Abstract
Relational caring is considered a core practice framework in the care of older persons and was greatly disrupted by COVID-19 pandemic-related isolation measures. Moral distress and injury were emergent themes in our critical incident study exploring how healthcare providers’ experiences caring for older persons had changed over the course of the pandemic. A secondary thematic analysis of 52 critical incidents (n=26) revealed that moral distress and moral injury were mediated through healthcare providers’ self-reported guilt and blame, as they internalized the structural and environmental failures to maintain the physical and mental health, and values of older persons in care. While moral injury is traditionally described in clinical contexts concerning rationing critical care/life-saving resources, our findings suggest that healthcare providers’ inability to provide relational care, and/or their encounters with structural/health systems constraints could also lead to moral injury. Moral injury negatively impacts the overall health of caregivers and older persons, as well as healthcare provider recruitment, mentorship and retention. Given that these impacts are persistent over time and infectious disease outbreaks are predicted to reoccur, addressing the structural factors of moral injury and building organizational efficacy as well as healthcare provider capacity for ethical knowing will foster people and systems resilience and improve the quality of care for older persons. We detail a conceptual model for mapping the enablers of relational care delivery for older persons
Presenters
Linda LiuPractice Lead, Seniors Emergency Medicine Centre, University Health Network, Ontario, Canada Lori Schindel Martin
Professor, Daphne Cockwell School of Nursing, Faculty of Community Services, Daphne Cockwell School of Nursing, Ryerson University, Ontario, Canada Sepali Guruge
Professor, Daphne Cockwell School of Nursing, Toronto Metropolitan University, Ontario, Canada
Details
Presentation Type
Theme
Social and Cultural Perspectives on Aging
KEYWORDS
Moral Injury, Older Adults, Relational Caring, Care Settings, Moral Resilience
