COVID-19 resources on dementia

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A UK survey of COVID‐19 related social support closures and their effects on older people, people with dementia, and carers

International Journal of Geriatric Psychiatry

Objectives: The aim of this national survey was to explore the impact of COVID‐19 public health measures on access to social support services and the effects of closures of services on the mental well‐being of older people and those affected by dementia. Methods: A UK‐wide online and telephone survey was conducted with older adults, people with dementia, and carers between April and May 2020.The survey captured demographic and postcode data, social support service usage before and after COVID‐19 public health measures, current quality of life, depression, and anxiety. Multiple linear regression analysis was used to explore the relationship between social support service variations and anxiety and well‐being. Results: 569 participants completed the survey (61 people with dementia, 285 unpaid carers, and 223 older adults). Paired samples t‐tests and X2‐tests showed that the mean hour of weekly social support service usage and the number of people having accessed various services was significantly reduced post COVID‐19. Multiple regression analyses showed that higher variations in social support service hours significantly predicted increased levels of anxiety in people with dementia and older adults, and lower levels of mental well‐being in unpaid carers and older adults. Conclusions: Being unable to access social support services due to COVID contributed to worse quality of life and anxiety in those affected by dementia and older adults across the UK. Social support services need to be enabled to continue providing support in adapted formats, especially in light of continued public health restrictions for the foreseeable future.

Last updated on hub: 21 September 2020

Achieving safe, effective, and compassionate quarantine or isolation of older adults with dementia in nursing homes

American Journal of Geriatric Psychiatry

Nursing homes are facing the rapid spread of COVID-19 among residents and staff and are at the centre of the public health emergency due to the COVID-19 pandemic. As policy changes and interventions designed to support nursing homes are put into place, there are barriers to implementing a fundamental, highly effective element of infection control, namely the isolation of suspected or confirmed cases. Many nursing home residents have dementia, associated with impairments in memory, language, insight, and judgment that impact their ability to understand and appreciate the necessity of isolation and to voluntarily comply with isolation procedures. While there is a clear ethical and legal basis for the involuntary confinement of people with dementia, the potential for unintended harm with these interventions is high, and there is little guidance for nursing homes on how to isolate safely, while maintaining the human dignity and personhood of the individual with dementia. This commentary discusses strategies for effective, safe, and compassionate isolation care planning, and present a case vignette of a person with dementia who is placed in quarantine on a dementia unit.

Last updated on hub: 08 October 2020

Activities delivered at home by family carers to maintain cognitive function in people with dementia socially isolating during COVID-19: evidence for non-technology based activities / interventions

Centre for Evidence Based Medicine

A rapid review to identify evidence for which non-technology based activities that can be delivered at home by family carers are effective in maintaining cognitive function in people with dementia who are socially isolating during COVID-19. These interventions can include reminiscence therapy, cognitive stimulation therapy, music-based interventions, art therapy or meaningful activities. The review found very few studies where family carers were trained or supported to deliver an intervention within the home environment. However, it identified a small body of evidence to suggest that activities delivered at home by family carers may have some positive effects on cognition and mood. The evidence suggests that engaging people with dementia in activities that they find enjoyable or those that link to past work/hobbies can be helpful in giving a sense of purpose and meaning during a time of isolation. Non-technology based interventions may have some practical advantages for those currently isolating at home since they are inexpensive and do not require extensive training.

Last updated on hub: 01 June 2020

Allowing visitors back in the nursing home during the COVID-19 Crisis: a Dutch national study into first experiences and impact on well-being

Journal of the American Medical Directors Association

Objectives: To prevent and control COVID-19 infections, nursing homes across the world have taken very restrictive measures, including a ban for visitors. These restrictive measures have an enormous impact on residents' well-being and pose dilemmas for staff, although primary data are lacking. A Dutch guideline was developed to cautiously open nursing homes for visitors during the COVID-19 pandemic. This study reports the first findings on how the guideline was applied in the local context; the compliance to local protocols; and the impact on well-being of residents, their family caregivers, and staff. Design: A mixed-methods cross-sectional study was conducted. Setting and Participants: In total, 26 nursing homes were permitted to enlarge their possibilities for allowing visitors in their facility. These nursing homes were proportionally representative of the Netherlands as they were selected by their local Area Health Authority for participation. At each nursing home, a contact person was selected for participation in the current study. Methods: A mixed-methods cross-sectional study was conducted, consisting of questionnaire, telephone interviews, analyses of documentation (ie, local visiting protocols), and a WhatsApp group. Results: Variation in local protocols was observed, for example, related to the use of personal protective equipment, location, and supervision of visits. In general, experiences were very positive. All nursing homes recognized the added value of real and personal contact between residents and their loved ones and indicated a positive impact on well-being. Compliance with local guidelines was sufficient to good. No new COVID-19 infections were reported during this time. Conclusions and Implications: These results indicate the value of family visitation in nursing homes and positive impact of visits. Based on these results, the Dutch government has decided to allow all nursing homes in the Netherlands to cautiously open their homes using the guidelines. More research is needed on impact and long-term compliance.

Last updated on hub: 21 August 2020

Caring safely at home

Social Care Institute for Excellence

SCIE's video-based resource designed for unpaid/informal carers. You may be caring for family members, friends or neighbours at home.

Last updated on hub: 11 June 2020

Coronavirus (COVID-19): information for families looking after someone with dementia

Dementia UK

Brings together advice and guidance for carers of people with dementia during the Covid-19 pandemic. Topics covered include: the ongoing challenges for people with dementia during coronavirus; questions and answers relating to the implications of coronavirus in specific settings; advice for people with dementia around face coverings; and care homes and the coronavirus outbreak.

Last updated on hub: 08 October 2020

Coronavirus (COVID-19): tips for the housing sector on supporting someone affected by dementia

Housing LIN

This briefing sets out a number of top tips for the housing sector, operators and commissioners of specialist housing – such as extra care or retirement housing – or general needs housing, on supporting people affected by dementia during the coronavirus pandemic. It also signposts to a selection of useful links and further practical advice. People living with dementia normally thrive on familiarity; familiar faces, a familiar environment, familiar food, and familiar routines, all of which may be compromised by the enforced period of isolation necessary to fight the coronavirus. The top tips highlight some of the best practice and legal issues in supporting decisions that might need to be made about health and wellbeing during the COVID-19 outbreak; considers how to continue to provide practical assistance, support and manage risks; and provides information on maintaining meaningful activity and minimising loneliness during this period of enforced isolation.

Last updated on hub: 11 August 2020

Coronavirus: information for people affected by dementia

Alzheimer's Society

Advice and information for people who are living with dementia and their carers during the Coronavirus (COVID-19) pandemic. It includes advice for carers who live with a person with dementia, information on how best to support someone living alone and tips for supporting for someone living with dementia from a distance. The guide also includes activity ideas, including online and digital activities; and links to additional resources.

Last updated on hub: 26 March 2020

Decision-making for receiving paid home care for dementia in the time of COVID-19: a qualitative study

BMC Geriatrics

Background: The lockdown imposed in the UK on the 23rd of March and associated public health measures of social distancing are likely to have had a great impact on care provision. The aim of this study was to explore the decision-making processes of continued paid home care support for dementia in the time of COVID-19. Methods: Unpaid carers caring for a person living with dementia (PLWD) who were accessing paid home care before COVID-19 and residing in the UK were eligible to take part. Participants were interviewed over the phone and asked about their experiences of using paid home care services before and since COVID-19, and their decision-making processes of accessing paid home care since the outbreak and public health restrictions. Results: Fifteen unpaid carers, who were also accessing paid care support for the PLWD before COVID-19, were included in the analysis. Thematic analysis identified three overarching themes: (1) Risk; (2) Making difficult choices and risk management; and (3) Implications for unpaid carers. Many unpaid carers decided to discontinue paid carers entering the home due to the risk of infection, resulting in unpaid carers having to pick up the care hours to support the person living with dementia. Conclusions: This is the first study to report on the impact of COVID-19 on paid home care changes in dementia. Findings raise implications for providing better Personal Protective Equipment for paid carers, and to support unpaid carers better in their roles, with the pandemic likely to stay in place for the foreseeable future.

Last updated on hub: 13 November 2020

Dementia and COVID-19: social contact

Alzheimer's Society

This briefing sets out the evidence for action to support social contact for people living with dementia and what the Government need to do next. It covers: the impact of COVID-19 on people with dementia in the UK; the importance of social contact for people living with dementia; maintaining social contact in care homes; supporting the delivery of home care services. The briefing observes that as well as the severe impact of COVID-19 itself, restrictions under lockdown have imposed a lack of social contact and interaction which are known to be contributing factor in the decline of people with dementia. The paper calls on the Government to lead a task force with Local Authorities and expert groups to address how they will support people with dementia as the country emerges from the lockdown over the next 6-12 months, with social contact at the heart of the solution. Specific recommendations for both care homes and home care are included.

Last updated on hub: 10 August 2020

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