COVID-19 resources on home care

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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

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. [Updated 6 January 2021]

Last updated on hub: 25 November 2020

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