'Loneliness will kill': N.L. long-term care homes struggled with COVID restrictions

Visitor restrictions during the COVID-19 pandemic left long-term care visitors with a "significant" increase in isolation, leading to concerns about residents' mental and physical health, says a study from Newfoundland and Labrador's Memorial University.

The recently released study. which surveyed 184 visitors of long-term care facility residents in the province, found pandemic restrictions led to feelings of loneliness, isolation, confusion and abandonment among their loved ones, particularly those with dementia.

The World Health Organization declared COVID-19 a global pandemic on March 11, 2020, and 12 days later provincial governments across Canada responded by imposing restrictions on long-term care homes and stopping all visitors, citing the vulnerability of residents and spread of infection.

The study said during the pandemic's first wave from March to August 2020, 84 per cent of COVID-19 deaths were in long-term care homes, the highest proportion among all Organization for Economic Co-operation and Development countries. The majority of these deaths were in Ontario and Quebec.

Sixty per cent of respondents reported that, during the restrictions, the overall health of their loved ones declined, while for 20 per cent, the resident they visited died.

"My mother was unable to see her husband, children, and grandchildren. Then she passed away during a lockdown in January 2022 and a month later, they lifted all restrictions," said one respondent. "My husband who has been in her life for over 20 years wasn't even allowed in the facility to say goodbye. It was traumatic for all involved. The treatment of my family and my mom will never be fully erased from our memories."

Prolonged isolation raised other mental and physical health concerns, the study noted. It can trigger behaviour in people with dementia that leads to prescription of sedatives or antipsychotic medications, it said.

One respondent said it was "heart-wrenching" seeing their loved one decline over a phone or iPad screen, and then only being allowed to visit in person when the patient was in palliative care.

"It was too late! I have never experienced such a traumatizing event in my lifetime," the respondent wrote.

The study said 26 per cent of those surveyed said their loved one was not allowed to participate in activities at the long-term care home while another 25 per cent noted the resident was not allowed to eat in common dining areas.

"I believe many of the activities were curtailed as a result of public health restrictions," said one respondent. "I further believe the staff did the best they could within the associated public health directions."

However, 52 per cent of those surveyed were happy with the overall quality of care, marking it "very good to good."

The study made five recommendations that can be used if another pandemic strikes, including that the province always allow at least one visitor per resident, so quality of life can be maintained. It also said socialization between residents should be prioritized by minimizing restrictions on regular extracurricular activities to avoid feelings of loneliness.

"Hopefully policymakers have learned, as we all have, from COVID," said one respondent. "It's tough to find that middle ground but that is their job. Restrictions in future will need to find a better balance. Loneliness will kill as well."