The impact of the COVID-19 pandemic on end of life care in LTCFs in England: A qualitative study of LTCF staff experiences

BackgroundThe COVID-19 pandemic significantly increased the number of deaths within LTCFs globally. Restrictions around visitation and social distancing were common, however, research conducted during the pandemic demonstrates that these policies impacted the ways in which end of life care was delivered in LTCFs. AimThis paper aims to understand the experiences of LTCF staff in providing end of life care in the UK and explores the barriers and facilitators to doing so in the context of policies issued by the government at the time. MethodsData from semi-structured interviews conducted with 24 LTCF staff working across eight LTCFs in the north-west of England were analysed. Qualitative interviews were conducted with LTCF staff members, exploring their experiences of working in adult social care during the COVID-19 pandemic. Themes related to providing end of life care during this time were identified and analysed using thematic analysis. FindingsThematic analysis identified four key themes including: discrepancies in following COVID-19 UK government guidelines including visitation at end of life as an exception; the influence of staffing on delivering end of life care; utilising technology to substitute physical presence at end of life visits; and the emotional impact of delivering end of life care under COVID-19 restrictions. ConclusionsThe findings demonstrate the numerous challenges care staff experienced when delivering end of life care during the COVID-19 pandemic in terms of the practicalities of managing resident deaths, facilitating visitation and the associated impact on emotional wellbeing. Ensuring that all LTCF staff are trained to recognise end of life care, in the event of a future pandemic, will better equip LTCFs. In addition, it is paramount that the government provide consistent guidance on managing family contact at end of life, while taking into account the impact of implementing such guidance on the mental and emotional wellbeing of LTCF staff members.