COVID-19 resources

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The struggle for good care: moral challenges during the COVID-19 lockdown of Dutch elderly care facilities

International Journal of Care and Caring

The COVID-19 lockdown of Dutch long-term care facilities between March and May 2020 affected the quality of lives of residents and opposed professional and personal ethics of care. This article, based on 25 in-depth interviews with healthcare chaplains, gives insight into what moral challenges appeared for care professionals. Moral challenges were related to: ‘family ruptures’, ‘residents’ loneliness and despair’, ‘cold-hearted deaths’ and ‘response and responsibilities’. The findings illuminate the complexity of providing care during the lockdown and show variation in the impact of these ethical experiences, in which both moral distress and moral resilience occurred.

Last updated on hub: 31 March 2022

‘No one was clapping for us’: care, social justice and family carer wellbeing during the COVID-19 pandemic in Wales

International Journal of Care and Caring

The inequalities laid bare by the COVID-19 pandemic have had particular implications for the wellbeing of family carers. This article considers these impacts from a social justice perspective, drawing on elements of the ethics of care and the capabilities approach, as well as findings from interviews with 30 family carers in Wales, UK, during the initial months of ‘lockdown’ in 2020. In the interviews, key themes emerged around the sense of loss, poorer outcomes, ‘caring solidarity’ and its absence, and concerns about the dominant discourse on care. Although rooted in the specifics of the pandemic experience, all have wider implications for how we understand wellbeing itself, and, in particular, its application to questions of social justice. We argue for the value of an extended conception of wellbeing ‐ one that avoids the individualistic tendencies of some accounts and incorporates the importance of relationality and extrinsic material factors.

Last updated on hub: 31 March 2022

The impact of physical distancing on socially vulnerable people needing care during the COVID-19 pandemic in the Netherlands

International Journal of Care and Caring

What was the impact of physical distancing on socially vulnerable groups needing care during the first COVID-19 pandemic lockdown in the Netherlands? The researchers conducted repeated qualitative interviews with 141 people in care relationships and 106 professionals, and two repeated surveys among older populations outside (n = 1697) and inside long-term care facilities (n = 2619). Findings show a diversity of experiences, ranging from relative calmness and feeling socially normal, to loneliness and loss of perspective. Care must be seen as essential social traffic needed to guarantee basic quality of life for these groups during disease outbreaks. Findings emphasise an empirical ethics approach to policy interventions.

Last updated on hub: 31 March 2022

Struggling to ‘do family’ during COVID-19: evidence from a German mixed-methods study

International Journal of Care and Caring

Applying the concept of doing family, which centres on the organisation of, and the practices in, families’ everyday lives, this research questions focus on the efforts mothers and fathers undertake to keep everyday life going during the pandemic. We analysed two-wave panel data of the project ‘Growing up in Germany’, and conducted 20 in-depth interviews with mothers and fathers in order to examine their strategies in detail. The findings confirm gender and other important differences, and reveal three major strategies to reconcile caring obligations with demands from paid work before and during the crisis.

Last updated on hub: 31 March 2022

Home care professionals’ views on working conditions during the COVID-19 pandemic: the case of Ireland

International Journal of Care and Caring

This article examines home care professionals’ views on working conditions during the COVID-19 pandemic. In particular, it identifies similarities and differences between private, public and non-profit providers. The article seeks to shed light on the impacts of marketisation/privatisation on working conditions during the pandemic. Statistical tests on 350 questionnaires received from care workers in Ireland demonstrate the difficult working conditions during COVID-19 and variations by type of employer. We discuss an apparent ‘return of the state’ in home care provision during the pandemic, which may have dampened differences between types of providers.

Last updated on hub: 31 March 2022

COVID-19, the trauma of the ‘real’ and the political import of vulnerability

International Journal of Care and Caring

Politics in the neoliberal/modern/Western world is structured based upon the assumption that political subjects are atomistic and self-sufficient; these assumptions suppress and deny (inter) dependency, relationality and vulnerability. Yet, the rapid spread of COVID-19 has devastated many communities, drastically changed political and social life, and foregrounded the ways in which vulnerability is an inescapable fact of our existence. Drawing upon Zizek’s reading of Lacan’s notion of the ‘real’ and the ethics of care, we analyse the COVID-19 pandemic so as to argue that vulnerability must be understood as a fundamental political concept that merits ongoing attention in our political systems.

Last updated on hub: 31 March 2022

Impact of the COVID‐19 lockdown on system usage of an innovative care support system and the mood of older adults

International Journal of Geriatric Psychiatry

Background: Older age is a substantial risk factor for serious illness from COVID-19. Moreover, isolation and quarantine are more likely to cause physical, mental and social deprivation in older age. Information and Communication Tools are means to prevent such consequences. Objective: This study aimed therefore to investigate the impact of the COVID-19 lockdown measures on the usage of an innovative technical support system deployed in Austria (AT) and Luxembourg (LU) consisting of several tools that allow independent living in older age. Methods: Thirty-nine older adults (11 male; 28 female) with a mean age of 74.3 (SD 7.3) years were included in the study. In total, 18 older people were recruited in AT and 21 in LU. Descriptive statistics were computed, and longitudinal models were fitted for technology use and self-reported mood. Results: The number of older adults using the system significantly decreased from the time before lockdown (39 [100%]) to during lockdown (26 [67%]) and thereafter (23 [59%]; p < 0.001). Multiple comparisons revealed a significant reduction in the average number of events for calendar and medication tools, but a substantial increase in communication and messaging events. Self-reported well-being declined during the lockdown and increased afterwards back to baseline levels. Conclusion: Communication was the main reason for using the support system. In addition, strategies and interventions are essential to support older adults when using information technology in the prolonged phases of the pandemic to sustain independent living.

Last updated on hub: 31 March 2022

Lonely older adults are more likely to delay or avoid medical care during the coronavirus disease 2019 pandemic

International Journal of Geriatric Psychiatry

Objectives: To examine the relationship between loneliness and self-reported delay or avoidance of medical care among community-dwelling older adults during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Analyses of data from a nationally representative survey administered in June of 2020, in COVID-19 module of the Health and Retirement Study. Bivariate and multivariable analyses determined associations of loneliness with the likelihood of, reasons for, and types of care delay or avoidance. Results: The rate of care delay or avoidance since March of 2020 was 29.1% among all respondents (n = 1997), and 10.1% higher for lonely (n = 1,150%, 57.6%) versus non-lonely respondents (33.5% vs. 23.4%; odds ratio = 1.59, p = 0.003 after covariate adjustment). The differences were considerably larger among several subgroups such as those with emotional/psychiatric problems. Lonely older adults were more likely to cite “Decided it could wait,” “Was afraid to go,” and “Couldn't afford it” as reasons for delayed or avoided care. Both groups reported dental care and doctor's visit as the two most common care delayed or avoided. Conclusions: Loneliness is associated with a higher likelihood of delaying or avoiding medical care among older adults during the pandemic.

Last updated on hub: 31 March 2022

Trust and inclusion during the Covid-19 pandemic: perspectives from Black and South Asian people living with dementia and their carers in the UK

International Journal of Geriatric Psychiatry

Introduction: People from ethnic minority backgrounds living with dementia are more likely to be diagnosed later and have less access to health and social care support than their White counterparts in the United Kingdom (UK). Covid-19 has exacerbated health inequalities and diminished trust from underserved communities in the government and health services. The wider aim of the study was to explore the impact of covid-19 on Black and South-Asian people living with dementia and their carers as well as exploring the experiences of dementia care. The present paper specifically explores their views on trust and mistrust using an ecological model. Method: Semi-structured interviews were conducted with 11 family carers and four people living with dementia from South Asian or Black communities living in the community. Thematic analysis was used to analyse data. Design: An exploratory qualiative design was used. Results: Four main themes were developed exploring trust at the structural, organisational, community and individual level. At the structural level, participants discussed the inequity of Covid-19, some lack of trust in the UK Government and confusion in its messaging, and the anxiety sometimes leading to curtailment of media usage. At the organisational level, there was some evidence of a perceived lack of person-centred and culturally sensitive care from healthcare professionals, as well as concerns around care homes as places of safety. At the neighbourhood community level, participants discussed both a distrust as well as a strengthening of relationships and, at the individual level, factors such as knowledge of services, identity, and faith influenced their experience of the pandemic. Conclusions: People living with dementia need support at all levels and this study highlights how the pandemic impacted each level. Ways to improve trust in the Government and health professionals alongside culturally adapted health messaging should be explored. Alongside this, an examination of how cultural values and norms may influence help-seeking responses to dementia and increase trust in services may be helpful post-pandemic.

Last updated on hub: 31 March 2022

Long-term care facilities (LTCFs) during the COVID-19 pandemic - lessons from the Asian approach: a narrative review

Journal of the American Medical Directors Association

Objectives: The COVID-19 pandemic put into question the organizational skills of LTCF. The containment measures implemented in several Asian countries avoided heavy death tolls in LTCF in contrast to other countries across the globe. The aim of this review is therefore to investigate and illustrate the measures that were undertaken in Asia to contain and prevent the spread of the COVID-19 pandemic in LTCF. Design: Narrative review. Setting and Participants: Asian older subjects institutionalized in LTCF. Methods: Broad literature research from July 2020–April 2021. The following search terms were used: “COVID-19 Nursing homes” AND the country of interest or “contact tracing.” Eligible categories for inclusion comprise editorials, reviews, government guidelines, letters to the editor, and perspectives. The COVID-19 measures were then subdivided into different sections and compiled into an evidence table. Results: Prompt measures were put into action since the beginning of the pandemic that avoided the spread of COVID-19 in LTCF. Examples range from simple acts of proper hand hygiene and environmental disinfection, swab testing, social distancing, preventive measures on health care workers, organizational measures such as quarantine, outbreak control, visitor restrictions, relationship with acute hospitals, and admission policy. Technology also played a fundamental role in promoting social distancing by using specific robots and in managing contact tracing. Conclusions and Implications: The Asian preventive control guidelines are similar to those recommended elsewhere. Difference in timing and past experience with prior outbreaks such as SARS and MERS might have favoured the Asian response. Furthermore, sociocultural values toward older persons by protecting and making sure that LTCF are part of the health care system could have also played a role.

Last updated on hub: 30 March 2022

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