Staff perceptions of the consequences of COVID‐19 on quality of dementia care for residents in Ontario long‐term care homes

Objectives The first wave of the COVID‐19 pandemic necessitated extensive infection control measures in long‐term care (LTC) and had a significant impact on staffing and services. Anecdotal reports indicate that this negatively affected LTC residents' quality of care and wellbeing, but there is scarce evidence on the effects of COVID‐19 on quality of dementia care in LTC. Methods From December 2020 to March 2021, we conducted a cross‐sectional online survey among staff who worked in LTC homes in Ontario, Canada. Survey questions examined staffs' perceptions of the impact of COVID‐19 on dementia quality of care during the initial wave of the COVID‐19 pandemic (beginning 1 March 2020). Results There were a total of 227 survey respondents; more than half reported both worsened overall quality of care (51.3%) and worsening of a majority of specific quality of care measures (55.5%). Measures of cognitive functioning, mobility and behavioural symptoms were most frequently described as worsened. Medical and allied/support staff had the highest odds of reporting overall worsened quality of care, while specialized behavioural care staff and those with more experience in LTC were less likely to. LTC home factors including rural location and smaller size, staffing challenges, higher number of outbreaks and less COVID‐19 preparedness were associated with increased odds of perceived worsening of quality of dementia care outcomes. Conclusions These findings suggest that COVID‐19 pandemic restrictions and related effects such as inadequate staffing may have contributed to poor quality of care and outcomes for those with dementia in LTC. Key points There is a lack of information on the impact of COVID‐19 on quality of dementia care in long‐term care (LTC). In this survey of LTC staff, approximately half of respondents reported worsened overall quality of dementia care related to the COVID‐19 pandemic and infection control measures. A majority of respondents reported worsening of specific measures of quality of care. In particular, a worsening of resident cognitive functioning, mobility and behavioural symptoms was reported. Worsened quality of care related to the COVID‐19 pandemic may have contributed to poor outcomes for those with dementia in LTC.