Project 459276

COVID-19 has had a devastating impact on older adults living in long-term care (LTC) & assisted living (AL). Residents in these settings experienced higher rates of COVID-19 infection and more serious outcomes than those in the community. Most media and research attention has focused on LTC, largely neglecting AL. AL residents are similar to those in LTC, and AL faces the same concerns as LTC about staffing, oversight, and infection prevention. However, AL provides fewer services and lower staffing levels than LTC. Yet, the immediate and longer-term effects of COVID-19 on AL residents remain poorly examined in Canada - and especially in Alberta, whose AL system (called Designated Supportive Living; DSL) is unique in the country. Our aim is to understand how COVID-19 and facility policies have impacted DSL & LTC residents' physical and mental health, quality of care, and health services use, and how these impacts have changed over time. We will conduct a population-based, observational study, using clinical and health administrative data for all DSL & LTC residents in Alberta between 01/2017 and 12/2021. We also have rich, unique survey data collected from 64 DSL homes and 35 LTC homes in Alberta, assessing preparedness for the pandemic, measures implemented, challenges encountered and interactions with residents' family/friend care partners. We will link these facility surveys to residents' clinical and health administrative data to assess how facility characteristics are associated with resident outcomes. This study addresses an urgent, critical need to better understand the impact of COVID-19 on a growing but under-researched care setting for older Canadians. Understanding how effects of COVID-19 on AL/DSL residents changed over time will lead to improvements in policies and practices related to family and resident communication, AL/DSL staffing and services, and balancing infection control measures with maintaining the health and well-being of DSL/AL residents.