Support for Nursing Home Caregivers During the COVID-19 Pandemic: A Review.

PURPOSE: To review support systems for nursing home caregivers (NHCGs) that were implemented during the first year of the coronavirus disease 2019 (COVID-19) pandemic. METHOD: Database searches in PubMed, ScienceDirect, and CINAHL resulted in five publications. RESULTS: Studies differed in design, interventions, and outcomes. An urgent eye movement desensitization and reprocessing protocol was feasible and effective among nurses in services highly mobilized during the acute phase of the pandemic. The "self-help plus" psychological intervention was not associated with significant reductions in anxiety or posttraumatic symptoms but prompted exploration of non-specific factors influencing its effectiveness. The Extension for Community Healthcare Outcomes in Long-Term Care of the Elderly virtual program increased confidence among NHCGs. Self-compassion training was associated with positive changes for certified nursing assistants. Weekly debriefing sessions implemented at one hospital highlighted pathogenic and salutogenic factors. CONCLUSION: The COVID-19 pandemic had a marked psychosocial impact on NHCGs and necessitated targeted interventions. Despite their limitations, these promising studies provided insights into potential support avenues. Policy considerations should stress the pivotal role of advanced practice nurses in shaping supportive work environments. Future research should focus on robust assessments of the efficacy of psychosocial interventions for NHCGs facing ongoing challenges posed by the pandemic, and even recurrent viral epidemics. [Journal of Gerontological Nursing, 50(10), 24-33.].

[Three professional perspectives for optimizing treatment in nursing homes]. / Trois perspectives professionnelles pour optimiser les traitements en EMS.

Carrying out an interprofessional medication review to optimize the treatment of nursing home residents is interesting in more ways than one. This is evidenced by the practical case managed and described here by the medical and nursing team who decided and implemented several consequential medication changes. The discussions involved medical, nursing, and clinical pharmacy perspectives, which complemented each other to enhance the effectiveness and safety of the resident's treatment while considering their specific personal and clinical situation. This synergy has resulted in improved quality of care, concretely felt by the resident himself, but it also increased knowledge that can be transferred to improve the use of medicines of other residents in the facility.

Optimiser le traitement de résidents et résidentes d'établissement médicosocial par l'analyse interprofessionnelle de leur médication est intéressant à plus d'un titre. C'est ce qui ressort du cas pratique décrit dans cet article par l'équipe médico-­soignante qui a décidé et opéré plusieurs changements de médication conséquents. La réflexion commune, nourrie des perspectives médicales, infirmières et de pharmacie clinique complémentaires, a permis d'accroître l'efficacité et la sécurité du traitement du résident, en respectant sa situation personnelle et clinique propre. Cette synergie a renforcé la qualité de la prise en charge, par ailleurs concrètement ressentie par le résident lui-même, mais aussi généré des connaissances transposables pour un meilleur usage des médicaments d'autres résidents et résidentes de l'institution.

Nursing home leader response during COVID-19: a qualitative descriptive study about use of external resources during the pandemic.

BACKGROUND: US nursing homes were ground zero for COVID-19 and nursing home leaders faced multiple challenges to keep residents and staff safe. Understanding the leader's role and their use of external resources to rapidly respond to the pandemic is important to better prepare for the next infectious disease outbreak emergency. The purpose of this study is to describe Missouri nursing home leaders' use of external resources to manage challenges encountered during the pandemic. METHODS: This qualitative descriptive study uses data from semi-structured interviews conducted with leaders from 24 Midwestern nursing homes between March 2022 and March 2023. Interviews were transcribed verbatim and analyzed using Dedoose software. Directed content analysis, guided by Donabedian's Structure, Process, Outcome framework, was used for analysis. Interviews were conducted as part of a larger mixed-methods study focused on developing knowledge and recommendations to improve US nursing homes' capacity to respond to infectious disease outbreaks. RESULTS: Forty-three interviews were conducted across the 24 homes. Participants included administrators (n = 24), nurse leaders (n = 19), and infection preventionists (n = 16). Six sub-categories of external resources/support were used by leaders to manage challenges during the pandemic:1) corporate support and communications, 2) statewide resources, 3) community-based resources, 4) health care coalitions focused on emergency response planning, 5) existing affiliations with local organizations i.e., hospitals, and 6) community members and families. Corporate support was a primary resource; however, it was limited to chain-based homes. Leaders from standalone homes seemed most reliant on statewide agencies, existing affiliations, and other community-based resources due to their lack of corporate connections. Health care coalitions were few, but when available, helped nursing homes prepare for the pandemic onset. Family and community members were vital despite being off-site from nursing homes at the pandemic onset. CONCLUSION: Leaders played a pivotal role in accessing and using external resources to manage challenges during the pandemic. Statewide and community-based agencies and existing affiliations were particularly critical for standalone homes who otherwise had little to no means of support. Federal, state and local agencies must consider opportunities to build multi-agency regional collaborations, local health care coalitions and community-based partnerships that include nursing homes as member. Finally, community members and family were important in providing support, thus closing visitation is a double-edged sword that needs careful, future consideration.

Exploring influencing factors to clinical leadership development: a qualitative study with healthcare professionals in Flemish nursing homes.

BACKGROUND: Nursing homes face a critical need for competent healthcare professionals to deliver high-quality care. Focusing on clinical leadership is crucial for equipping healthcare professionals with the skills necessary to manage complex care needs, collaborate effectively within multidisciplinary teams, and improve care quality in nursing homes. Developing clinical leadership fosters professional growth and enhances healthcare professionals' ability to tackle the challenges unique to the nursing home environment. However, the concept of clinical leadership in nursing homes remains poorly defined and investigated. This study aimed to explore and define influencing factors for the development of clinical leadership within healthcare professionals in nursing homes. METHODS: A qualitative study was conducted in Flanders, Belgium, using semi-structured focus group interviews (n = 5) with healthcare professionals (n = 41), including nurse assistants, licensed practical nurses, registered nurses, occupational therapists, recreational therapists, psychologists, and gerontologists. Interviews were audio-taped, transcribed, analysed and interpretated by using a thematic analysis based on descriptive phenomenology. RESULTS: Clinical leadership development within healthcare professionals' hinges on four pivotal themes: (1) Cultivating an empowering working environment that fosters open feedback, encourages peer learning, and champions a stimulating learning climate. (2) Nurturing a supportive leadership style in formal leaders that exemplifies role modeling, accessibility, and a coaching approach. (3) Elevating well-developed professional identity through targeted training, experience, and a talent-oriented work approach. (4) Fostering team dynamics marked by commitment, collaboration, support, and trust. CONCLUSIONS: The study's findings on the influencing factors for clinical leadership development should be actively applied in nursing homes and guide the creation of targeted training programs and leadership development initiatives. Awareness of these factors are crucial to optimise and to support the development and implementation of clinical leadership in nursing homes in an attempt to reduce the workforce shortages.

Extensivist: improving the delivery of enhanced health in older people's care homes.

BACKGROUND: Older people living in care homes are often frail and clinically complex. The Enhanced Health in Care Homes (EHCH) framework supports organisational and clinical strategies to deliver good care, promoting proactive person-centred care by whole system collaboration. We evaluate the impact of a new role, the Extensivist, in the delivery of EHCH for older people living in care homes. AIMS: To evaluate implementation processes and the clinical utility of the Extensivist in older people care homes in the London borough of Southwark. METHODS: The Extensivist (Band 8a Advanced Nurse Specialist skilled in frail older people) was embedded within the care home general practitioners (GP) service for a 2-year pilot (2019-2021). Implementation processes were evaluated. Impact of the Extensivist role was evaluated by the number of Comprehensive Geriatric Assessment (CGA) completed, interventions and other clinical activity performed as well as qualitative case studies and semistructured feedback from care home workers and professionals. RESULTS: The Extensivist feasibly delivered CGA and implemented intervention plans. The role iteratively developed to support wider aspects of care including advance care planning (ACP) and training. Challenges included building trust, the time-consuming nature of CGA, ACP and coordinated communication. Case studies and semistructured feedback indicated the role was considered valuable in the delivery of clinical care, supporting residents, families, care homes and GPs and as a resource for education for care home workers. CONCLUSIONS: The Extensivist is a valuable resource and a linchpin in the delivery of EHCH framework in care homes for older adults in Southwark. Further evaluations to assess reproducibility in other areas of the UK are warranted.

Experiences of family caregivers and nursing home staff interactions during the adaptation process of elderly individuals moving to nursing home: a qualitative study.

OBJECTIVE: To explore the interaction between family members and nursing home staff during the adjustment period of newly admitted elderly individuals in a nursing home. DESIGN: A qualitative descriptive study based on semistructured interviews; data were analysed using a thematic topic analysis approach. SETTING: Interviews were conducted face-to-face. PARTICIPANTS: An interview was undertaken with 15 nursing home staff and 12 family members of recently admitted elderly individuals in three nursing facilities from November 2022 to January 2023 in a major Chinese urban centre. RESULTS: This study identified 5 main themes and 10 subthemes. The 5 themes identified are: Information transmission and sharing, pleasant interaction atmosphere, interaction dilemmas and challenges, inadequate organisational management and the necessity and anticipation of interaction. CONCLUSION: During the process of older persons transitioning to institutional care, we discovered issues and unresolved requirements in the interactions between family members and nursing home staff. In summary, there is a need to enhance the development of an interactive environment that supports the institutionalisation of older persons. The findings derived from this study are valuable for developing interactive programmes. TRIAL REGISTRATION NUMBER: ChiCTR2100045590, date: 19 April 2021.

SARS-CoV-2 outbreak management in nursing homes in Ireland: reflections of COVID-19 response teams from earlier to later waves of the pandemic.

BACKGROUND: A review of key learnings from the response to the COVID-19 pandemic in nursing homes in Ireland can inform planning for future pandemics. This study describes barriers and facilitators contributing to COVID-19 outbreak management from the perspective of frontline teams. METHODS: A qualitative study involving ten online focus group meetings was conducted. Data was collected between April and June 2023. The focus group discussions explored the views, perceptions and experiences of COVID-19 Response Team (CRT) members, clinical/public health experts who worked with them, and care professionals who worked in frontline managerial roles during the pandemic. All nine Community Healthcare Organisations and six Public Health Areas in Ireland were represented. Inductive reflexive thematic analysis was carried out using NVivo Pro 20. RESULTS: In total, 54 staff members participated in focus group meetings. Five themes were developed from a thematic analysis that covered topics related to (1) infection prevention and control challenges and response to the pandemic, (2) social model of care and the built environment of nursing homes, (3) nursing home staffing, (4) leadership and staff practices, and (5) support and guidance received during the pandemic. CONCLUSIONS: The response to the COVID-19 pandemic has resulted in a steep learning curve, internationally and in Ireland. Preparing better for future pandemics not only requires changes to infection control and outbreak response but also to the organisation and operation of nursing homes. There is a great need to strengthen the long-term care sector's regulations and support around staffing levels, nursing home facilities, governance, use of technology, infection prevention and control, contingency planning, and maintaining collaborative relationships and strategic leadership. Key findings and recommendations from the Irish example can be used to improve the quality of care and service delivery at local, national, and policy levels and improve preparedness for future pandemics, in Ireland and internationally.

Association Between Organizational Context and Resident Pain in Assisted Living: A Repeated Cross-Sectional Study.

OBJECTIVES: Resident pain has been a common quality challenge in congregate care for older adults, and organizational context may explain variations in resident pain beyond resident-level factors. Most studies have focused on nursing homes (NHs), largely neglecting assisted living (AL). AL residents are at similar risk for pain as NH resident, but with AL providing fewer services and staffing resources. Our objective was to examine whether organizational context in AL was associated with resident pain during the first two waves of the COVID-19 pandemic. METHODS: This repeated cross-sectional study linked AL home surveys, collected in COVID-19 waves 1 (March-June 2020) and 2 (October 2020-February 2021) from a key contact, to administrative Resident Assessment Instrument-Home Care (RAI-HC) records in these homes. Surveys assessed preparedness for COVID-19 outbreaks, availability of a registered nurse or nurse practitioner, direct care staff shortages, decreased staff morale, COVID-19 outbreaks, confinement of residents to their rooms, supporting video calls with physicians, facilitating caregiver involvement. The dependent variable (moderate daily pain or pain of a severe intensity) and resident covariates came from the RAI-HC. Using general estimating equations, adjusted for repeated resident assessments and covariates, we assessed whether AL organizational context was associated with resident pain during the pandemic. RESULTS: We included 985 residents in 41 facilities (wave 1), and 1134 residents in 42 facilities (wave 2). Pain prevalence [95% confidence interval] decreased non-significantly from 20.6% [18.6%-23.2%] (March-June 2019) to 19.1% [16.9%-21.6%] (October 2020-February 2021). Better preparedness (odds ratio = 1.383 [1.025-1.866]), confinement of residents to their rooms (OR = 1.616 [1.212-2.155]), availability of a nurse practitioner (OR = 0.761 [0.591-0.981]), and staff shortages (OR = 0.684 [0.527-0.888]) were associated with resident pain. CONCLUSIONS: AL organizational context factors were associated with resident pain. Policy and management interventions can and must address such factors, providing potentially powerful levers for improving AL resident quality of care.

Realizing the Promise of Technologies for Enhancing Aging in Place Within Long-Term Care Homes.

While residential long-term care (LTC) settings can be the right places to age well, they have received relatively little attention in research and policy conversations about technology. In this commentary, we discuss how technologies are currently being integrated into LTC, the ethical challenges and considerations this raises and the potential for improving how technologies are designed and implemented to empower and make the lives of older residents better. We advocate for innovative policy reforms and standards to ensure that technology design and development are equitable and inclusive and better aligned with the wishes and values of older adults and their families.

Building a culture of safety in Australian residential aged care facilities: protocol for a longitudinal mixed methods research programme.

INTRODUCTION: The quality and safety of care within residential aged care facilities (RACFs) have been linked to their organisational culture. However, evidence for understanding and improving culture in this setting is limited. This research programme aims to validate a survey to measure organisational culture and determine the relationship of culture with safety and quality of care, then to evaluate an organisational culture change programme in Australian RACFs. METHODS AND ANALYSIS: This is a longitudinal mixed methods programme of research conducted across four studies in collaboration with a national aged care provider that cares for more than 5000 residents:Study 1: Cross-sectional staff survey of organisational culture in >50 RACFs with concurrent collection of data on quality and safety of care, and staff outcomes, to explore their associations with culture.Study 2: Ethnographic fieldwork in eight RACFs sampled to achieve maximum variation. Data from interviews, observations and documents will be analysed to identify the underlying assumptions and how cultural assumptions influence the enactment of safety and quality.Study 3: Evaluation of the implementation of the Speak Up for Safety culture change programme, focusing on its contextualisation for RACFs, implementation determinants and outcomes. Data will be collected through semistructured interviews, complimented with secondary data from program training and feedback system usage.Study 4: Evaluation of the effectiveness of the culture change programme using baseline data from study 1 and a follow-up survey of organisational culture postimplementation to assess changes in organisational culture and staff behaviour. ETHICS AND DISSEMINATION: The study has received approval from the Macquarie University Human Research Ethics Committee. Informed consent will be sought from all participants. Findings will be disseminated through journal articles, conference presentations and reports to the collaborating provider and RACFs. Survey data will be deposited into a data repository for use by others working on related research.

Incidence of Pressure Injuries in Patients at Risk Using a Powered Alternating Pressure Air Mattress: A Noninterventional Study in a Real-World Setting.

PURPOSE: The aim of the study was to determine the clinical value of using a powered alternating pressure air mattress (P-APAM) in the prevention of pressure injury (PI) in patients at medium to high risk. DESIGN: Noncomparative, observational study. SUBJECTS AND SETTING: The sample comprised 86 patients who were >18 years old, were classified as having medium to high risk of PI, had no PI at baseline, and were lying more than 15 hours a day on a specific P-APAM. Data were collected between September 2018 and July 2019, in 4 nursing homes, and 1 long-term care geriatrics hospital department in France. METHODS: In addition to guideline-based care for PI prevention, patients were followed up for 35 days following placement on the P-APAM. The main outcome was the percentage of patients who developed between day 0 and day 35 at least 1 PI of at least stage 2 on the sacrum, spine, or heel. Secondary outcomes were patient assessments of comfort, caregiver satisfaction, mattress noise level, and mattress safety. RESULTS: No patients experienced a PI (incidence = 0%; 95% confidence interval, 0.00%-4.28%). Patients were satisfied or very satisfied with the mattress in most cases in terms of comfort (77.9%) and stability (73.0%). Patients also rated the noise level of the mattress as satisfactory or very satisfactory in all cases (100%). CONCLUSION: When combined with guideline-based PI prevention measures, use of the P-APAM was associated with a low incidence of PI.

Nursing Home Certificate of Need Moratoria During the COVID-19 Pandemic Had Little Impact on Access.

In over half of US states, health planning boards monitor and control the supply of health care through certificate of need (CON) laws. The COVID-19 pandemic led several states to impose moratoria on CON regulations, hoping to bolster hospital and skilled nursing facility (SNF) beds. Using a difference-in-difference research design, we leverage 2015 to 2021 cost report data from SNFs to study the association between COVID-related CON moratoria and health care supply. Counties that imposed moratoria experienced a slight decline in per-capita SNF bed count. However, once adjusted for potential differential shocks in pre-pandemic high utilization counties, we find little evidence that moratoria led to increased nursing home capacity, overall or by urbanicity. In the context of nursing homes, we conclude that CON deregulation was relatively ineffective at mitigating pandemic-era supply concerns.

Perceptions of Older People in Nursing Facilities About Advance Care Planning: A Systematic Review.

BACKGROUND: With the ageing of the population intensifying, the implementation of advance care planning (ACP) in nursing facilities is especially crucial. OBJECTIVE: This study aimed to search and synthesise qualitative studies exploring the perspectives of older people in nursing facilities about ACP discussions. METHODS: The researchers conducted searches of PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, VIP and CBM between the time of inception and October 2023. The PICo model was used to build the inclusion and exclusion criteria. Following the inclusion and exclusion criteria, two researchers screened the literature, extracted data and then integrated the literature using the integrative synthesis. RESULTS: A total of 12 articles were included, 47 themes were extracted, and three research integrations were summarised: (1) understanding of ACP; (2) attitude towards ACP; and (3) influencing factors of participation in ACP. CONCLUSION: This study offers guidance for the future development of ACP on the participation of older people in nursing facilities. IMPLICATIONS FOR PRACTICE: It is necessary to strengthen the education of ACP-related knowledge in conjunction with the cultural characteristics of different countries, to provide interdisciplinary support for older people through professional teamwork and to promote the development and improvement of ACP-related practices.

The effectiveness of a knowledge translation intervention on the implementation of NEWS2 in nursing homes, a pragmatic cluster RCT.

BACKGROUND: Improving the uptake of relevant and reliable research is an important priority in long-term care to achieve sustainable and high-quality services for the increasingly older population. AIM: The purpose was to assess the effectiveness of a tailored, adaptive and a multifaceted KT capacity program, relative to usual practice, on the implementation of National Early Warning Score 2 (NEWS2). METHODS: This study was carried out as a pragmatic cluster-randomized controlled trial. The capacity program consisted of an educational part to address implementation capacity gaps and a facilitation-upon-implementation part to address a relevant knowledge gap in nursing homes. A collective decision was made to address the challenge of early detection of clinical deterioration among nursing home residents, by implementing the (NEWS2) as clinical innovation. Public nursing homes in a Norwegian municipality (n = 21) with a total of 1 466 beds were eligible for inclusion. The study-period spanned over a 22-month period, including a 12-month follow-up. Data was extracted from the Electronic Patient Journal system and analyzed using multilevel growth model analysis. RESULTS: The intervention had a large effect on the use of NEWS2 among care staff in intervention nursing homes, compared to the control group (standardized mean difference, d = 2.42). During the final month of the implementation period, residents in the intervention group was assessed with NEWS2 1.44 times (95% CI: 1.23, 1.64) per month, which is almost four times more often than in the control group (mean = 0.38, 95% CI: 0.19, 0.57). During the follow-up period, the effect of the intervention was not only sustained in the intervention group but there was a substantial increase in the use of NEWS2 in both the intervention (mean = 1.75, 95% CI: 1.55, 1.96) and control groups (mean = 1.45, 95% CI: 1.27, 1.65). CONCLUSIONS: This tailored implementation strategy had a large effect on the use of NEWS2 among care staff, demonstrating that integrated knowledge translation strategies can be a promising strategy to achieve evidence-based care in the nursing home sector. TRIAL REGISTRATION: ISRCTN12437773 . Registered 19/3 2020, retrospectively.

The influence of care home registration type and size on senior care leader's confidence to provide palliative and end-of-life care: an explanatory sequential mixed methods study.

BACKGROUND: Care home staff are key providers of palliative and end-of-life care. Yet, little is known about how care home characteristics can influence care leader's confidence in their ability to provide optimal palliative and end-of-life care. AIM: To understand the influence of care home registration type (nursing, residential or dual registered) and size on senior care leader's confidence to provide palliative and end-of-life care. DESIGN: An explanatory sequential mixed methods study comprising an online cross-sectional survey (including the Palliative Care Self-Efficacy Scale) and qualitative individual interviews. Analysis of survey data used a multivariate logistic regression and qualitative interview data used Framework Analysis. A 'Following the Thread' method was undertaken for data integration. SETTING/PARTICIPANTS: UK care home senior care leaders, purposively sampled by registration type, size and geographical location. RESULTS: The online survey (N = 107) results indicated that nursing home senior care leaders had higher confidence scores on the Palliative Care Self-Efficacy Scale than residential care home leaders (aOR: 3.85, 95% CI 1.20-12.31, p = 0.02). Care home size did not show effect when adjusting for registration type (medium - aOR 1.71, 95% CI 0.59-4.97, p = 0.33; large - aOR 0.65, 95% CI 0.18-2.30, p = 0.5). Interviews (n = 27) identified three themes that promote confidence, (1) 'feelings of preparedness' stemming from staff expertise and experience and care home infrastructure, (2) 'partnership working' with external services as a valued member of the multidisciplinary team, and (3) a shared language developed from end-of-life care guidance. CONCLUSION: Care home senior care leader's confidence is influenced by care home characteristics, particularly availability of on-site registered nurses and the infrastructure of large care homes. All care home leaders benefit from training, working with external, multidisciplinary teams and use of guidance. However, mechanisms to achieve this differed by care home type and size. Further exploration is needed on successful integration of palliative care services and interventions to enhance confidence in residential care homes.

Navigating artificial intelligence in care homes: Competing stakeholder views of trust and logics of care.

The COVID-19 pandemic shed light on systemic issues plaguing care (nursing) homes, from staff shortages to substandard healthcare. Artificial Intelligence (AI) technologies, including robots and chatbots, have been proposed as solutions to such issues. Yet, socio-ethical concerns about the implications of AI for health and care practices have also been growing among researchers and practitioners. At a time of AI promise and concern, it is critical to understand how those who develop and implement these technologies perceive their use and impact in care homes. Combining a sociological approach to trust with Annemarie Mol's logic of care and Jeanette Pol's concept of fitting, we draw on 18 semi-structured interviews with care staff, advocates, and AI developers to explore notions of human-AI care. Our findings show positive perceptions and experiences of AI in care homes, but also ambivalence. While integrative care incorporating humans and technology was salient across interviewees, we also identified experiential, contextual, and knowledge divides between AI developers and care staff. For example, developers lacked experiential knowledge of care homes' daily functioning and constraints, influencing how they designed AI. Care staff demonstrated limited experiential knowledge of AI or more critical views about contexts of use, affecting their trust in these technologies. Different understandings of 'good care' were evident, too: 'warm' care was sometimes linked to human care and 'cold' care to technology. In conclusion, understandings and experiences of AI are marked by different logics of sociotechnical care and related levels of trust in these sensitive settings.

Nursing Process for institutionalized older adults: contributions from knowledge awareness workshop.

OBJECTIVE: To analyze the knowledge of professionals working in a Nursing Home about the Nursing Process before and after the awareness workshop. METHODS: This is strategic action research, developed with nursing professionals and managers of a Nursing Home in Rio Grande do Sul, Brazil. Data were collected between January and June 2023, through semi-structured interviews before and after an awareness workshop. Discursive textual analysis of the data was carried out. RESULTS: The central category "Understanding about the Nursing Process in Nursing Homes" emerged, which was unitized into two units of meaning and three categories of analysis. CONCLUSION: Data revealed non-use and lack of knowledge of the Nursing Process before awareness raising. Afterwards, a deeper understanding of the topic and its importance was identified. Awareness-raising workshops contribute to transformation of knowledge.

The Experiences of Migrant Care Workers in Long-term Care Facilities: A Scoping Review.

The employment of migrant care workers provides a remedy to face the challenges of increased demand for care of older adults. A scoping review aimed to identify, categorize, and summarize the existing knowledge about migrant care workers' working experiences in long-term care facilities. Identifying gaps in the literature can inform future research. Five electronic databases were searched in April 2024 in addition to a manual search for articles published in English. Forty-five articles were reviewed. A few studies described migrant care assistants' main tasks as assisting physical care and care assistants' characteristics grouped into personal and acquired qualities to provide good quality care. Migrant care workers experienced work satisfaction, achievement, adaptability and adjustment, organizational support, work burden, sense of loneliness, low wages, low social status, and loss of profession. They faced challenges involving inadequate knowledge of palliative care, communication and language barriers, cultural and religious differences, and health concerns. Friendly and discriminatory relationships were found between migrant care workers and stakeholders. Existing evidence regarding the experiences of migrant care workers in delivering palliative care to dying residents or facilitating death preparation is limited. Additionally, there is a notable absence of data from the perspectives of employers and residents on discrimination issues. Further research is necessary to investigate these areas.