Impact of the COVID-19 pandemic on end of life care delivery in care homes: A mixed method systematic review

Abstract

Background: Current evidence suggests that COVID-19 is having a negative impact on the delivery of end of life care in care homes around the world. There is a need to collate current evidence to provide a comprehensive overview to assess extent of the problem.

Aim: To describe and evaluate the impact of the COVID-19 pandemic on end of life care delivery in care homes.

Design: Systematic review and narrative synthesis of studies reporting qualitative and quantitative data.

Data sources: The databases MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and March 2021.

Results: Nine studies were included. For care home staff, challenges included significant increases in responsibility and exposure to death, both of which have taken an emotional toll. Results indicate that staff tended not to be offered adequate emotional support or afforded the time to grieve. For those receiving end of life care, results indicate that the end of life care that they tended to receive, especially in the form of advance planning, was disrupted by the pandemic.

Conclusion: The effect of the pandemic has been to exacerbate existing problems in the provision of end of life care in care homes for both service providers and users, making that which was previously opaque starkly visible. Future research is needed to explore the effects of the pandemic and its management on those receiving end of life care in care homes and their significant others.

Keywords: COVID-19; Palliative care; coronavirus infections; pandemics; residential facilities; systematic review; terminal care.