Long-Term Care Crisis Management & Renewal Task Force

Project leads: Dawn Bowdish, Canada Research Chair in Aging and Immunity and a professor of medicine and Andrew Costa, Schlegel Chair in Clinical Epidemiology & Aging and associate professor in the Faculty of Health Sciences

Project Description: Bowdish and Costa are co-leading one of the largest single studies on long-term care homes in Canada to find out how well vaccination works in residents in long-term care, and which features of these homes may be directly linked with outbreaks.

The study, in partnership with Schlegel Villages, St. Joseph’s Health System, and Health Sciences North Research Institute, involves more than 2,000 residents, staff, and visitors of long-term care homes in Ontario and will take place over the course of a year.

The focus of the study is to help determine how well vaccination works in residents of long-term care homes and whether a resident’s previous exposure to the virus or immune system response can protect them or make them vulnerable to further infection. This information will be mapped with other available data to better understand the spread of COVID-19 and immunity across the province

Resources

• Learn more about the COVID in long-term care study
• Article: Vaccines and long-term care: Large McMaster study receives $5M in funding

Leads: Michael Wilson, assistant director, McMaster Health Forum; associate professor, Health Research Methods, Evidence, and Impact and Kerry Waddell, technical focal point, RISE

Profile description: The long-term care sector has been hard hit by the COVID-19 pandemic in Canada and in many other high-income countries. This has led to many questions about how long-term care homes can improve the prevention and management of COVID-19 outbreaks as well as how to support the renewal in long-term care homes as a whole based on lessons learned from the pandemic and about challenges that preceded it.

There are many activities that crisis management and renewal plans will need to consider. This profile organizes key findings from evidence documents and experiences from other countries and from Canadian provinces and territories relating to five types of activities including:·

• Preventing infections
• Managing outbreaks
• Renewing delivery, financial and governance arrangements
• Supporting residents and staff
• Promoting alternatives to long-term care

This evidence profile is a ‘living’ document as it is updated once per month to identify new evidence and experiences.

Resources

• Long-term care crisis management and renewal – Living evidence profile

Project Lead: Sharon Kaasalainen, professor, School of Nursing, Gladys Sharpe Chair in Nursing

Project Description: The COVID-19 pandemic has revealed deep flaws in Canada’s long-term care system, but it has also provided an opportunity for renewal.

Implementing a palliative approach in long-term care (LTC) settings is a step toward reimagining LTC, particularly for the most vulnerable residents. It places residents and families at the centre of care decisions and means residents with life-limiting illness such as dementia, frailty, end-stage organ disease, and cancer can be supported from the moment they enter long-term care to the day of their death.

Spearheaded by a national team of health researchers Strengthening a Palliative Approach in Long-term Care (SPA-LTC) draws together best practices in palliative care within LTC settings around the world. It’s an approach that’s Informed by clinical experience and original research, with an emphasis on strengthening the relationships between residents, families, and health care providers.

SPA-LTC provides needed resources to LTC providers and policymakers to stimulate improved care for all residents, especially those most in need.

Resources:

• Learn more about SPA-LTC

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Project leads: Rebecca Ganann, assistant professor, School of Nursing, McMaster University, Elaine Moody, assistant professor, School of Nursing, Dalhousie University,  Ruth Martin Misener, professor and director School of Nursing, Dalhousie University Jenny Ploeg, professor, School of Nursing, McMaster University, Marilyn MacDonald professor, School of Nursing Dalhousie University, Lori E. Weeks, professor, School of Nursing, Dalhousie University, Keisha Jefferies, registered nurse, PhD candidate, School of Nursing, Dalhousie University

Description: In the wake of the COVID-19 pandemic, policymakers are looking for ways to better support and protect older Canadians, including enabling older people to continue to live in their own homes.

Supporting older adults to live in the community has become a priority not only for policy makers, but for health system leaders and community members, including many older people themselves.

To enable this population – many of whom are experiencing frailty – to continue living in the community, a range of supports are needed, which result in out-of-pocket expenses paid by older people or their caregivers without reimbursement.

This review identifies the out-of-pocket expenses that older adults with frailty and their caregivers face that allow them live in the community or drive the need for higher levels of care (e.g., long-term care admissions). This review also highlights the policy and practice efforts that need to be put in place to enable aging at home to become a reality.

Resources:

• INFOGRAPHIC – Aging in place: What are the out-of-pocket costs incurred for individuals and their caregivers who are living in the community with frailty?