COVID-19 pandemic in long-term care: An international perspective for policy considerations

ABSTRACT

This paper identifies key factors rooted in the systemic failings of the long-term care sector amongst four high income countries during the COVID-19 pandemic. The goal is to offer practice and policy solutions to prevent future tragedies. Based on data from Australia, Canada, Spain and the United States, the findings support evidence-based recommendations at macro, meso and micro levels of practice and policy intervention. Key macro recommendations include improving funding, transparency, accountability and health system integration;and promoting not-for-profit and government-run long-term care facilities. The meso recommendation involves moving from warehouses to "green houses.” The micro recommendations emphasize mandating recommended staffing levels and skill mix;providing infection prevention and control training;establishing well-being and mental health supports for residents and staff;building evidence-based practice cultures;ensuring ongoing education for staff and nursing students;and fully integrating care partners, such as families or friends, into the healthcare team. Enacting these recommendations will improve residents' safety and quality of life;families' peace of mind;and staff retention and work satisfaction.