Supplementary Material for: Caregiver Involvement and Concerns with Care of Residents of Assisted Living Before and During the COVID-19 Pandemic

Introduction Family/friend caregivers play an essential role in promoting the physical and mental health of older adults in need of care – especially during the COVID-19 pandemic and especially in assisted living (AL) homes, were resident care needs are similarly complex as in long-term care homes but fewer staffing resources and services are available. However, little research is available on caregiver involvement and concerns with care of AL residents prior to and during waves 1 and 2 of the COVID-19 pandemic. This study addressed this important knowledge gap. Methods This prospective cohort study used baseline and follow-up online surveys with primary caregivers to AL residents in Western Canada who were 65 years or older and had lived in the AL home for at least 3 months before Mar 1, 2020. Surveys assessed the following outcomes in the three months prior to and during waves 1 and 2 of the pandemic: socio-demographics, 5 ways of visiting or communicating with residents, involvement in 16 care tasks, concerns with 9 resident physical/mental health conditions, perceived lack of resident access to 7 care services, and whether caregivers felt well informed and involved with resident care. Results Based on 386 caregiver responses, in-person visits dropped significantly in wave 1 of the pandemic and so did caregiver involvement in nearly all care tasks. While these rates increased in wave 2, most did not return to pre-pandemic levels. Correspondingly, caregiver concerns (already high before the pandemic) substantially increased in wave 1 and stayed high in wave 2. These were particularly elevated among caregivers who did not feel well informed/involved with resident care. Discussion/Conclusions Restricted in-person visiting disrupted resident care and was associated with worse perceptions of resident health and wellbeing. Continued caregiver involvement in resident care and communication with caregivers even during lockdowns is key to mitigating these issues.研究背景 家庭与亲友照护者在满足照护需求的老年群体身心健康促进工作中发挥着至关重要的作用，在新冠疫情期间尤为如此，而辅助生活（assisted living, AL）机构更是这类场景的典型代表——该类机构的入住者照护需求与长期护理院同样复杂，但可用的人力配置资源与服务却更为匮乏。然而，针对新冠疫情第一波和第二波浪潮前后，辅助生活机构入住者的照护者参与情况及其照护相关顾虑的研究仍较为匮乏。本研究旨在填补这一重要的认知空白。 研究方法 本项前瞻性队列研究面向加拿大西部65岁及以上、且于2020年3月1日前已在辅助生活机构居住满3个月的入住者的主要照护者，采用基线与随访在线问卷开展研究。问卷在疫情第一波和第二波浪潮前后的三个月内，对以下指标进行评估：社会人口学特征、5种与入住者的探访或沟通方式、参与16项照护任务的情况、对入住者9项身心状况的顾虑程度、对入住者无法获得7项照护服务的感知情况，以及照护者是否认为自己已充分了解照护信息并参与到入住者的照护工作中。 研究结果 基于386份照护者的有效回复，疫情第一波浪潮期间，线下探访次数显著下降，照护者参与几乎所有照护任务的比例也随之降低。尽管第二波浪潮期间这些指标有所回升，但多数并未恢复至疫情前水平。相应地，照护者的顾虑程度（疫情前本已处于较高水平）在第一波浪潮期间大幅上升，并在第二波浪潮期间维持高位，这一情况在那些认为自己未充分了解照护信息或未参与到入住者照护工作中的照护者群体中尤为显著。 讨论与结论 受限的线下探访破坏了入住者的照护工作，并与对入住者健康与福祉状况的负面感知相关。即便在封控期间，也应持续推动照护者参与入住者的照护工作并保持与照护者的沟通，这是缓解上述问题的关键所在。