Position Statement for Mental Health Care in Long-Term Care During COVID-19

Abstract

COVID-19 has disproportionately impacted older adults in long-term care (LTC) facilities in Canada. There are opportunities to learn from this crisis and to improve systems of care in order to ensure that older adults in LTC enjoy their right to the highest attainable standard of health. Measures are needed to ensure the mental health of older adults in LTC during COVID-19. The Canadian Academy of Geriatric Psychiatry (CAGP) and Canadian Coalition for Seniors’ Mental Health (CCSMH) have developed the following position statements to address the mental health needs of older adults in LTC facilities, their family members, and LTC staff. We outlined eight key considerations related to mental health care in LTC during COVID-19 to optimize the mental health of this vulnerable population during the pandemic.

This Was My Crimean War: COVID-19 Experiences of Nursing Home Leaders

“…8,9 Most COVID-19 nursing home research focused on experiences of frontline staff: extreme workloads, exposure to suffering, fear of contagion, and needs for leadership support to mitigate traumatic stress. 3,10,11 Unique experiences of leaders have had little attention. Recent surveys 11,12 have not distinguished leader experiences from other nursing home staff.…”

Characterizing PRN Use of Psychotropic Medications for Acute Agitation in Canadian Long-Term Care Residents with Dementia Before and During COVID-19

“…It is possible that even simple non-pharmacological interventions such as regularly scheduled walks provided some level of maintenance therapy for dementia patients with agitation and that discontinuation of these beneficial activities led to more occurrences of breakthrough agitation. Another factor to consider is that LTC staff were facing a myriad of new stressors from staffing shortages and COVID-19 protocols that increased their daily workload [ 66 ]. This likely had a detrimental effect on their ability to provide routine care and acted as a barrier to the delivery and efficacy of non-pharmacological strategies.…”

Managing the Impact of COVID-19 in Nursing Homes and Long-Term Care Facilities: An Update

“…Both the COVID-19 pandemic itself in addition to infection control measures and visiting bans had profound impact on mental health and well-being of nursing home residents. 8 Throughout the first year of the pandemic, both the pandemic itself and visiting bans have been linked to increased risk of depressive symptoms in residents 192 in addition to worsening of preexisting depression. 193 Similarly, the prevalence of depressive symptoms significantly increased in comparison to prepandemic levels in one longitudinal study, 194 and studies have suggested a decline in cognitive function and an increase in depressive symptoms following the strict lockdown measures.…”