Support Needed to Ensure Well-Being of Long-Term Care Aides

A new study examines the impact COVID-19 had on long-term care aides.

A recent study from the University of Alberta examined the impact the first year of the COVID-19 pandemic had on long-term care aides in nursing homes. Fifty-two care aides from eight different facilities participated in the study, selected according to ownership model and how they were impacted by COVID.

"Pandemic experiences of frontline LTC workers are not well described, limiting our understanding of how pandemic conditions and public health measures affected them," the study said. "Further, limited research explores how care aides cope during and after times of extreme stress."

According to the study, care aides, by nature of the job, were already considered a high risk for issues such as poor mental health, burnout, and job dissatisfaction.

"Amplifying this, they experience systemic biases," the study continued. "Most are middle-aged and female. Many are immigrants and speak English as an additional language. Most have limited post-secondary education or formal training."

Over 90% of the care aides interviewed for the study were female and had been born outside of Canada. Of that group, 76% spoke English as a second language. It was noted that care aide experiences were consistent throughout all eight facilities.

The study's findings were separated into two themes: compounding distress and resilience and optimism.

Compounding distress

Staff shortages, increased workloads, witnessing residents' isolation, and not having time to grieve resident deaths, combined with the worry of possible infection themselves exacerbated the stress and fatigue of many care aides during the first year of the pandemic.

"Care aides expressed profound guilt upon observing decline in cognitive status and mental and physical health of residents from prolonged isolation and immobility," the study found. "Most talked about the emotional toll of being unable to offer physical touch, comfort, and companionship. They were distressed by rushing care and limiting it to essential care only."

Yet, despite the depression, fatigue, and anxiety the care aides experienced, the study revealed that many staff—when asked about how they were feeling—would say they were fine.

Staffing shortages were the most severe problem, with care aides themselves being sick or not showing up to work for fear of getting infected. Many of them had to work extended hours and multiple consecutive shifts.

During this time, care aides also noted that there was little communication with managers, which made it difficult to stay up to date with changes in staffing, policies, and care for residents, the study reported.

Resilience and optimism

The study found that care aides heavily leaned on each other for support, compassion, and acceptance.

"They relied on each other to discuss feelings and bring humor into their work," the study stated. "They described this connection as 'family,' with shared fears and experiences bringing them closer."

The study concluded that it is imperative for leaders to support the mental health and well-being of care aides, with suggestions to adequately staff workplaces and improve policy guidelines and interventions. Not only should care be administered to care aides to reduce stress and burnout, but to neglect their well-being also jeopardizes the quality of care and life of long-term care residents.