COVID-19 resources on Home care

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Barriers and facilitators to providing home-based care in a pandemic: policy and practice implications

BMC Geriatrics

Objective: The purpose of this study is to describe the experiences of home-based care providers (HBCP) in providing care to older adults during the pandemic in order to inform future disaster planning, including during pandemics. Design: Qualitative inquiry using an abductive analytic approach. Setting and participants: Home-based care providers in COVID-19 hotspots. Methods: Telephone interviews were conducted with 27 participants (administrators, registered nurses and other members of the allied healthcare team), who provided in-home care during the pandemic in Medicare-certified home health agencies. Interviews focused on eliciting experiences from HBCP on challenges and successes in providing home-based care to older adults, including barriers to care and strategies employed to keep patients, and providers, safe in their homes during the pandemic. Results: Data was distilled into four major themes that have potential policy and practice impact. These included disrupted aging-in-place resources, preparedness actions contributing to readiness for the pandemic, limited adaptability in administrative needs during the pandemic and challenges with unclear messaging from public health officials. Conclusions: Home-based care plays an essential role in maintaining the health of older adults in disaster contexts, including pandemics. Innovative solutions, informed by policy that generate evidence-based best practices to support HBCP are needed to reduce barriers and increase protective factors, in order to maintain continuity of care for this vulnerable population during disruptive events.

Last updated on hub: 21 April 2022

Difficulty and help with activities of daily living among older adults living alone during the COVID-19 pandemic: a multi-country population-based study

BMC Geriatrics

Background: Older adults who live alone and have difficulties in activities of daily living (ADLs) may have been more vulnerable during the COVID-19 pandemic. However, little is known about pandemic-related changes in ADL assistance (such as home care, domiciliary care) and its international variation. We examined international patterns and changes in provision of ADL assistance, and related these to country-level measures including national income and health service expenditure. Methods: We analysed data covering 29 countries from three longitudinal cohort studies (Health and Retirement Study, English Longitudinal Study of Aging, and Survey of Health, Ageing and Retirement in Europe). Eligible people were aged ≥50 years and living alone. Outcomes included ADL difficulty status (assessed via six basic ADLs and five instrumental ADLs) and receipt of ADL assistance. Wealth-related inequality and need-related inequity in ADL assistance were measured using Erreygers’ corrected concentration index (ECI). Correlations were estimated between prevalence/inequality/inequity in ADL assistance and national health-related indicators. We hypothesized these measures would be associated with health system factors such as affordability and availability of ADL assistance, as well as active ageing awareness. Results: During COVID-19, 18.4% of older adults living alone reported ADL difficulties (ranging from 8.8% in Switzerland to 29.2% in the USA) and 56.8% of those reporting difficulties received ADL assistance (ranging from 38.7% in the UK to 79.8% in Lithuania). Females were more likely to receive ADL assistance than males in 16/29 countries; the sex gap increased further during the pandemic. Wealth-related ECIs indicated socioeconomic equality in ADL assistance within 24/39 countries before the pandemic, and significant favouring of the less wealthy in 18/29 countries during the pandemic. Needs-related ECIs indicated less equity in assistance with ADLs during the pandemic than before. Our hypotheses on the association between ADL provision measures and health system factors were confirmed before COVID-19, but unexpectedly disconfirmed during COVID-19. Conclusion: This study revealed an unequal (and in some countries, partly needs-mismatched) response from countries to older adults living alone during the COVID-19 pandemic. The findings might inform future research about, and policies for, older adults living alone, particularly regarding social protection responses during crises.

Last updated on hub: 21 April 2022

COVID-19 testing in adult social care

UK Health Security Agency

This guidance outlines the COVID-19 testing available for testing staff, residents and visitors for all adult social care settings. The guidance covers: eligibility for free testing in adult social care; symptomatic testing for staff and residents; asymptomatic staff testing; rapid response testing in care homes and high-risk extra care and supported living; outbreak testing in care homes; and step by step testing process for all adult social care. This page also brings together guidance documents on specific aspects of testing, including: how to use your rapid lateral flow test; testing terms and conditions; and self-test for staff, service users and visitors in adult social care settings: privacy notice. [First published 24 March 2021. Last updated 31 March 2022]

Last updated on hub: 07 April 2022

Under reconstruction: the impact of COVID-19 policies on the lives and support networks of older people living alone

International Journal of Care and Caring

In the spring of 2020, the Austrian government introduced COVID-19 containment policies that had various impacts on older people living alone and their care arrangements. Seven qualitative telephone interviews with older people living alone were conducted to explore how they were affected by these policies. The findings show that the management of everyday life and support was challenging for older people living alone, even though they did not perceive the pandemic as a threat. To better address the needs of older people living alone, it would be important to actively negotiate single measures in the area of conflict between protection, safety and assurance of autonomy.

Last updated on hub: 31 March 2022

Home care professionals’ views on working conditions during the COVID-19 pandemic: the case of Ireland

International Journal of Care and Caring

This article examines home care professionals’ views on working conditions during the COVID-19 pandemic. In particular, it identifies similarities and differences between private, public and non-profit providers. The article seeks to shed light on the impacts of marketisation/privatisation on working conditions during the pandemic. Statistical tests on 350 questionnaires received from care workers in Ireland demonstrate the difficult working conditions during COVID-19 and variations by type of employer. We discuss an apparent ‘return of the state’ in home care provision during the pandemic, which may have dampened differences between types of providers.

Last updated on hub: 31 March 2022

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: 15 March 2022

Time to reflect is a rare and valued opportunity; a pilot of the NIDUS-professional dementia training intervention for homecare workers during the Covid-19 pandemic

Health and Social Care in the Community

Most people living with dementia want to continue living in their own home for as long as possible and many rely on support from homecare services to do so. There are concerns that homecare often fails to meet the needs of clients with dementia, but there is limited evidence regarding effective interventions to improve its delivery for this client group. We aimed to assess whether a co-designed, 6-session dementia training intervention for homecare workers (NIDUS-professional) was acceptable and feasible. Facilitated training sessions were delivered over 3 months, followed by 3, monthly implementation meetings to embed changes in practice. Two trained and supervised facilitators without clinical qualifications delivered the intervention via group video-calls during Oct 2020–March 2021 to a group of seven homecare workers from one agency in England. Participants provided qualitative feedback 3- and 6-months post intervention. Qualitative interview data and facilitator notes were integrated in a thematic analysis. Adherence to the intervention and fidelity of delivery were high, indicating that it was acceptable and feasible to deliver in practice. Thirty of a possible 42 (71.4%) group sessions were attended. This thematic analysis reports one over-arching theme: ‘Having time and space to reflect is a rare opportunity’. Within this, this study identified four subthemes (Having time to reflect is a rare opportunity; Reflecting with peers enhances learning; Reflection and perspective taking can improve care; Recognising skills and building confidence) through which this study explored how participants valued the intervention to discuss their work and learn new skills. Attendance was lower for the implementation sessions, perhaps reflecting participants’ lack of clarity about their purpose. The findings were used to consider how we can maintain positive impacts of the manualised sessions, so that these are translated into tangible, scalable benefits for people living with dementia and the homecare workforce. A randomised feasibility trial is underway.

Last updated on hub: 07 March 2022

The COVID-19 pandemic: the evaluation of the emergency remote parent training program based on at-home support for children with down syndrome

Children and Youth Services Review

During the COVID-19 pandemic, the development of emergency remote training programs for young children with Down syndrome, learning difficulties, and severe health problems and their parents became a requirement. The present study aimed to evaluate the impact of the “applied emergency remote training program”, prepared to address the needs of parents with children with Down syndrome and to offer them at-home support. It is an evaluative case study conducted with 11 parents of 11-35 months old children with Down syndrome. The findings demonstrated that the program could be conducted in a home environment, it improved the interactional behavior of both parents and children, reduced the number of difficult routines, and was considered as an educational, instructive, and band-aid solution. Issues such as the development of systematic psycho-social support systems that increase full participation and motivation of parents in distance education programs are important during extreme times such as the pandemic. Difficulties in online data collection, the employment of coaching and counseling systems in information maintenance, individualization of the program, the improvement of the interactivity in the program, and the development of applied training programs on different topics still wait for a solution.

Last updated on hub: 07 March 2022

LTCcovid International living report on Covid-19 and long-term care

London School of Economics and Political Science

This live report has been compiled collaboratively by researchers on Long-Term Care all over the world. It aims to: provide an overview of long-term care systems around the world; assess how the people who use and provide long-term care have been affected by the COVID-19 pandemic; describe the measures adopted to mitigate the impacts of the pandemic in the long-term care sector; compile actions and reforms that countries are adopting to strengthen their care systems and be better prepared for future pandemics and shocks. This report does not seek to provide detailed or comprehensive information for each country, but instead aims to summarise key reports and articles and point the reader towards those. It builds on the country reports previously published in this website, as well as other more recent sources. It is being developed collaboratively, by answering a list of questions for as many countries as possible and updating as new information and research become available.

Last updated on hub: 16 February 2022

Survey of NCF membership: impact of the Omicron variant

National Care Forum

Findings from a survey of NCF Membership on the impact of the Omicron variant, suggesting an increase in the pressures facing the social care sector as a result of the new variant compounded by the limitations of government support on the frontline. 66% of the homecare providers responding are now having to refuse new requests for home care and 43% of providers of care homes are closing to new admissions, while 21% of providers of home care are handing back existing care packages. Overall, the providers responding reported 18% vacancy rate and 14% absence as a result of the Omicron variant. While the absence rate may be temporary, the vacancy rate has been well documented as growing at an alarming rate over the last six months and has been compounded by other policy decisions such as mandating vaccines as a condition of deployment.

Last updated on hub: 25 January 2022

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