"We are still tired": staff and administrators' experiences during the COVID-19 pandemic within California residential care facilities for older adults.

BACKGROUND: Extensive research has been conducted on the impacts of the COVID-19 pandemic on long-term care workers in specialized care facilities. However, little is known about the impacts faced by facilities that provide generalized long-term support and care, such as residential care facilities for older adults (RCFs). This study describes the challenges experienced by staff and administrators of RCFs during the COVID-19 pandemic. METHODS: An electronic questionnaire collecting data using both closed- and open-ended questions on staff experiences was sent to 5,721 unique RCF administrator emails within the state of California between June-December 2021. Email addresses were obtained from the public database of RCFs available through the California Health and Human Services Open Data Portal. Descriptive statistics were calculated on quantitative data regarding staff preparedness training, access to resources, and administrators' confidence in meeting recommended guidelines during the pandemic. Inductive thematic analysis was conducted on qualitative data regarding the confidence levels in meeting pandemic guidelines and challenges faced related to staff stress and morale. RESULTS: A total of 150 RCF administrators across California (response rate of 2.6%) completed the survey. Over three-fourths of respondents indicated their facilities had a designated staff member to train other staff members on emergency preparedness plans and the most frequently used resources during the COVID-19 pandemic were the Department of Social Services Community Care Licensing Division (88.7%), the county health department (86.7%), and the Centers for Disease Control and Prevention (80.7%). Administrators felt least confident in their facilities' ability to maintain adequate staffing (52.0%), communication with nearby hospitals (62.1%) and communication with state and local public health officials (69.8%) during the pandemic. Three central themes emerged from the thematic analysis on staff stress and morale: (1) physical safety, mental and emotional impact of the COVID-19 pandemic; (2) staffing issues; and (3) challenges with guidelines in managing the ongoing pandemic. CONCLUSIONS: Findings from this research study can be used to actively target training resources for facility administrators and staff that have been identified as most frequently used and relevant for emergency preparedness in these understudied facilities. Additionally, developing a better understanding of the staffing stress and morale difficulties in RCFs can provide insight on how policymakers can assist these critical facilities in better preparing for future crises.

Face-To-Face with the Pandemic: Experiences of Staff in Portuguese Residential Care Facilities.

The COVID-19 pandemic has placed care facilities for older adults under high pressure. This study aimed to identify the perception of staff in Portuguese Residential Care Facilities for Older Adults about their experience during and right after the first lockdown (March/April 2020) due to the COVID-19 pandemic. It comprises 198 respondents who answered an open question about their experiences during the pandemic on an online questionnaire. The main findings suggested three themes: 1) a cascade of new needs on top of old problems; 2) working on the razor's edge: a difficult balance between protecting against the virus and maintaining one's well-being; and 3) a need for support and appreciation. The pandemic has exposed and accentuated the fragilities of Residential Care Facilities in Portugal, which operate with low budgets, and minimum staff. The measures to protect against infection have to be balanced by actions to maintain psychosocial and rehabilitation activities with the residents, to promote their well-being and functional capacity.