Researchers studying impact of COVID-19 restrictions on long-term care residents

Feature Stories | 17 Apr 2023

This is Part 1 in a trilogy of stories related to COVID-19. For more, visit Part 2.

Long-term care residents have generally faced higher COVID-infections and death rates, but new research is exploring the pandemic’s impact on their quality of life.

Researchers from Queen’s University and Providence Care are conducting a comprehensive assessment of long-term care (LTC) homes – studying the connection between pandemic social restrictions and the overall health outcomes of residents.

“We know that social isolation and loneliness are major risk factors for poor health outcomes and even early death,” explains Dr. Catherine Donnelly, the Director of the Health Services and Policy Research Institute (HSPRI) at Queen’s University. “So how do we consider those factors in an outbreak – managing the outbreak while also making sure people maintain social connections and positive relationships?”

The team is trying to understand what “actually made a difference to the quality of life of residents,” says Kim Schryburt-Brown, an Occupational Therapist and a Clinical Resource Project Consultant with Seniors Mental Health Behavioural Support Services at Providence Care. “So, if you were a home that was still able to run groups, how did you do it? How do you follow the rules and allow residents to have the socialization that we're hypothesizing is essential to their overall health?”

The collaboration is a shining example of a regional health project that quickly expanded into work that will have a provincial and national impact.

It started during a virtual meeting attended by Schryburt-Brown during the early days of the pandemic. “Colleagues were telling us they were noticing that the residents weren’t doing as well as they were pre-COVID,” she recalls. “Homes focused on providing the basics: ensuring residents were fed, bathed, and given their medications. These things are definitely important, but they don’t provide people with a reason to live. What we were hearing is that people were giving up.

“I had this lightbulb moment where I realized that there was a naturally-occurring experiment that happened across Ontario,” she adds. “The same directives were given to all long-term care homes, but how it was operationalized was very different.” For example, some homes were able to continue with small group activities to help residents maintain social connections and levels of activity, while some residents reported that they were not allowed to leave their rooms.

“What is the impact? We don’t know that yet. That’s what we want to figure out.”

Providence Manor in Kingston during COVID-19 visitor restrictions in 2020

Schryburt-Brown reached out to leadership at Providence Care, who connected her with investigators from Health Services and Policy Research Institute (HSPRI), Dr. Morgan Slater, a research scientist; Dr. Donnelly, also an Associate Professor in the School of Rehabilitation Therapy; and Dr. Ana Johnson, a professor in the Department of Public Health Sciences, and an ICES Senior Adjunct Scientist.

“This started just looking into the 36 long-term care homes in southeastern Ontario, so originally our group was pretty small. We did the survey, asking the homes what was going on with their staff, with their residents, and when we got the results back and we thought we were on to something. That’s when Morgan and Catherine had the idea to apply for a Canadian Institutes of Health Research (CIHR) grant, and it was at that point we expanded our research team.”

In 2022, CIHR awarded the team more than $470K over two years to examine the impact of COVID-19 physical distancing restrictions on the health and wellness of long-term care residents in Ontario.

As part of their mixed-methods study, 21 qualitative interviews with residents or their care partners have been conducted. “We wanted their lived experiences during the pandemic,” Dr. Donnelly explains.

Every long-term care home in Ontario was also asked to complete a survey on how physical distancing directives were implemented in their facilities back in April 2020. The research team received over 200 responses.

The survey data will be linked to coded, administrative health data sets held by ICES to see if there are associations between the levels of social interaction homes maintained and the overall health outcomes of residents, explains Dr. Slater.

Researchers are at an early phase in their data analysis and will continue to hold focus groups with the directors of some LTC homes. Their final analysis hopes to shed light on the delicate balance between public health measures and socialization when it comes to residents’ health.

Schryburt-Brown and Dr. Donnelly say it is all about discovering best practices and best health outcomes.

“We want to see if we can actually show what happened so that, for future outbreaks or pandemics, we know that it’s not just about keeping people fed and bathed but also having that social connection,” Schryburt-Brown explains. “Our theory is that it’s central to residents’ quality of life and health.”

Researchers studying impact of COVID-19 restrictions on long-term care residents

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