COVID-19 resources on Home care

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Adherence of home‐based Wu Qin Xi programs during the COVID‐19 epidemic in Shanghai

International Journal of Geriatric Psychiatry

Details of an exercise intervention published in a letter to the editor. Home‐based exercise programs are widely accepted to improve immunity and prevent infection at home. In the COVID‐19 epidemic particular situation, home‐based exercise programs play a key part in immunity enhancement as well as infection prevention. Authorities selected the Wu Qin Xi (WQX) exercises program because it can can improve the cognitive function, anxiety, depression, sleeping, and balance ability in elderly people. This study investigated the exercise adherence with a sample of 1500 participants. Findings: An important component facilitating the optimal effectiveness of exercise programs is a high level of exercise adherence. Conclusion: is that WQX exercise program was found to be an home‐exercise program that achieves high adherence in elderly adults who lived in these communities during outbreak of the COVID‐19 epidemic in Shanghai.

Last updated on hub: 21 December 2020

How can patients with COVID-19 and their family or unpaid carers be enabled and supported to manage palliative care treatment safely and effectively at home?

Centre for Evidence-Based Medicine

A review of the evidence to determine how people with COVID-19 and unpaid carers could be enabled and supported by healthcare professionals to manage palliative care treatment safely and effectively at home. There is a need for prompt, responsive and anticipatory support for carers at home who may be feeling unsure about their role in providing end-of-life care and where to turn to for support and treatment for their relative. Key messages emerging from the literature include: healthcare systems have had to adapt rapidly to respond to the COVID-19 pandemic – as a result, some family and unpaid carers may take on additional responsibilities in providing palliative care treatment for patients who have opted to die at home but carers may feel unsure about their role in providing end-of-life care and where to turn for support and treatment for their relative; no empirical research was found that has been conducted during the current COVID-19 pandemic to inform how to support carers of people receiving palliative care at home or to clarify whether this approach is safe for all involved; research assessing the needs of home carers in other palliative care contexts suggests carers may be enabled to manage medication at home, provided that appropriate support and education is given, and that carers have the required capabilities; the use of digital technology can help, but healthcare professionals should be aware that not all carers have access to suitable equipment; providing education for carers, relevant to their caring role, as well as supporting their general wellbeing, can be of benefit – however, providing formal, structured interventions presents considerable challenges during the pandemic.

Last updated on hub: 15 December 2020

Characteristics and well-being of urban informal home care providers during COVID-19 pandemic: a population-based study

BMJ Open

Objectives Globally, the COVID-19 pandemic has overwhelmed many healthcare systems, which has hampered access to routine clinical care during lockdowns. Informal home care, care provided by non-healthcare professionals, increases the community’s healthcare capacity during pandemics. There is, however, limited research about the characteristics of informal home care providers and the challenges they face during such public health emergencies. Design A random, cross-sectional, population-based, RDD, telephone survey study was conducted to examine patterns of home care, characteristics of informal home care providers and the challenges experienced by these care providers during this pandemic. Setting Data were collected from 22 March to 1 April 2020 in Hong Kong, China. Participants A population representative study sample of Chinese-speaking adults (n=765) was interviewed. Primary and secondary outcome measures The study examined the characteristics of informal home care providers and self-reported health requirements of those who needed care. The study also examined providers’ self-perceived knowledge to provide routine home care as well as COVID-19 risk reduction care. Respondents were asked of their mental health status related to COVID-19. Results Of the respondents, 25.1% of 765 provided informal home care during the studied COVID-19 pandemic period. Among the informal home care providers, 18.4% of respondents took leave from school/work during the epidemic to provide care for the sick, fragile elderly and small children. Care providers tended to be younger aged, female and housewives. Approximately half of care providers reported additional mental strain and 37.2% reported of challenges in daily living during epidemic. Although most informal home care providers felt competent to provide routine care, 49.5% felt inadequately prepared to cope with the additional health risks of COVID-19. Conclusion During public health emergencies, heavy reliance on informal home healthcare providers necessitates better understanding of their specific needs and increased government services to support informal home care.

Last updated on hub: 10 December 2020

How has Covid-19 impacted on care and support at home in Scotland?

Scottish Parliament

Findings from a survey to understand the impact of Covid-19 on care at home services, and what issues the pandemic has highlighted, improved, or made worse. The survey ran from 10 August 2020 to 7 September 2020 and the Committee received over 700 responses, including 415 responses from family members of those receiving care at home and unpaid carers and 93 responses from individuals receiving care at home. Key findings include: there was a reduction of care as a result of the pandemic; care at home staff do not receive the same support or recognition as NHS staff; concern regarding safety mainly related to access to and appropriate use of PPE as well as testing and training of care staff; ensuring continuity of care was the second most important issue to respondents, with concerns around quality and consistency of care as well as the need for designated carers to reduce the number of staff entering homes; the reduction of visits, activities and respite services, and resulting loss of a routine, increased feelings of loneliness and isolation for those in receipt of care and of anxiety, depression and mental exhaustion for unpaid carers; despite a reduction in care being delivered, staff saw increased workloads, with new tasks required as a result of the pandemic such as additional staff training, increased staff meetings and increased paperwork; access to additional support and services (food and prescription deliveries, access to activities and entertainment) and access to hospital, GP services and medical equipment was critically important to respondents; it was felt that one to one communication between services and service users needed to improve. Finally, it was suggested that more needs to be done to listen to the needs of those receiving care and involve them in decision making.

Last updated on hub: 26 November 2020

Rapid learning review of domiciliary care in Northern Ireland

Northern Ireland. Department of Health

This rapid learning review has collated and considered any learning about domiciliary care issues during the Covid-19 pandemic in Northern Ireland in order to inform current and future planning as the pandemic continues. The review focused on four themes: service user and carer experience; service provision; workforce experience; and infection prevention and control. Work stream leads were appointed for each theme and they undertook a wide engagement with a range of stakeholders and using a variety of methods for collecting data. In addition, a workforce and management survey was carried out to seek feedback on three of the four themes. These were workforce, service provision/business continuity and infection prevention and control. A rapid literature review was also commissioned to add to the evidence from stakeholders. The evidence from the literature review was broadly consistent with the messages from the stakeholder engagement with common themes and lessons learned identified. The review highlighted some of the challenges domiciliary care staff faced such as PPE, training, testing and lack of adequate support. Staff felt overlooked and that domiciliary care did not get the recognition it deserved. The review has also highlighted the wider systemic issues that affect domiciliary care, including pay, terms and conditions of the workforce. Domiciliary care service users and their family carers reported feeling forgotten about and afraid to use domiciliary care because of fear of infection during the earlier stages of the pandemic. For many others, however, domiciliary care was the only service that continued for them. Both situations placed service users and carers under very significant pressure.

Last updated on hub: 26 November 2020

A testing service for homecare workers in England

Department of Health and Social Care

Sets out how homecare agencies in England can order regular tests for their homecare (domiciliary care) staff. NHS Test and Trace is making weekly Covid-19 testing available to all homecare workers in Care Quality Commission (CQC)-registered domiciliary care organisations. The guidance prescribes that agency managers should order tests every 28 days for their homecare workers; four tests are delivered for each homecare worker to the agency, for a 28 day testing cycle; each homecare worker should be given four test kits every 28 days; every 7 days a care worker should take a test, register it online, and return it by post between Thursday and Sunday. Homecare workers will receive their results in 2 to 4 days by email and text message (SMS). This approach aims to: identify homecare workers who currently have Covid-19 so they are able to self-isolate if their result is positive; protects those receiving care from infection passed to them by homecare workers who are confirmed positive; and prevents and controls the spread of the virus by identifying asymptomatic cases. [First published: 20 November 2020; Last updated:14 May 2021]

Last updated on hub: 25 November 2020

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


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

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