RESUMEN
BACKGROUND: Long-term care (LTC) homes have been disproportionately impacted during COVID-19. PURPOSE: To explore the perspectives of stakeholders across Canada around implementing a palliative approach in LTC home during COVID-19. METHODS: Qualitative, descriptive design using one-to-one or paired semi-structured interviews. RESULTS: Four themes were identified: (1) the influence of the pandemic on implementing a palliative approach, (2) families are an essential part of implementing a palliative approach, (3) prioritizing advance care planning (ACP) and goals of care (GoC) discussions in anticipation of the overload of deaths and (4) COVID-19 highlighting the need for a palliative approach as well as several subthemes. CONCLUSION: The COVID-19 pandemic influenced the implementation of a palliative approach to care, where many LTC homes faced an overwhelming number of deaths and restricted the presence of family members. A more concentrated focus on home-wide ACP and GoC conversations and the need for a palliative approach to care in LTC were identified.
Asunto(s)
Planificación Anticipada de Atención , COVID-19 , Humanos , Cuidados a Largo Plazo , Cuidados Paliativos , Pandemias , CanadáAsunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Grupo de Atención al Paciente/organización & administración , Neumonía Viral/terapia , Trauma Psicológico/terapia , COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/psicología , Humanos , Pacientes Internos/psicología , Salud Mental , Servicios de Salud Mental/organización & administración , Pandemias , Atención al Paciente/métodos , Neumonía Viral/complicaciones , Neumonía Viral/psicología , Trauma Psicológico/etiología , Calidad de la Atención de Salud , SARS-CoV-2RESUMEN
Certain members of society are disproportionately affected by the COVID-19 crisis and the added strain being placed on already overextended health care systems. In this article, we focus on refugee newcomers. We outline vulnerabilities refugee newcomers face in the context of COVID-19, including barriers to accessing health care services, disproportionate rates of mental health concerns, financial constraints, racism, and higher likelihoods of living in relatively higher density and multigenerational dwellings. In addition, we describe the response to COVID-19 by a community-based refugee primary health center in Ontario, Canada. This includes how the clinic has initially responded to the crisis as well as recommendations for providing services to refugee newcomers as the COVID-19 crisis evolves. Recommendations include the following actions: (1) consider social determinants of health in the new context of COVID-19; (2) provide services through a trauma-informed lens; (3) increase focus on continuity of health and mental health care; (4) mobilize International Medical Graduates for triaging patients based on COVID-19 symptoms; and (5) diversify communication efforts to educate refugees about COVID-19.