# Operating Ethnicity-Focused Senior Long-Term Care Homes in Ontario, Canada During the COVID-19 Pandemic

## TL;DR

This paper explores how ethnicity-focused long-term care homes in Ontario managed during the pandemic, highlighting challenges and benefits of culturally specific care.

## Contribution

It provides insights from underrepresented LTC stakeholders, emphasizing culturally responsive approaches in pandemic preparedness.

## Key findings

- Ethnicity-focused LTC homes provided culturally safe spaces during the pandemic.
- Operational challenges included social isolation and logistical difficulties.
- Participants suggested solutions to political and economic constraints affecting LTC homes.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Highlights the systemic challenges within LTC settings during a public health emergency.Examines how the decision makers, managers, and leaders of LTC homes catering to vulnerable groups disproportionately impacted during the COVID-19 pandemic in Ontario, Canada, faced the COVID-19 pandemic.

Highlights the systemic challenges within LTC settings during a public health emergency.

Examines how the decision makers, managers, and leaders of LTC homes catering to vulnerable groups disproportionately impacted during the COVID-19 pandemic in Ontario, Canada, faced the COVID-19 pandemic.

Public health significance—Why is this work of significance to public health?
Identifies how pre-existing systemic and health inequities, cultural and language barriers, and funding limitations intensified vulnerabilities among elderly LTC residents during COVID-19.Analyzes perspectives of decision makers, managers, and leaders of ethnicity-focused senior LTC homes during the COVID-19 pandemic, groups often underrepresented in the literature, adding depth to the existing literature on COVID-19 pandemic impacts and preparedness.

Identifies how pre-existing systemic and health inequities, cultural and language barriers, and funding limitations intensified vulnerabilities among elderly LTC residents during COVID-19.

Analyzes perspectives of decision makers, managers, and leaders of ethnicity-focused senior LTC homes during the COVID-19 pandemic, groups often underrepresented in the literature, adding depth to the existing literature on COVID-19 pandemic impacts and preparedness.

Public health implications—What are the key implications or messages for practitioners, policy makers, and/or researchers in public health?
There is a need for integration of culturally responsive, people-centred approaches into pandemic preparedness, funding models, staffing strategies, and infection prevention and control planning for LTC homes.There is a need to prioritize construction and management of LTC homes, considering the special needs of ageing and diverse populations in the Global North.

There is a need for integration of culturally responsive, people-centred approaches into pandemic preparedness, funding models, staffing strategies, and infection prevention and control planning for LTC homes.

There is a need to prioritize construction and management of LTC homes, considering the special needs of ageing and diverse populations in the Global North.

Canada’s ageing population continues to grow rapidly and significantly more diverse, which will require unique health and home service needs. The COVID-19 pandemic exacerbated existing challenges in Canada’s healthcare system and demonstrated the need for long-term care (LTC). Semi-structured interviews were conducted with 17 decision makers, managers, and leaders in long-term ethnically focused facility care. Braun & Clarke’s six-stage process of thematic analysis was applied using an iterative, deductive approach to examine the experiences of stakeholders involved in the operational, managerial, financial, and clinical aspects of an ethnicity-focused LTC. Findings highlighted salient characteristics of impactful ethnicity-focused care and factors were uniquely shaped by the delivery of culturally specific care. Key subthemes included social isolation and emotional impact, operational and logistic difficulties during COVID-19, mitigation measures implemented in response, and the social, behavioural, and health benefits observed among seniors living in these LTC homes. Participants identified political and economic constraints (e.g., provincial funding) to establishing ethnicity-focused care homes but proposed several solutions and highlighted potential benefits that could support successful implementation. Analysis of experiences of operational challenges in safely and adequately running ethnicity-focused LTC reinforces the value of ethnicity-focused LTC during times of crisis such as the COVID-19 pandemic, as they provide a culturally safe and familiar space with preventive measures applied in a timely manner for seniors to engage with their peers in an environment that meets their health needs, ensuring safety standards.