# Understanding the Lived Experience of Family Caregivers of Loved Ones in Long-Term Care During COVID-19 Through Art

## TL;DR

This study explores how pandemic visitation rules in long-term care hurt family caregivers' mental health and highlights the need for more inclusive policies.

## Contribution

The study uses arts-based methods to reveal the emotional impact of pandemic policies on LTC caregivers, emphasizing the need for trauma-informed and family-inclusive approaches.

## Key findings

- Caregiver exclusion due to infection-control rules led to emotional distress and disrupted care continuity.
- Arts-based research effectively captured emotional experiences often overlooked in traditional studies.
- Trauma-informed and culturally safe policies are needed to improve LTC during crises.

## Abstract

Public health relevance—How does this work relate to a public health issue?
This study highlights how COVID-19 visitation restrictions, implemented as public health measures, unintentionally caused harm to residents and family caregivers, revealing structural weaknesses in long-term care (LTC) systems.Lockdowns and exclusion policies led to trauma, grief, and burnout among caregivers, making this a significant public health concern related to mental health and social determinants of health.

This study highlights how COVID-19 visitation restrictions, implemented as public health measures, unintentionally caused harm to residents and family caregivers, revealing structural weaknesses in long-term care (LTC) systems.

Lockdowns and exclusion policies led to trauma, grief, and burnout among caregivers, making this a significant public health concern related to mental health and social determinants of health.

Public health significance—Why is this work of significance to public health?
The findings show that policies designed to protect physical health can negatively affect emotional and psychological health, emphasizing the need for holistic approaches.Recognizing family caregivers as integral to care delivery is crucial for improving health outcomes and reducing systemic strain during crises.

The findings show that policies designed to protect physical health can negatively affect emotional and psychological health, emphasizing the need for holistic approaches.

Recognizing family caregivers as integral to care delivery is crucial for improving health outcomes and reducing systemic strain during crises.

Public health implications—What are the key implications or messages for practitioners, policymakers, and/or researchers in public health?
Public health policies should embed family involvement and trauma-informed practices in LTC, even during emergencies, to prevent isolation-related harm.Practitioners and policymakers must prioritize caregiver mental health resources, culturally safe care models, and flexible visitation protocols to mitigate future crises.

Public health policies should embed family involvement and trauma-informed practices in LTC, even during emergencies, to prevent isolation-related harm.

Practitioners and policymakers must prioritize caregiver mental health resources, culturally safe care models, and flexible visitation protocols to mitigate future crises.

Public health restrictions during COVID-19 disproportionately affected older adults, especially those in long-term care (LTC) and their families. Family caregivers (FCs) are essential care partners in LTC settings, yet pandemic policies largely excluded them, creating emotional and systemic consequences. This study explored FCs’ experiences of visitation restrictions in British Columbia, Canada, using an arts-based qualitative approach within a larger mixed-methods project. Eight FCs participated in completing a total of twelve artworks, including photographs, collages, and creative writing that reflected their experiences. Virtual talking circles were used to facilitate the sharing and description of their experiences. Findings revealed three interconnected theme categories with eleven sub-themes. These themes suggest a plausible pathway: infection-control rules may lead to caregiver exclusion, disrupting relational continuity and oversight and contributing to distress and task-centered care. While context-specific and exploratory, results underscore the need for trauma-informed, family-inclusive policies and cultural safety in LTC. Arts-based research methods provided a powerful lens for capturing emotional realities often missed by conventional research.