Care home study highlights COVID's mental toll

Being unable to see and touch loved ones during the pandemic has triggered a range of negative emotions among study participants, researchers say.

The impact on relatives of being prevented from visiting during lockdown was severe and often went unrecognized, the study concludes.

Researchers are urging policy changes that enable care home managers to arrange indoor visits for designated relatives or friends if isolation is severely affecting residents.

Outdoor visits

The study team also wants socially distanced outdoor visits to be routinely offered when family carers and residents request them—if local restrictions allow.

And researchers say care homes should encourage more video-based communication between residents and their families to counter the impact of visit restrictions.

Particular thought must be given to residents whose physical needs or cognitive impairment dictate that outdoor visits or Zoom calls are not an option.

The study, led by the University of Edinburgh, calls for a more collaborative, human rights-based approach to policy making that involves relatives, carers' organizations and care home providers.

"It's likely that the impact of relatives being unable to visit will be felt for years to come, especially in cases where a loved one died or became seriously ill," says Dr. George Palattiyil, School of Social & Political Science.

Better suited

It advocates services that are better suited to minority ethnic communities. Researchers say lockdown has exacerbated pre-existing issues, such as a failure to meet residents' communication needs and a lack of support for their dietary and faith-based requirements.

Researchers say the pandemic has also revealed how little society values older people with dementia. Interviewees frequently claimed that if the pandemic had affected children as seriously as it did older people, the response would have been very different.

Many study participants said their experience of care homes had not adequately balanced their right to a family life against the risk of infection.

Health benefits

The mental health benefits of regular visiting are emphasized throughout the study, which also involves the University of the West of Scotland, the University of Strathclyde and the Institute for Research & Innovation in Social Services.

Researchers, who conducted 36 in-depth interviews with family carers, said COVID-19 had prompted many positive creative changes in care home practices.

The team also had informal café style conversations with care home staff, spoke to a variety of stakeholders and completed a nationwide online survey of people with loved ones in care homes.

Staff had become more pro-active in their communication with relatives, and made greater use of digital technology. Many workers felt these changes could improve future practices.

Loved ones who felt they had been kept well informed by staff, experienced less mental distress than those who did not. But the study says most policy makers and key figures in the sector had shown only a superficial understanding of lockdown's impact on families.

"So many interviewees expressed admiration and support for care home staff. The sector has much to learn from care homes that were able to innovate with new forms of communication," says Dr. Dina Sidhva, University of the West of Scotland.

Little affirmation

Respondents said there had been little acknowledgement of family as partners in providing care and a failure to fully understand the importance of that relationship.

Researchers say the widely differing experiences of family carers reflects a diverse sector that has public, private and third sector providers. This means it is difficult to implement national guidance in a consistent, equitable and appropriate manner.

Policy makers should consider whether funding arrangements for care homes are sufficient for the additional training and staffing needs resulting from COVID-19, the study says.