The COVID-19 pandemic wreaked havoc on long-term care in Canada. Through the first two waves in 2020, over 80 p.c of all Canadian COVID-19 deaths occurred in long-term care houses. Whereas vaccination and coverage modifications have helped to cut back the variety of deaths, long-term care houses are nonetheless experiencing COVID-19 outbreaks and extreme staffing shortages.
The individuals who present front-line care to our most weak seniors in long-term care have skilled trauma throughout this time — watching these of their care undergo and die whereas placing themselves and even their very own households in danger within the service of their work.
They have to not be forgotten as federal and provincial governments start the laborious and important work now to reform long-term care in Canada. Efforts to enhance the standard of care and life for long-term care residents should embrace initiatives addressing the well being and well-being of front-line employees, equivalent to care aides.
Licensed nursing assistants, private assist employees, and different care aides present as much as 90 p.c of direct care to long-term care residents in Canada. They’re the most important workforce in long-term care, and their well being and well-being instantly have an effect on long-term care residents’ high quality of care.
In a not too long ago revealed research, my colleagues and I discovered that care aides are nonetheless experiencing antagonistic results from working by way of the COVID-19 pandemic.
Our research surveyed 52 care aides from 9 long-term care houses in Alberta and British Columbia between January and April 2021. It included for-profit and not-for-profit houses that skilled excessive and low charges of COVID-19 infections from March to December 2020.
Earlier than the pandemic, these employees have been already experiencing job dissatisfaction, and plenty of have been at a excessive danger of burnout. Many labored part-time with out advantages. In addition they confronted systemic biases, as principally middle-aged feminine immigrants whose first language was not English and who had restricted post-secondary schooling or formal coaching.
Whereas troublesome working situations in long-term care houses existed properly earlier than COVID-19, the pandemic exacerbated them.
Our research discovered that care aides suffered psychological and emotional misery working at long-term care houses in the course of the first waves. They felt grief as residents died from COVID-19, with some reporting that it felt like they’d misplaced their very own dad and mom or grandparents.
They felt responsible as they watched residents’ psychological, bodily and cognitive well being decline from lengthy intervals of isolation and excessive loneliness throughout lockdowns.
They frightened about contracting and transmitting the virus to residents or their relations. Care aides described going to nice lengths to forestall spreading COVID-19 to their household, together with altering garments of their storage after work and typically avoiding relations altogether.
In addition they struggled with extreme staffing shortages, which elevated their workload and lowered the period of time they might spend offering one-on-one care to residents. There was little time for resident bathing, oral care, hair or nails, or making human connections by way of a hug or holding fingers.
In addition they confronted communication points, with regular channels breaking down. Care aides mentioned they not often spoke to long-term care managers instantly and have been usually not included in consultations on resident care planning regardless of their information of residents’ wants and needs. They reported being the final to seek out out about coverage modifications, typically studying issues second- or third-hand.
Some care aides additionally suffered wage losses when pandemic insurance policies required them to work at just one long-term care residence to cut back the possibility of spreading COVID-19. The ensuing pay reductions made it troublesome for some to assist their households.
Care aides relied on peer assist, teamwork, and, typically, their religion communities to deal with the difficulties. Sharing their fears and experiences with one another helped them stay resilient.
Nonetheless, regardless of their resilience, they want extra assist.
They want higher pay and dealing situations, extra full-time hours, enough staffing ranges and sources, pandemic preparedness, and psychological well being assist.
Methods to assist care aides should be developed in partnership with them and consider their cultural range. This is not going to be straightforward. The well being care system, significantly long-term care, is beneath main stress because of extreme staffing shortages. Managers and different supplier teams are additionally beneath important duress.
However care aides are those who present direct care to our moms and dads — upwards of 90 p.c. They’re additionally those offering important emotional and quality-of-life assist.
To miss this group is to danger jeopardizing the standard of care, high quality of life, and high quality of finish of life for weak residents in long-term care houses.
Carole Estabrooks is a professor of nursing.