COVID-19 resources on Home care

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Factors associated with COVID-19 in care homes and domiciliary care, and effectiveness of interventions: a rapid review

Public Health England

The purpose of this rapid review was to identify and assess direct evidence from the COVID-19 pandemic on factors associated with COVID-19 in care homes and domiciliary care, and interventions to minimise the extent of COVID-19. 22 studies were identified, 13 (4 preprints) examining factors associated with the transmission of COVID-19 in care homes and 9 (3 preprints) examining the effectiveness of interventions (search up to 31 August 2020). No studies reported on domiciliary care. The review shows that multiple observational studies have consistently reported the use of temporary staffing and the movement of staff between different care homes, lack of sick pay provision for care home staff, ‘for profit’ ownership (US-based studies), lower quality ratings, and lower levels of trained nurses (amongst other factors) as being associated with increased levels of COVID-19. There is limited evidence on the effectiveness of interventions, and available evidence is weak. Routine testing with early intervention (1 study) and voluntary staff confinement (1 study) were associated with lower COVID-19 and descriptive studies reported the use of multiple consecutive strategies. Further research is needed, and studies that better infer causality.

Last updated on hub: 02 February 2021

Self-direction of home and community-based services in the time of COVID-19

Journal of Gerontological Social Work

During the COVID-19 pandemic, nursing homes and assisted living facilities have accounted for over 20% of all infections, adult day care and other congregate sites have closed, and traditional home care agencies are facing staff shortages. In this environment, self-direction of home and community-based services, where the participant can hire their own staff and manage a budget that can be used for a broad range of goods and services including home modifications and assistive devices, is seen as a promising intervention. Using self-direction participants can minimize the number of people who enter their homes and pay close family and friends who were already providing many hours of informal care, and now may be unemployed. The Center for Medicare and Medicaid Services is encouraging this approach. This commentary presents information on how states have responded using the new CMS Toolkit by expanding who can be a paid caregiver, increasing budgets and broadening the kinds of items that can be purchased with budgets to include items like personal protective equipment and supports for telehealth. This Commentary concludes with policy and research questions regarding how the delivery of long-term services and supports (LTSS) may change as the world returns to“normal”.

Last updated on hub: 28 January 2021

Caregiving in times of uncertainty: helping adult children of aging parents find support during the COVID-19 outbreak

Journal of Gerontological Social Work

The COVID-19 pandemic, which is especially dangerous to older people, has disrupted the lives of older people and their family caregivers. This commentary outlines the adaptive and emerging practices in formal supportive services for family caregivers, the changing types of support that family caregivers are providing to their older relatives, and the ways family caregivers are seeking informal caregiving support during the COVID-19 outbreak.

Last updated on hub: 28 January 2021

Working with people in their own homes this winter

Department of Health and Social Care

Explains how home care and support workers, social workers, health professionals and families can work together to reduce the risk of COVID-19 infection this winter. It covers infection prevention and control measures; testing; vaccination; and wellbeing. [Last updated 1 April 2021]

Last updated on hub: 25 January 2021

Informal dementia carers had to make difficult decisions about paid care during COVID-19

National Institute for Health Research

Explores how the first nationwide COVID-19 lockdown affected unpaid carers, and how they made decisions about accessing paid care. This research brings to the fore longstanding problems with care for people living with dementia. These issues include a lack of continuity of paid care, poor monitoring of care staff entering homes, and minimal support for unpaid carers. The research team interviewed 15 unpaid carers by telephone between April and May 2020. All carers had been accessing or trying to access paid home care before the pandemic. All were adult family or friends of someone with dementia. The researchers drew three themes from the interviews: carers felt concerned by the risk of paid carers bringing coronavirus into the home – lack of personal protective equipment (PPE) and feeling unprepared to provide additional care heightened these fears; carers had difficult choices to make – many avoided hospitals and other health providers and struggled to weigh up the options of cancelling or continuing paid care and some described real fears of re-obtaining paid care post-COVID if they cancelled during lockdown; and implications for unpaid carers included increased workload and difficulty in accessing food deliveries.

Last updated on hub: 11 January 2021

Caring in COVID

National Care Forum

A collection of stories about care, communities and leadership during the COVID-19 pandemic. This piece of social history records and highlights the response from NCF members, brought together as a collection of real-life stories in an ebook. The compendium details how, during the COVID-19 pandemic and ensuing restrictions, NCF members and the communities they serve, came together and rose to the challenge to support those who needed it most. Contents include: stories from the frontline; community and volunteer voices; keeping it fun; keeping the connection; the many faces of leadership; and partner stories.

Last updated on hub: 22 December 2020

Mid-year 2020-21 adult social care activity

NHS Digital

Local Authorities are part of the front line of organisations dealing with the coronavirus (COVID-19) pandemic in England. This management information is not looking directly at the response to the crisis. Instead, it aims to give users some insight into the impact of the pandemic on the ongoing statutory duties of local authorities to provide assessments, support and funding for the appropriate level of social care needed by its adult population, and to safeguard its citizens from abuse or deprivations of liberty. Data was collected from local authorities on a voluntary basis, to a shorter timeline than usual and without much of the comprehensive data quality assurance usually in place for the equivalent annual data collections. Key facts include: coverage – 81% of local authorities in England provided data to this one-off, voluntary data collection; long term support – the number of clients in receipt of long term social care support at the end of March 2020 was lower than the previous year, and this decreased further in the first half of 2020-21; safeguarding activity – there appears to have been a slight increase of approximately 4% in the total number of safeguarding concerns raised to local authorities so far this year, compared to half the annual total from 2019-20, and a c.9% decrease in the enquiries that commenced in the period; DoLS applications – fewer applications for Deprivation of Liberty Safeguards (DoLS) were received by local authorities in the first half of 2020-21 (a decrease of 3.3% compared to the first half of 2019-20, following many years of increasing volumes). The number of applications completed also fell, by 16.5%, compared to the first half of 2019-20.

Last updated on hub: 22 December 2020

COVID-19 infection prevention and control guidance for family and friends (informal carers) who support people in their own homes

Health Service Executive

This guidance has been developed to help carers and people who are cared for on how to protect each other from COVID-19. It is also intended to help healthcare workers who advise people who provide care about how to keep safe from infection. It sets out the steps that carers need to take before and during their visit to the person they care for.

Last updated on hub: 22 December 2020

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

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