Impact of COVID-19 restrictions on Ontario long-term care and retirement home residents' health, well-being and function

Background: To limit spread of COVID-19, long-term care (LTC) and retirement homes restricted residents from leaving homes and family members from entering. Many settings also limited movement of residents within homes. These restrictions were a logical approach to attempt to limit spread of the virus; however, they had serious consequences for the health, well-being, function and autonomy of older adult residents, and important implications for family members and staff in the facilities; these consequences have not been methodically examined. Objectives and methods: Using quantitative and qualitative methods we will 1) conduct a survey to detail and categorize levels of pandemic restrictions in LTC and retirement homes across Ontario; 2) use mobile device data to explore actual movement patterns in these settings; 3) access provincial COVID-19 data to trend outbreak and infection rates with changes in movement restrictions; 4) track outcomes related to health, well-being and function (e.g. RAI-MDS scores for function in activities of daily living, cognition and mood for LTC residents; frailty scores and disease profiles for LTC home residents) to measure the impact of movement restrictions on the well-being, health and function of Ontario LTC home residents; and 5) conduct qualitative interviews to describe the experience of movement restrictions and implications for residents, family members and LTC and retirement home staff. These data and methods will enable us to identify the impact of restrictions on health, well-being and function in the short and longer term. Impact and expected outcomes: This is the first study examining the impact of restrictions in LTC and retirement homes on residents' health, well-being and function, and implications for family and staff. This novel and highly relevant study will provide much needed knowledge to inform practice in LTC and retirement care homes to reduce potential harms in this and future pandemic situations.