Implementing & Scaling Up the LTC Palliative Toolkit During COVID

The impact of the COVID-19 pandemic on the Canadian long-term care (LTC) sector has been a national tragedy. Similar to many other countries, Canada has observed an unprecedented and exponential increase in the number of deaths in LTC due to the COVID-19 pandemic. Prior to COVID-19, our Strengthening a Palliative Approach in LTC (SPA-LTC) work highlighted how residents and families were faced with making critical and emotional end-of-life decisions without any preparatory discussions, resulting in stress and conflict. Most recently, the SPA-LTC team has developed a LTC palliative toolkit that can address the immediate LTC homes needs in response to COVID-19. The LTC toolkit includes tools and practices that support the following: 1. Engagement of residents and families across disease trajectories, including virtual informational resources and instructional videos 2. Workforce capacity development through (a) online staff education modules about implementing a palliative approach, and (b) supports to reduce stress and improve psychological health during COVID-19 and beyond 3. Development of organizational structures and processes embedded in the LTC home to promote a palliative approach to care The research questions/objectives of our CFHI funded study are to: A. conduct a scale-up assessment of the new LTC palliative toolkit in three provinces (ON, SK, NB) B. identify ways to adapt the LTC palliative toolkit for diverse regions and contexts C. document lessons learned from implementation in diverse settings D. evaluate the implementation and effectiveness of the toolkit in participating LTC homes during COVID-19