A study carried out by researchers at the University of Waterloo has concluded that even though the COVID-19 pandemic is negatively affecting the mental health of residents of long-term care (LTC) homes, there are mitigation measures that can improve the situation and provide advice to decision makers.
The study looked at seven long-term care homes in New Brunswick to track the mental health changes the residents endured through lockdowns by studying conditions such as depression, delirium and behavioural problems.
The study, “Evaluating the Effect of COVID-19 Pandemic Lockdown on Long-Term Care Residents’ Mental Health: A Data-Driven Approach in New Brunswick,” was published in JAMDA (Journal of the American Medical Directors Association).
The study found that many of the problems were the result of long periods of isolation, lack of family contact, and lack of stimulation from social activities.
The study revealed that LTC residents have a high prevalence and increased baseline risk of developing mental health conditions. It said depression is the most common psychiatric condition in nursing homes — ranging from 11 to 16 per cent — along with delirium, a condition that can develop rapidly over several hours or days.
It is estimated to affect 14 per cent of home residents. The other conditions of general behavioural problems — affecting 26 to 66 per cent of residents — were found to be disruptive and distressing for residents, staff members and families.
Information was collected by the interRAI LTCF data system, which is a standardized clinical information system used by LTC homes in more than 30 countries around the world, said the study.
The document said the LTC homes initiated lockdowns from March 12 to March 16, 2020, halting all group activities.
"Once lockdown began, recreation staff were redeployed to focus on keeping family connected with LTC residents. Strategies included window visits and video chats. To support these initiatives, the government of New Brunswick supplied LTC homes with one iPad per every 10 residents to connect with family members via video chat in April 2020," said the study.
"One of the homes also hired students to facilitate virtual calls and engage in one-on-one visits with residents."
In May and June, the homes also allowed in-person outdoor visits.
"Provincially, there were no COVID-19 cases in New Brunswick LTC homes between March and September 2020. Therefore, these homes provide evidence about the net impact of lockdowns where COVID-19 is not present in homes or in the surrounding communities," said the study.
The homes in New Brunswick successfully used these systems to help keep residents engaged, said John Hirdes, the principal investigator of the study and a professor in the School of Public Health and Health Systems at the University of Waterloo.
“They brought in new staff and programs and showed that you can do a good job in terms of mental health during lockdown.”
Hirdes also said policy makers can use the clinical information systems' outputs to guide future resource deployment when considering restrictions in LTC homes. He added that health-service researchers can examine the data to identify better management strategies for the future.
In conclusion the study said LTC residents, isolated because of the COVID-19 pandemic, are at increased risk for negative outcomes.
"Our analyses demonstrate that poor mental health outcomes associated with lockdown in LTC homes can not only be measured but mitigated with thoughtful interventions," said the study.
"Policy makers can use the associated outputs to guide resource deployment, and health service researchers can examine the data to identify better management strategies for when pandemic strikes again," the study added.
The study was authored by Caitlin McArthur, Margaret Saari, George Heckman, Nathalie Wellens, Julie Weir, Paul Hebert, Luke Turcotte, Jalila Jbilou and John Hirdes.
Len Gillis is a Local Journalism Initiative reporter at Sudbury.com, covering health care in Northern Ontario. The Local Journalism Initiative is funded by the federal government.
