Abstract
Background: Recent research has found that family (e.g., informal, unpaid) caregivers to those in long-term care can experience significant risk of social isolation, a harmful social outcome linked to poor health and wellbeing. For many, the COVID-19 global pandemic has been a time marked by challenges that have exacerbated existing risk of social isolation and has likely impacted mental health and wellbeing among caregivers. As such, this paper outlines a protocol to investigate the extent to which the COVID-19 pandemic has impacted the psychological health and well-being of family caregivers of people living in residential long-term care.
 Methods/Design: A descriptive phenomenological design and photovoice methodology will be used alongside focus groups to capture the perspectives and voices of 15-20 family caregivers. Data will be analyzed thematically, and themes will be developed collaboratively alongside participants. A secondary analysis will be guided by a cumulative inequality lens to consider how the COVID-19 pandemic has differentially affected caregivers.
 Discussion: The results will fill a significant gap in the existing literature on caregiver isolation during this pandemic and inform the development and/or refinement of caregiver supports.
Highlights
Recent research has found that family caregivers to those in long-term care can experience significant risk of social isolation, a harmful social outcome linked to poor health and wellbeing
long-term care (LTC) residents account for approximately 17.0% of COVID-19 cases in Canada and 82% of all related deaths (HolroydLeduc & Laupacis, 2020) due in part to aspects of the LTC home which may promote the rapid spread of infectious disease (Applegate & Ouslander, 2020; Louie et al, 2007)
PV is an effective tool to use in our study as it aids in the collection and dissemination of knowledge in a way that enables family caregivers to be involved in identifying and assessing the strengths and concerns they face during and after the COVID-19 pandemic, create dialog, and share knowledge of their experiences and priorities (Hergenrather et al, 2009)
Summary
Recent research has found that family (e.g., informal, unpaid) caregivers to those in long-term care can experience significant risk of social isolation, a harmful social outcome linked to poor health and wellbeing. For individuals without the tools to connect with those outside of the home, social distancing could have a severe longer term impact, in exacerbating behavioral and psychological symptoms of dementia, leading to further isolation (Banerjee et al, 2020) and surges in mental health concerns in this already at-risk population. This can apply to individuals living within long-term care (LTC) settings, as well as family members (Grenade & Boldy, 2008). As a result of both lockdown measures and fear of contagion, many older adults who depend on frequent visits from family and friends are becoming increasingly isolated (Vahia et al, 2020)
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