Abstract
Background: Older adults are particularly affected by the covid-19 illness caused by the SARS-CoV-2, with epidemiological data demonstrating significant morbidity and mortality risk within the older adult population. The increased risk of dying from covid-19 appears to be linked to both the vulnerabilities that come with advanced age and co-morbid conditions associated with aging (Defrancesco et al., 2021). people with dementia living in Long-term care facilities (LTCF) are at a higher risk of contracting SARS-CoV-2. The key feature of dementia is that of cognitive decline, characterised by problems with memory, language, thinking and judgement. The cognitive limitations associated with dementia have been associated with reduced adherence to infection prevention and control (IpC) practices and procedures which can lead to increased transmission of the virus in this group of patients (Ryoo et al., 2020). In addition to increased transmission risk, poor outcomes from covid-19 in older people causes the risk to be amplified. The provision of care for people with dementia living in LTCF during this pandemic, has presented several challenges for Health Care Workers (HCWs).
Aim: This integrative review investigated the published research exploring HCWs experience of care provision for people with dementia living in LTCF during the covid-19 pandemic.
Methodology and Methods: An integrative review methodology has been utilised as described by Whittemore and Knafl (2005). A systematic search for relevant quality literature was supported by inclusion/exclusion criteria using the following databases: Ovid Emcare, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar. Evaluation of data was performed using the preferred Reporting Items for Systematic Reviews and Meta-Analyses (pRISMA) and JBI quality appraisal tools, research articles once identified were analysed using constant comparison analysis.
Results: The systematic search of the aforementioned databases identified 11 published research studies. These data were analysed used a constant comparison analysis approach and identified four syntheses, 1) HCW experience of the impact of restrictions to visiting 2) HCW workplace anxiety during the covid-19 pandemic 3) Communication between HCWs and Family with and without the use of Technology and 4) End of Life (EOL) care, incorporating palliative care, Advance Care planning (ACp) and expert outside advice.
Conclusion: This review highlighted the significance of the experiences of HCWs caring for people with dementia, living in LTCF during the covid-19 pandemic. Using an integrative review methodology, four syntheses were identified and further discussed in the context of wider literature. The findings of this review confirmed the importance of supporting HCWs experiencing anxiety whilst caring for residents with dementia in LTCF during the covid-19 pandemic, assisting HCWs with new ways of communicating with families, providing opportunities with virtual technology communication platforms, providing IpC information and education as a business-as-usual and strengthening palliative care practice in LTCF.