Pandemic measures 'necessary' but led to loneliness, anxiety in Ontario LTC residents: report

Loneliness, anxiety and depression were just some of the effects of pandemic restrictions on the well-being of long-term care home residents in Ontario, a report by the patient ombudsman has found. 

In the report, "Honouring Voices and Experiences, Long-Term Care Home Survey," Craig Thompson found that 75 per cent of respondents to three surveys saw a general decline in the emotional well-being of residents due to the restrictions, while 66 per cent noted a general decline in physical well-being.

Pandemic policy changes at the homes included visitor restrictions, reduced programs and services, and infection prevention and control measures. Those restrictions caused an increase in memory decline, sadness, confusion, a decrease in the ability to communicate, difficulties with eating, weight loss and a decline in mobility among other things, the report said.

The report, released on Wednesday, said long-term care homes face a challenge as the pandemic continues because they will be required to strike a balance between public health restrictions, which involve limiting contact and keeping distance, and daily quality of life experienced by residents.

"It's heartbreaking. It's sad," Thompson said in an interview this week.

"When you take away the physical contact with folks by restricting visitation, so many things begin to fall apart. It is a true linchpin in people's health and well-being to be able to interact with people, loved ones, staff, other residents. It's profound."

'Impacts have been real,' patient ombudsman says

Thompson said long-term residents are a vulnerable population and restrictions to reduce the risk of infection should be in place for a limited time only. Long-term care homes should adopt strategies to keep a close eye on residents and their well-being, and those strategies could include hiring more recreational staff to offset the impact of restrictions, he said.

"What this report and the survey results show is that those impacts have been real and that there's still a lot of work that we need to do when we're looking at putting in restrictions to make sure that they come with the least amount of impact to the residents and the loved ones in long term care," he said.

The report was compiled from more than 1,300 responses from families, residents, staff and volunteers at long-term care homes across Ontario. The patient ombudsman conducted three separate public surveys between May and August 2021. 

"Strict infection prevention and control measures were certainly necessary to protect residents from the highly infectious and deadly COVID-19 virus. However, residents' quality of life and the essential support of family, friends and caregivers needs to be given greater consideration as Ontario continues to battle the pandemic," the report said.

"The results suggest that the very measures intended to keep residents safe from infection ultimately resulted in unintended harm and at times quite significant harm."

Other findings of the report include:

• Residents and caregivers said a lack of family visits contributed to significant stress and decline. About 50 per cent of caregivers reported they continue to have problems when they go to visit to residents.
• Responses from staff varied depending on their role. For example, 87 per cent of long-term care home management versus 60 per cent of staff reported that programs to support staff emotional health and well-being were available or in place.
• Long-term care homes that successfully navigated the pandemic were prepared ahead of time, acted proactively, and provided clear communication to staff, residents and loved ones.

The report follows two patient ombudsman COVID-19 special reports, which looked at more than 1,600 complaints that the office received related to the virus from March 2020 through April 2021. 

For Nick Puopolo, whose mother, Saveria Puopolo, has lived in Woodbridge Vista Care Community in Vaughan, Ont. for more than four years, the findings of the report resonate but also confirm what families already know.

Puopolo said his mother hasn't been the same since the pandemic's first and second waves. She wasn't able to see family members for months, she survived COVID-19 and is now in a wheelchair.

Puopolo also said his mother has deteriorated "quite a bit" physically and emotionally. "She's not the same woman she was pre-COVID," he said.

"Every time you leave she gets upset because she thinks you're not coming back because of what happened during COVID during the lockdown. They get very emotional when it's time to leave," he said. "They hang onto you and squeeze you to the point where they just don't want to let go."

Ministry vows to hold operators of home accountable

In an email this week, Ontario's long-term care ministry said it plans to increase enforcement, accountability and transparency in long-term care by doubling the number of inspectors and the number of fines levied against operators who break the law. It also says it plans to hire more staff to provide four hours of direct care per resident per day. 

"We have made a clear commitment to protect the health and well-being of our residents in long-term care homes and we will ensure all operators are accountable to government, taxpayers, and most importantly residents and families," ministry spokesperson Wendy Lampert said in the email.

The surveys that formed the basis of the report were developed by patient ombudsman. All three surveys were posted on patient ombudsman's website.

The patient ombudsman received 1,374 responses to the three surveys including 29 responses from residents, 894 responses from family members, friends and other caregivers, 451 responses from staff, including 145 administrators and managers, and 306 other staff volunteers.

As of Tuesday, all visitors will need to be fully vaccinated against COVID-19 to enter a long-term care home.

According to provincial data, there have been 1,560 outbreaks in Ontario long-term care homes since the pandemic began, with 15,687 cases among residents and 7,435 cases among staff.

More than 4,000 long-term care residents have died with COVID-19 in Ontario.