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Connecting with care: Supporting social well-being in long-term care homes during pandemics and beyond

September 03, 2020
Person uses tablet to communicate.

Keeping connected to family and friends is important for long-term care home residents, but the COVID-19 pandemic has created challenges in facilitating those relationships. Ryerson researchers are studying those challenges and how they’ve been overcome.

How should health-care providers working with residents in long-term care homes balance the safety of residents with the need to maintain crucial social connections? Long-term care homes have faced numerous challenges during the COVID-19 pandemic, with many of the reported deaths in Canada linked to such facilities. But keeping social connections is important too – and can make a difference to people’s health and well-being.

Two Ryerson University Faculty of Community Services professors, Sepali Guruge and Lori Schindel Martin of the Daphne Cockwell School of Nursing, are launching a pair of studies with the goal of illuminating best practices in relational care during a pandemic. Relational care is the care that addresses the importance of human connectedness for overall wellness. Through their research, they’ll aim to understand what successful strategies were used to overcome challenges presented during the pandemic to providing relational care, as well as examining incidents where there was room for improvement.

“We need to understand the connections the staff and the family members had prior to the pandemic, and then see how their caring together got changed overnight, so to speak,” said professor Guruge of the impact COVID-19 has had in long-term care homes. The changes, such as limiting in-person visits, have left many families and staff frustrated.

Professor Schindel Martin says that there has been a “terrible tension” that providers have faced trying to balance resident safety with their need to connect with others. “Those social connections matter deeply and can make a drastic difference to the person’s health and well-being,” said professor Guruge. Relational care can be undervalued or go unnoticed, especially in times of a crisis like a pandemic.

“This kind of work, the relational care component, is unspoken. People do not understand its absolute power to help the individual feel engagement and belongingness,” said professor Schindel Martin.

Good relational care from health-care providers isn’t a matter of luck. “The public seems to believe that high-level interpersonal skills are a happy accident because the nurse in the case is especially kind. This belies the complex standards and competencies that nurses are expected to provide,” said professor Schindel Martin. Both of these new studies will highlight how good relational care can be practised, even in times of crisis, not just by families and individual health-care providers but also by the facilities themselves. Professors Guruge and Schindel Martin’s research will also suggest how relational care can be considered by policy-makers.

Even once the COVID-19 pandemic ebbs, the best practices and resources developed by the researchers and their partners can be applied to maintaining the social connections of people in long-term care homes during other outbreak events, such as annual influenza seasons or future pandemics.

The researchers and their teams will undertake their studies by interviewing health-care providers and residents’ families about their perspectives on how relational care has been maintained and ensured during COVID-19. Outcomes from the two projects will include a guidebook that captures creative, innovative strategies to maintain relational care and resources to assist in maintaining the mental health and well-being of health-care providers.

One of the projects will look at co-creating strategies to address the well-being of older people during the COVID-19 pandemic and is supported by the Ontario COVID-19 Rapid Research Fund (external link) , a Government of Ontario initiative. In addition to professors Guruge and Schindel Martin, the research team comprises fellow faculty members from the Daphne Cockwell School of Nursing: professors Souraya Sidani, Suzanne Fredericks, Elizabeth McCay, Elaine Santa Mina, Joyal Miranda and Donald Rose, along with Ryerson alumna Linda Liu of the University Health Network.

The other project will explore the perspectives of carers to develop strategies and relational best practices for residents in long-term care during COVID-19 and is supported by the 2020 Ryerson COVID-19 SRC Response Fund, an initiative of Ryerson’s Office of the Vice-President, Research and Innovation. The team for this project includes Ryerson professor Souraya Sidani as well as researchers Veronique Boscart from Conestoga College, Sherry Dupuis and George Heckman from University of Waterloo, Lynn McCleary from Brock University, Bharati Seth from King’s University College at Western University, and Kathy McGilton at University Health Network.

Some of the organizations collaborating with the teams are AdvantAge Ontario, Behavioural Supports Ontario, Concerned Friends of Ontario Citizens in Care Facilities, the Gerontological Nursing Association Ontario, and the Ontario Long-Term Care Association.