Perspectives across Canada about implementing a palliative approach in long-term care during COVID-19

Julia Kruizinga; Stephanie Lucchese; Shirin Vellani; Vanessa Maradiaga Rivas; Sandy Shamon; Karine Diedrich; Laurel Gillespie; Sharon Kaasalainen

doi:10.1186/s12904-023-01142-3

Perspectives across Canada about implementing a palliative approach in long-term care during COVID-19

BMC Palliat Care. 2023 Mar 30;22(1):32. doi: 10.1186/s12904-023-01142-3.

Authors

Julia Kruizinga¹, Stephanie Lucchese², Shirin Vellani², Vanessa Maradiaga Rivas², Sandy Shamon³, Karine Diedrich⁴, Laurel Gillespie⁴, Sharon Kaasalainen²

Affiliations

¹ School of Nursing, McMaster University, Hamilton, ON, Canada. kruizij@mcmaster.ca.
² School of Nursing, McMaster University, Hamilton, ON, Canada.
³ Department of Family Medicine, Division of Palliative Care, McMaster University, Hamilton, ON, Canada.
⁴ Canadian Hospice Palliative Care Association, Ottawa, ON, Canada.

Abstract

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.

Keywords: COVID-19; Long term care; Palliative approach to care.

MeSH terms

Advance Care Planning*
COVID-19*
Canada
Humans
Long-Term Care
Palliative Care
Pandemics