L.Back 1, C. Lengyel1
1 Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB

Healthcare providers (HCP) find opportunities for end-of-life discussions difficult in long-term care (LTC). Poor communication surrounding anticipated decline may result in unwanted interventions for residents and leave substitute decision makers (SDM) feeling unsupported during the dying process. COVID-19 may further complicate the end-of- life experiences of many residents.

Examine EOL nutrition-related perspectives of HCPs in Canadian LTC homes during COVID-19.

Using Qualtrics, an online survey was sent to long-term care HCPs using purposive and snowball sampling from April 21 to September 16, 2021. 70 completed surveys were analyzed (100% Female; avg age=40.8 years). Information on COVID-19 and nutrition at end-of-life conversation delivery, timing and team-member involvement, HCP comfort-level with, and reasons for end-of-life conversations was collected.

Respondents included registered dietitians (n=57;83%), nurses (n=7;10%), speech language pathologists, social workers, occupational therapists (n=3;4%) and administrators (n=2;3%). During COVID-19, HCPs indicated nutrition at end-of-life conversations were primarily delivered by phone (n=48;57.1%), timing was unchanged (n=56; 9.4%), team member involvement was unchanged (n=56;82.1%). HCPs noted an increase in SDM-initiated conversations (n=16;28.1%) or no change (n=13;22.8%). HCPs indicated moderately-high confidence levels with nutrition at end-of-life conversations with residents, families, or SDMs (n=18;31%). However, HCPs felt conversations about nutrition at end-of-life were moderately more stressful (n=19;32.8%) or very stressful (n=1;22.4%) during COVID-19. HCPs indicated most end-of-life conversations occurred due to resident mental health changes (n=26;33.7%), and due to nutrition-related COVID-19 symptoms (n=18;23.4%).

During COVID-19, government restrictions impacting family presence, increases in resident decline due to COVID-19 impacts, lack of change in timing and team member involvement in end-of-life conversations may have resulted in increased HCP stress. Furthermore, communication changes during COVID-19 may have resulted in unwanted interventions for residents.

Provides baseline knowledge of current end-of-life practices within the context of COVID-19 in Canadian LTC homes.

Riverview Health Centre