical, cognitive, and sensory impairments of LTC residents also impede their independence in using technologies ( Chu et al, 2021 ).…”

Did managers of long-term care facilities neglect the functionality of older adults? A survey during the COVID-19 pandemic

“…The study found that technological and virtual innovations were effective strategies to promote a stronger family presence in LTC 32 . For Saad et al, 31 86.6% of participants perceived remote visits as a viable strategy. Digital technology allowed residents to participate in family events, bond with geographically distant relatives, and expand their cultural and entertainment opportunities, which were previously hindered.…”

“…Despite health professionals with fear of contamination, the return of in-person visits from family and volunteers improved the well-being of older adults living in LTCF. 29 , 30 Saad et al 31 surveyed LTCF residents, family members, caregivers, and clinical and management staff about the implications for health inequalities of suspending visits in Canada (Ontario). They indicated that suspending visits was considered unfair and a violation of the rights of residents.…”

“…Although the strategies to mitigate its effects showed some efficiency, they were not viable and had limited emotional value. 31 …”

“…Remote visits were challenging because they required cognitive abilities. 31 Despite the help from LTCF staff, some residents could not meet the demand from family members of frequency and duration. The staff also feared bringing COVID-19 into LTCF or contracting the disease.…”