Poor and Lost Connections: Essential Family Caregivers’ Experiences Using Technology with Family Living in Long-Term Care Homes during COVID-19

Abstract

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.

“It’s the worst thing I’ve ever been put through in my life”: the trauma experienced by essential family caregivers of loved ones in long-term care during the COVID-19 pandemic in Canada

“…Remaining staff who continued working did so under incredibly dire and poor conditions (Webster, 2021 ) which likely contributed to oversights in communication reflected in our study. Recent research elucidated how the aforementioned context in LTC in addition to structural inequities impacted EFCs ability to access and use technologies during the lockdowns (Chu et al, 2022 ). EFCs felt powerless and hopeless in the situation without any allies in the LTCHs or the government.…”

“…One such practice model is one from the Veterans Affairs in the U.S. (Dang et al, 2020 ) where a proactive team approach was utilized to tailor outreach and communication to family members in order to identify, screen, support, educate, coordinate care, for high-risk residents and their caregivers. A vital part of a collaborative LTC system is ensuring adequate investments into digital resources, that will facillitate timely and effective communication at a home level (Chu et al, 2022 ; Chu, Ronquillo et al, 2021 ).…”

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 ).…”

Residential Environment Assessment by Older Adults in Nursing Homes during COVID-19 Outbreak

“…These results suggest recommending the provision of personal/private spaces in residential settings for older adults, in order to maintain their privacy and to have an individual space in which to avoid contact with other residents in the event of infectious outbreaks, as has happened with COVID-19. They also point to the need to provide information and communication technologies as a means of relating to the outside world (family, friends, acquaintances, medical consultations, other consultations), to avoid feelings of isolation and loneliness, as well as telemedicine-based access to health consultations [ 34 ]. Providing residents with the knowledge and strategies for its use is also crucial.…”

“…Faced with COVID-19′s impacts and the difficulties brought about by confinement, numerous scientific publications have emphasized different issues, such as the importance of addressing the need for telemedicine-based consultations with health professionals to allow remote assessment by specialists [ 30 ], but also virtual relationships with family or friends [ 31 , 32 ]. Despite worker and staff efforts to help residents use electronic devices to stay in touch with their relatives [ 31 , 33 ], the still-poor provision of this technology, the fact that it cannot be adapted to residents’ needs, and this demographic group’s digital divide have hindered communication during the pandemic [ 34 ], which has also led to an increased risk of perceived isolation and loneliness [ 35 ]. In response to this isolation, the use of advanced technologies, as well as the maintenance of virtual intergenerational contacts, is proposed to improve social interaction [ 36 ].…”