The impact of the COVID-19 pandemic on end-of-life care in LTCFs in England : A qualitative study of LTCF staff experiences

Cotterell, Natalie and Moore, Danni Collingridge (2026) The impact of the COVID-19 pandemic on end-of-life care in LTCFs in England : A qualitative study of LTCF staff experiences. Palliative Care and Social Practice, 20. ISSN 2632-3524

Text (10.1177_26323524251413623.pdf)
10.1177_26323524251413623.pdf - Published Version
Available under License Creative Commons Attribution-NonCommercial.
Download (507kB)

Abstract

Background: The COVID-19 pandemic significantly increased the number of deaths within long-term care facilities (LTCFs) globally. Restrictions around visitation and social distancing were common; however, research conducted during the pandemic demonstrates that these policies impacted the ways in which end-of-life care was delivered in LTCFs. Aim: This paper aims to explore the experiences of LTCF staff members in England in providing end-of-life care in the context of policies issued by the government at the time. Methods: Secondary analysis of data collected from qualitative, semi-structured interviews conducted with 24 LTCF staff working across eight LTCFs in the north-west of England were analysed. Interviews were conducted with LTCF staff members, exploring their experiences of working in adult social care during the COVID-19 pandemic. Themes related to providing end-of-life care during this time were identified and analysed using thematic analysis. Findings: Thematic analysis identified four key themes including: discrepancies in following COVID-19 UK government guidelines including visitation at end of life as an exception; the influence of staffing on delivering end-of-life care; utilising technology to substitute physical presence at end-of-life visits; and the emotional impact of delivering end-of-life care under COVID-19 restrictions. Conclusion: The findings demonstrate the numerous challenges LTCF staff experienced when delivering end-of-life care during the COVID-19 pandemic in terms of the practicalities of managing resident deaths, facilitating visitation, and the associated impact on emotional well-being. Ensuring that all LTCF staff are trained to recognise end-of-life care, in the event of a future pandemic, will better equip LTCFs in providing high-quality care. It is paramount that guidance on managing family contact at end of life is consistent, while considering the impact of implementing such guidance on the mental and emotional well-being of LTCF staff members.