Describing of issues within long-term care during the covid-19 pandemic: inappropriate antipsychotic use in persons with dementia and future strategies to improve pandemic protocols

Abstract

During the COVID-19 pandemic, long-term care (LTC) homes in Ontario were left severely underprepared, and many residents, specifically those with behavioral and psychological symptoms of dementia (BPSD), were contained and sedated using antipsychotics as chemical restraints. LTC homes were understaffed, crowded, did not have proper infection control protocols and overall lacked funding: all of which left them underprepared when faced with the COVID-19 pandemic. These issues became massive problems that led to many resident deaths during COVID-19. Though recommendations were given to help improve the above weaknesses in LTC after the severe acute respiratory syndrome (SARS) outbreak of 2002-2004, they were not applied to the LTC sector. This paper will recommend future strategies for Ontario's LTC by analyzing past recommendations and changes made in other countries that saw fewer resident deaths during the COVID-19 pandemic. Specifically, implementing quality improvement (QI) projects to improve weaknesses and test changes on a small scale to measure improvements, and implement policy changes to staffing, crowding, funding, training, and types of therapies given to those with dementia in LTC homes to better pandemic preparedness and decrease the use of antipsychotics as chemical restraints.