Canadian Long-Term Care Aides Faced Mental and Emotional Distress Enforcing COVID-19 Isolation

COVID-19 is still a health problem, especially in long-term care facilities worldwide. A new study reviewed the problem in Canada and found the staff in facilities faced tremendous stress in enforcing isolation and doing their jobs. 

A brief published in the Journal of the American Geriatrics Society studied the experience of aides working in long-term care facilities during the COVID-19 crisis. 

Certified nursing assistants and personal support workers comprise the largest group of long-term health care facility staffers. These workers provide as much as 90% of direct care to residents in nursing homes and assisted living facilities.

While the focus of long-term care facilities remains the health and well-being of the care recipients, the health and well-being of the staff directly affect both quality of care and the quality of life for residents.

Quality of Care Influenced by Health & Safety of Staffers

A study funded by the Alberta Ministry of Health interviewed long-term care aides from eight long-term care facilities in Alberta and one in British Columbia, Canada. The results revealed the impact on staff during the virus crisis. The results can be used going forward to maintain quality of care and maintain the health and well-being of the staff providing the care.

The results were not surprising to many experts. The long-term care aides experienced mental and emotional distress from enforcing resident isolation, grief related to resident deaths, fear of contracting and spreading COVID-19, increased workload combined with staffing shortages, and rapidly changing policies.

The study showed that the resilience of long-term care aides was supported by their strong relationships, faith and community, and capacity to maintain positive attitudes.

Long-Term Care in Canada

Long-term care facilities are not publicly insured under the Canada Health Act. It is governed by provincial and territorial legislation. Across Canada, jurisdictions offer a different range of services and cost coverage. 

Home care services are not publicly insured through the Canada Health Act in the same way as hospital and physician services. In Canada, most home and community care services are delivered by provincial, territorial, and some municipal governments.

Private Long-Term Care Insurance in Canada provides funding for the policyholder to receive personal in-home care or facility care in the facility of their choice. Many Canadian families will provide care for loved ones before being sent to a care facility.

Key Points from Study

There were several points from the research:

• In long-term care, staff illnesses, additional infection prevention and control measures, and changing orders restricting visitors and enforcing isolation resulted in significantly increased workloads and less time available for care aides care for residents. 

COVID-19 heightened fears of transmitting the virus to residents at work and family members at home.

• Care aides experienced mental distress from enforcing severe isolation measures that resulted in the resident decline, from the deaths of residents due to COVID-19; and from an overwhelming fear of contracting the virus themselves or spreading it to their families.

• Care aides used unique coping strategies, including relationships with coworkers, extended family, and faith and cultural communities, as consistent sources of resilience.

Long-term care facilities continue to be significantly affected by COVID-19.

Aides experienced significant hardships mentally, emotionally, physically, socially, and economically. However resilient they are, they require adequate support going forward. This includes sufficient staffing levels and resources, pandemic preparedness, and mental health supports.

The study showed that the strain on resources during the COVID-19 crisis and the resulting negative effects on residents have amplified the need to ensure sufficient direct care hours for resident care and to ensure adequate mental health and wellness support for long-term care aides, as well as supportive work environments.