November 23, 2021

The CIHR Institute of Aging (CIHR-IA) has launched its strategic planning process to identify priorities for research on aging in Canada, and we are seeking your opinion and advice as we develop our new strategic plan. With our current Strategic Research Priorities 2019-2021 coming to an end, CIHR-IA is also aiming to align research priorities in aging with the new CIHR Strategic Plan 2021-2031: A Vision for a Healthier Future.
Our goal is to obtain diverse perspectives from our stakeholders related to research on the health and wellbeing of older adults across Canada, including information about needs and gaps to be addressed. The information gathered through this survey will inform us on research priorities on the topic of aging in Canada, and your responses will be used to guide the future development of programs and funding initiatives.
This survey is anonymous and should take about 15-20 minutes to complete. The survey will automatically save your responses as you move to the next page. Should you wish to edit previous pages, please use the ‘previous’ button in the survey to take you back to your answers.
The survey will close on December 20, 2021.

Articles include:

1. Rethinking Long-Term Care,Audrey Laporte and Arjumand Siddiqi
2. Our Values Are Showing: Long-Term Care and the Pandemic, Pat Armstrong
3. Long-Term Care’s Financial Sustainability, Don Drummond and Duncan G. Sinclair
4. Federalism and Long-Term Care in Canada: A New Approach, Carolyn Hughes Tuohy
5. Excellent Long-Term Care for Canadians and Federal Legislation, Colleen M. Flood, Bryan Thomas and Kelli White
6. Socialize, De-Commodify and De-Financialize Long-Term Care, Martine August
7. Staffing for Quality in Canadian Long-Term Care Homes, Carole A. Estabrooks
   Commentary: There Is No Place Like Home … But Things Could Be Better, Whitney Berta and Alison Dawson
8. Moving beyond More of the Same, but Better – How Campuses of Care Can Transform Long- Term Care, Frances Morton-Chang and Paul A. Williams
9. Caregivers at the Heart of Re-Imagined Long-Term Care Delivery in Canada: Beyond the Pandemic, Carol Fancott, Tanya MacDonald, Kim Neudorf and Maggie Keresteci
10. Deaths in Nursing Homes during the COVID-19 Pandemic – Lessons from Japan, Kazuhiro Abe and Ichiro Kawachi

The tragic deaths of residents and staff during the COVID-19 pandemic called attention to the longstanding need for transformational change and redesign in nursing homes. Stressors on the nursing home staff from increased workloads, to staffing shortages, and emotional strain were amplified. Nursing home managers’ retention is a known challenge. Factors influencing their intention to stay include work overload, inability to ensure high quality of care, insufficient resources, and a lack of perceived empowerment and recognition. To tailor interventions to improve nursing home manager’s quality of work life, we need a thorough understanding of the characteristics of this group. Our objective here is to describe manager characteristics in the Western Canadian nursing homes immediately prepandemic.

The COVID-19 crisis has hit the long-term care (LTC) sector particularly hard, with large numbers of people dependent on care and particularly vulnerable to COVID-19 have fallen ill, and a disproportionate rate of LTC workers both exposed to, and infected by, COVID-19. The analysis presented in this report describes the effects of COVID-19 on LTC in OECD countries, mainly showing infection rates and mortality of LTC recipients. It takes stock of the wide range of policy responses that countries have implemented, detailing the changes over time on testing strategies, reduction of interactions and isolation measures, digitalisation of services, and workforce. The report also assesses emergency preparedness in the sector, as well as workforce, organisational and coordination challenges. Finally, the report analyses how policy responses affected care continuity and the well-being of residents while also outlining the effectiveness of vaccination.

The COVID-19 pandemic has disproportionately affected Canada’s long-term care (LTC) sector, with residents of LTC and retirement homes accounting for 67% of all COVID-19-related deaths as of February 15, 2021. This study investigated the impact of the COVID-19 pandemic on LTC residents across Canada during the first six months of the pandemic, including how care changed for residents, using data from the Canadian Institute for Health Information’s LTC and acute care databases. The results suggest that LTC residents received less medical care, with fewer physician visits and hospital transfers compared with the same period in 2019. They also had less contact with family/friends compared with the same period in 2019, which was associated with higher levels of depression. In provinces where it could be measured, the number of LTC resident deaths from all causes was higher than pre-pandemic years during the peak of the first wave, even in jurisdictions with few COVID-19-related deaths in LTC.

BACKGROUND: Considerable progress has been made to advance the field of knowledge translation to address the knowledge-to-action gap in health care; however, there remains a growing concern that misalignments persist between research being conducted and the issues faced by knowledge users, such as clinicians and health policy makers, who make decisions in the health care context. Integrated knowledge translation (IKT) is a collaborative research model that has shown promise in addressing these concerns. It takes advantage of the unique and shared competencies amongst researchers and knowledge users to ensure relevance of the research process and its outcomes. To date, core competencies have already been identified to facilitate training in knowledge translation more generally but they have yet to be prioritized for IKT more specifically. The primary aim of this study was to recruit a group of researchers and knowledge users to identify and prioritize core competencies for researchers and knowledge users to engage with IKT. METHODS: We recruited health care knowledge users (KUs) and researchers with experience and knowledge of IKT for a quantitative, cross-sectional study. We employed a modified Delphi approach consisting of three e-survey rounds to establish consensus on competencies important to IKT for KUs and researchers based on mean rating of importance and agreement between participants. RESULTS: Nineteen (73%) of the initial 26 participants were researchers (response rate = 41% in the first round; retention in subsequent rounds > 80%). Participants identified a total of 46 competencies important for IKT (18 competencies for KUs, 28 competencies for researchers) under 3 broad domains. Technical research skills were deemed extremely important for researchers, while both groups require teamwork and knowledge translation skills. CONCLUSIONS: This study provides important insight into distinct and overlapping IKT competencies for KUs and researchers. Future work could focus on how these can be further negotiated and contextualized for a wide range of IKT contexts, projects and teams. Greater attention could also be paid to establishing competencies of the entire team to support the research co-production process.

This study describes changes in dining practices and provider perspectives on meal-related challenges due to the coronavirus disease (COVID-19) pandemic. An online survey was disseminated between July and September 2020 through stakeholder networks and social media with 1,036 respondents. Altered dining practices included residents eating in rooms (54.3%), spacing residents in common areas for meals (69.3%), and disposable dish use (44.9%). The most common mealtime challenges were reduced socializing opportunities at meals (29.3%), inadequate staffing (22.8%), reduced family/volunteer help (16.7%), and assisting residents to eat (10.5%). Many participants (72.2%) felt conflict balancing safety and relationship-centred care. Geographic region, home size, building age, respondent’s job title, pre-pandemic relationship-centred practices, and mealtime satisfaction, and some pandemic-initiated practices were associated with mealtime challenges and feeling conflicted in binary logistic regression analyses. Considering trade-offs between safety and relational aspects of mealtimes during the pandemic is crucial.

This policy analysis reviews three popular proposals with significant political endorsement to enhance long-term care (LTC), here defined broadly to include residential care facilities, home care, and community care, in the wake of the coronavirus disease (COVID-19) crisis: national standards, provincial autonomy, and de-privatization. The proposals are summarized succinctly followed by a neo-institutionalist analysis of the obstacles to enact them based upon a series of interviews conducted prior to COVID-19 with senior civil servants in Canadian provinces for a newly published book (Marier, 2021) and political considerations. While the federal government has pursued the avenue of instituting national standards, the provinces have clearly expressed a desire to secure higher federal health transfers and pursue LTC reforms on their own. Considering the diversity of LTC arrangements across the provinces, which impact the politics of LTC within each jurisdiction, and the presence of many Conservative governments in provincial capitals, Ottawa faces an uphill battle to transform profoundly the LTC landscape.

PURPOSE: Long-term care (LTC) organizations have struggled to protect their vulnerable clients from the ravages of the COVID-19 pandemic. Although various suggestions on containing outbreaks in LTC facilities have gained prominence, ensuring the safety of residents is not just a crisis issue. In that context, the authors must reasses the traditional management practices that were not sufficient for handling unexpected and demanding conditions. The purpose of this paper is to suggest rethinking the underlying attributes of LTC organizations and drawing insight from the parallels they have to high-reliability organizations (HROs). DESIGN/METHODOLOGY/APPROACH: The authors analyzed qualitative data collected from a Canadian LTC facility to shed light on the current state of reliability practices and culture of the LTC industry and to identify the strengths and weaknesses of the traditional management approaches. FINDINGS: To help the LTC industry develop the necessary crisis management capacity to tackle unexpected future challenges, there is an urgent need for adopting a more systemic top-down approach that cultivates mindfulness, learning and resilience. ORIGINALITY/VALUE: This study contributes by applying the HRO theoretical lens in the LTC context. The study provides the LTC leaders with insights into creating a unified effort at the industry level to give rise to a high-reliability-oriented industry.

Much is already written on how the COVID-19 pandemic ravaged Canada’s frail, elderly population – the impact of the global pandemic turned the decades-long challenges within our nation’s long-term care sector into daily news coverage. While no commission or report can ever begin to relieve the pain and suffering of individuals who lived through the pandemic, healthcare leaders owe it to all to respond to the urgent call for action to re-envision elder care for the future. The time to act is now. Our leaders need to collaborate and connect with our seniors to take quick action on their recommendations. Our leaders need to be nimble and creative; they need to work together across the system to rethink how aging seniors can be supported and change the system, its funding models and, ultimately, how we value and care for our aging population now and into the future.