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Faculty of Health Sciences

Mary Heersink Program in Global Health

Long-Term Care in Crisis: The Reality of COVID-19

Long-term care (LTC) is in crisis, with 82% of COVID-19 deaths in Canada connected to LTC and retirement homes. A consortium of researchers from McMaster, University of Toronto, McGill, and an international team of collaborators are examining the LTC system and its response to the COVID-19 pandemic.

Overview

This research is funded by the Canadian Institutes of Health Research (CIHR). The findings include a repository of high-quality research and grey literature, a clearer understanding of regulatory frameworks, a review of existing human resource capacity, and a description of national exemplars of care and epidemiological factors in LTC.

The evidence provides solutions for multiple stakeholders – including governments, service providers and healthcare workers – and a roadmap for reform.

The project is led by Dr. Andrea Baumann, Associate Vice-President Global Health and is comprised of a series of sub-projects led by Principal Investigators from various institutions.

 

 

Sub Projects

This project is comprised of a series of sub-projects led by Principal Investigators from McMaster, U of T, McGill, and the University of Ottawa.

An analysis of exemplar cases of LTC homes, outbreak protocols, and how effectively LTC homes managed COVID-19 – Dr. Andrea Baumann
While many LTC homes are in crisis due to COVID-19, there are exemplars in the industry that have minimized the impact of the pandemic on their residents and workers. This research analyzes these exemplar LTCs to understand the various factors, decisions and protocols that helped them care for their residents during the pandemic. It provides concrete examples and a potential roadmap for the sector going forward.

An analysis of exemplar cases of LTC homes, outbreak protocols, and how effectively LTC homes managed COVID-19 – Dr. Melanie Lavoie-Tremblay
Quebec has been among the Canadian provinces hardest hit by COVID-19. This research examines two LTCs in Quebec that have kept the pandemic at bay – neither home has had a reported case of COVID-19 among their residents. Through interviews with nurses, personal support workers, therapists and other workers, this work explores how these two exemplar LTCs kept their residents safe during a global pandemic.

A policy simulation model (forecasting for LTC staffing) – Dr. Audrey Laporte
Staffing plays a critical role in meeting the needs of LTC residents across the province. This research involves the development of a forecasting model for LTC staffing. The model projects the estimated demand, supply, and surplus/gap of personal support workers (PSWs) and nurses (RNs and RPNs) in Ontario.

The evolving roles of formal caregivers in LTC – Dr. Whitney Berta
Nurses, personal support workers, health care aides and other regulated and unregulated workers are the backbone of the LTC system. This research explores the evolving roles of formal caregivers, and synthesize what is known and emerging about relationships amongst roles, the environments (perceptions of safety, perceptions of organizational support, work climate and culture, quality of work life) in which these workers provide care, their work attitudes (psychological empowerment organizational commitment, job satisfaction, work stress), and work outcomes (quality of care, retention and turnover, burnout) in the LTC sector.

Accountability in LTC – Dr. Raisa Deber
Approaches to accountability can vary across sectors and jurisdictions. Previous research has indicated a need to define accountability, specifying for what, by whom, to whom and how, as well as what happens when outcomes are not achieved. This research examines approaches to accountability in LTC, including how it is regulated in Ontario, how it varies for type of services, and its relationship to governance/ownership structures. The evidence will inform policy recommendations regarding accountability mechanisms.

The viability of Ontario’s LTC homes – Dr Blair Roblin
The demand for LTC home in the coming decades is expected to escalate. Yet the sector faces significant challenges finding and encouraging the construction and operation of these homes. This research examines the complexities in government regulation and funding, inequities in for-profit versus not-for-profit ownership, challenges in access, to capital and the scarcity of human resources.

Legal framework for governance of long-term care and residents’ rights – Danielle Bisnar, Partner, Cavalluzzo LLP; Kylie Sier, Associate, Cavalluzzo LLP
This research examines the legal frameworks governing the LTC sector including residents’ and workers rights.

Publications

The following publications are part of the LTC in Crisis research grant:

Longwoods. Vol. 17, Special Issue. Long-Term Care in Crisis: The Reality of COVID-19.

PLOS ONE

Akhtar-Danesh N, Baumann A, Crea-Arsenio M, Antonipillai V (2022) COVID-19 excess mortality among long-term care residents in Ontario, Canada. PLOS ONE, 17(1), e0262807.

Events & Webinars

The following events are part of the LTC in Crisis research grant:

McMaster University and National Collaborating Centre for Determinants of Health – May 2023 – Addressing Inequity and Abuse in Long-Term Care: Implications for Public Health Practice 

Canadian Health Workforce Network – June 2022 – Long-Term Care in Crisis – The Reality of COVID-19: Our long-standing failure to protect our vulnerable elders

McMaster University and CanCOVID Webinar – September 28, 2022 – Long-Term Care in Crisis: The Reality of COVID-19