COVID-19 resources on home care

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Older and ‘staying at home’ during lockdown: informal care receipt during the COVID-19 pandemic amongst people aged 70 and over in the UK

SocArXiv

On 23 March 2020 the UK went into lockdown in an unprecedented step to attempt to limit the spread of coronavirus. Government advice at that time was that all older people aged 70 and over should stay at home and avoid any contact with non-household members. This study uses new data from the Understanding Society COVID 19 survey collected in April 2020, linked to Understanding Society Wave 9 data collected in 2018/19,in order to examine the extent of support received by individuals aged 70 and over in the first four weeks of lockdown from family, neighbours or friends not living in the same household, and how that support had changed prior to the outbreak of the coronavirus pandemic. The research distinguishes between different types of households as given with guidance not to leave home and not to let others into the household, those older people living alone or living only with a partner also aged 70 and above are more likely to be particularly vulnerable. The results highlight both positive news alongside causes for concern. The receipt of assistance with Instrumental Activities of Daily Living(IADLs), especially shopping, has increased particularly among those living alone or with an older partner, reflecting the rise of volunteering and community action during this period. However, not all older people reported a rise, and the majority reported ‘no change’, in the support received. Moreover, amongst those older people reporting that they required support with at least one Activity of Daily Living (ADL) task prior to the pandemic, around one-quarter reported receiving no care from outside the household and one-in-ten of those with two or more ADL care needs reported receiving less help than previously. Although formal home care visits have continued during the pandemic to those who have been assessed by the local government to be in need, it is important to acknowledge that some older people risk not having the support they need.

Last updated on hub: 17 November 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

Triggers of mental health problems among frontline healthcare workers during the COVID‐19 pandemic in private care homes and domiciliary care agencies: lived experiences of care workers in the Midlands region, UK

Health and Social Care in the Community

COVID‐19 was first reported in China and later spread across the world causing panic because there is no cure for it. The pandemic has adversely affected frontline health workers and patients, owing to poor preparedness. The study explored the triggers of mental health problems among frontline healthcare workers during the COVID‐19 pandemic. An exploratory qualitative approach was utilised in the study. Forty individual semi‐structured interviews were held with frontline healthcare workers. A thematic approach underpinned by some aspects of interpretive phenomenological analysis (IPA) and the Silences Framework (SF) was utilised. The research found that triggers of mental health problems among frontline health workers in private care homes and domiciliary care agencies are fear of infection and infecting others, lack of recognition/disparity between National Health Service (NHS) and social care, lack of guidance, unsafe hospital discharge, death and loss of professionals and residents, unreliable testing and delayed results and shortage of staff. It is important to support frontline workers in private care homes and domiciliary care agencies.

Last updated on hub: 09 November 2020

An inquiry into the lived experience of Covid-19 in the home care sector in Ireland: the experiences of home care provider organisations

Home and Community Care Ireland

This exploratory research into the health, social and economic impact of the covid-19 pandemic on the eighteen home care provider organisations who responded to a survey sheds light on how those on the forefront of home care coped during one of the largest viral outbreaks in modern history. A questionnaire consisting of ten open-ended questions was developed following a rapid literature review and internal consultations. These questions were categorised under five subheadings: management, service provision, relationships, health and wellbeing, and the future. Key findings include: The most significant problem was workforce shortage – specifically, two thirds of organisations indicated low staffing levels due to a lack of childcare brought about by the closure of schools and creches; almost every third organisation noted a decrease in home care services, ranging from 20-30 per cent, mostly due to clients cocooning and self-isolating; another issue that featured strongly across all responses was related to uncertainty surrounding the pandemic – stress, fear, worry and even panic; almost every other organisation identified Protective Personal Equipment (PPS) to be a significant cause for concern – supply and distribution was a considerably more prevalent issue than the actual cost of PPE; to ensure the smooth running of business at a very chaotic time, all the providers implemented a range of novel policies and procedures – this rapid development of new ways of delivering service safely took place on several interrelated levels; the crisis exposed any structural shortcomings within the home care sector, but equally it brought about a sense of togetherness, cooperation and mutual support within the sector – and beyond it.

Last updated on hub: 09 November 2020

Mitigating the impact of the COVID-19 outbreak: a review of international measures to support community-based care

International Long-term Care Policy Network

This report provides a brief overview of the policy responses and practice measures used internationally to respond to the impact of COVID-19 on the provision of community-based care. The data provided is largely collected from the country reports on the COVID-19 long-term care situation, including Australia, Austria, Brazil, China, England, Germany, Hong Kong, Ireland, Israel, Italy, Netherlands, Slovenia, South Korea, and the United States. Key findings include: community-based care faces unique challenges during the COVID-19 pandemic compared to other parts of the long-term care continuum; several countries have taken steps to prevent the spread of COVID-19 infections in community-based care including the closure of adult day centres and other service providers; continuity of care is of upmost importance – a disruption of care and support could have serious negative impacts on individual health and well-being due to increased risk of loneliness and social isolation; the dispersed nature of community based care suggests that direct governmental action and oversight may be more difficult to provide than for residential care settings such as care homes or nursing facilities; efforts to maintain continuity of care in community-based care include government financial support to home care workers; recruitment of volunteers and family members to act as paid carers; and the provision of remote psychological supports to home care workers; some countries have taken steps to move patients and home care workers to residential care settings; few countries are specifically reporting data on infections and deaths among users of home care – an exception to this is Australia; overall evidence of national measures to support community-based care is still lacking for most countries.

Last updated on hub: 04 November 2020

Providing care and support at home to people who have had COVID-19

Social Care Institute for Excellence

Quick guide to help home care workers and personal assistants (PAs) to provide care and support to people who have left hospital after having COVID-19.

Last updated on hub: 03 November 2020

Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: experiences of frontline workers in the English Midlands region, UK

Journal of Interprofessional Care

The first cases of Coronavirus (COVID-19) were reported in Wuhan, China in December 2019. Globally millions of people have been diagnosed with the virus whilst thousands have died. As the virus kept spreading health and social care frontline workers (HSCFW) were faced with difficulties when discharging their duties. This paper was set out to explore the challenges faced by different frontline workers in health and social care during the COVID-19 pandemic. The research utilized an explorative qualitative approach. A total of forty (N = 40) in-depth one-to-one semi-structured interviews were undertaken with HSCFW who included support workers (n = 15), nurses (n = 15), and managers (N = 10). Health and social care workers were drawn from domiciliary care and care homes (with and without nursing services). All the interviews were done online. The data were thematically analyzed, and the emergent themes were supported by quotes from the interviews held with participants. Following data analysis the research study found that lack of pandemic preparedness, shortage of Personal Protective Equipment (PPE), anxiety and fear amongst professionals, challenges in enforcing social distancing, challenges in fulfilling social shielding responsibility, anxiety and fear amongst residents and service users, delay in testing, evolving PPE guidance and shortage of staff were challenges faced by frontline health and social care workers during COVID-19 pandemic. The results of the current study point to a need for adequate pandemic preparedness within the health and social care sector to protect both frontline workers and the individuals they look after.

Last updated on hub: 01 November 2020

Recommendations in covid-19 times: a view for home care

Brazilian Journal of Nursing (Revista Brasileira de Enfermagem)

Objective: To suggest recommendations for the practice of Home Nursing in the context of COVID-19. Method: Reflective study, originated from readings associated with the theme, available in current guidelines from the Pan American Health Organization, World Health Organization and the Ministry of Health. Results: Recommendations were developed from current scientific evidence for prevention of infections, control of epidemics and pandemics in the Brazilian home scenario. Final considerations: the reflections achieved contribute to guiding actions for better assistance to the patient, family caregivers and the community in the perspective of safe home care with COVID-19, and it is characterized as an introductory discussion on the theme, encouraging new studies to be carried out from the unfolding of the current scenario.

Last updated on hub: 19 October 2020

Impact of COVID-19 policy responses on live-in care workers in Austria, Germany, and Switzerland

Journal of Long-Term Care

Context: The measures taken to counter the COVID-19 pandemic restricted the circular migration of live-in care workers between their countries of origin and the elderly persons’ households. Objective: In this comparative policy analysis, the impact of COVID-19 related policy measures for transnationally organised live-in care in Austria, Germany, and Switzerland is investigated. Method: Policy measures and media debates were analysed and inquiries with care workers, representatives of care agencies, unions, and activist groups were carried out between March and June 2020. Findings: In accordance with their institutionalisation of live-in care, Austria, Germany, and Switzerland responded differently to the challenges the pandemic posed to live-in care arrangements. However, all three countries focused on extending care workers’ rotas and re-establishing transnational mobility. These priorities subordinated the interests of care workers to those of care recipients. Furthermore, the measures remained short-term solutions that failed to acknowledge the fundamental flaws and inequalities of a care model that relies primarily on female migrant workers and wage differentials within Europe. Limitations: This policy comparison is based on an in-depth analysis of COVID-19 related policies, supplemented by inquiries among stakeholders with whom research had been done prior to the pandemic. More in-depth interviews are required to further substantiate the findings concerning their perspectives and gain insight into the longer-term effects of the pandemic. Implications: The pandemic has brought the flaws of the live-in care model to the fore. Countries need to rethink their fragile care policies, which build on social inequality and uninhibited transnational mobility.

Last updated on hub: 15 October 2020

What is the risk of transmission of COVID-19 when delivering domiciliary care, and how effective are interventions that aim to minimise that risk?: a rapid review

Public Health England

A review of the evidence related to the transmission of COVID-19 in domiciliary care. No studies were found describing the risk of transmission when delivering domiciliary care (either from the care worker to care receiver or vice versa). Furthermore, no studies were found describing the effectiveness of interventions that aim to reduce the spread of COVID-19 when delivering domiciliary care. Professional opinions on how to safely deliver domiciliary care were identified in the literature; these support the application of general infection prevention and control practices, the use of risk assessments, ensuring staff are appropriately trained and employing an ‘only when necessary’ approach to face-to-face contact.

Last updated on hub: 12 October 2020

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