Older Adults’ Quality of Life in Long-Term Care: A Cross-Sectional Comparison Before and During the COVID-19 Pandemic

Background: Alternate-level-of-care (ALC) patients waiting for admission to long-term care (LTC) in Ontario hospitals are an important subgroup of ALC patients. Understanding the characteristics of ALC patients waiting for LTC can identify opportunities for alternative discharge options. Methods: Characteristics from a sample of 13,915 ALC patients waiting for LTC in acute and complex hospitals were analyzed and compared to those from a sample of 113,046 long-stay home care clients in Ontario. Population-level data were obtained using Ontario's RAI-HC database for the period January 2007 to September 2008. Findings: Relative to older long-stay home care clients, ALC patients waiting for LTC admission have more functional impairment and complex health needs. A combination of targeted transitional care and more resource-intensive home care services are needed to successfully address ALC patients' care needs in the community. Conclusions: A substantial portion of ALC patients waiting for LTC placement in acute and complex care hospitals may be more appropriately cared for in community settings if adequate community-centred resources are put in place.