A Mixed-Methods Study of End-of-Life Care in Assisted Living During the COVID-19 Pandemic: National Survey of Administrators and In-Depth Interviews With Bereaved Next of Kin

Using a national survey of assisted living administrators (<i>n</i> = 2,084) and interviews with residents' bereaved next of kin (<i>n</i> = 30), we describe policies administrators reported complying with at the worst of the COVID-19 pandemic and explore relationships between COVID-19-related policies and bereaved next-of-kin's perceptions of end-of-life care quality, integrating findings to develop a comprehensive examination of end-of-life care in assisted living. During the pandemic, most administrators reported allowing compassionate care visits and hospice services. Next of kin described limited visitation and external care services and declines in residents' physical, mental, and social well-being, emphasizing the difficulty of missing precious time together. This study examines next-of-kin experiences of residents who died during the COVID-19 pandemic, providing evidence to inform future infection control policies.