The impact of COVID-19 restrictions and care home strategies on residents with dementia as experienced by family carers in Italy

Abstract

Objectives

The COVID-19 pandemic and public health measures caused serious consequences for several population cohorts, including people with dementia in care homes and their families. The aim of this study was to explore the impact of COVID-19 on care home residents with dementia as experienced by family carers in Italy. Specifically, strategies implemented to overcome the pandemic’s constraints, their influence upon care, and consequences for everyday life of residents with dementia and carers were investigated.

Methods

Semi-structured interviews explored participants’ experiences of the pandemic, its restrictions and the services’ status during lockdown. Transcripts were analysed via thematic analysis.

Results

26 family carers were interviewed. Three themes emerged: (1) COVID-19 restrictions negatively affected both residents with dementia and family carers, (2) Changing policies in care homes during COVID-19, and (3) Technology use in care homes during COVID-19. COVID-19 restrictions severely affected care home residents with dementia, disrupted their daily living, and accelerated their cognitive decline. Consequently carers’ emotional burdens increased. Care home response strategies (safe visiting and digital solutions) were critical, though they were not enough to compensate for the lack of close in-person contacts.

Conclusions

Mixed evidence emerged about the feasibility of care home strategies and their associated benefits. To meet arising needs and possible future pandemic waves, there is a need for updated health strategies. These should prioritise a continuity of therapeutic activities and minimize negative effects on residents’ quality of life, whilst incorporating feasible and accessible digital solutions to provide remote communication and psychological support for family carers.

Keywords:

• COVID-19
• dementia
• care homes
• long-term care
• physical distancing
• social isolation
• technology
• caregivers
• mental health
• public health

Acknowledgements

We wish to thank all the participants who volunteered and all care facilities who supported this study. Specifically: ASP Valloni-Marecchia (Rimini, Emilia Romagna); Casa Madre Teresa di Calcutta (Padova, Veneto); Casa Residenza Anziani Nuovo Roverella (Cesena, Emilia Romagna), and Casa di Riposo Virgo Carmeli (Potenza, Basilicata). This study would not have been possible without them.

Disclosure statement

The authors declare no conflicts of interest.

Funding

CG and MG are funded by the National Institute for Health Research Applied Research Collaboration North West Coast (ARC NWC). The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.

Authors’ contributions

CG led the study and designed the study in the UK with MG and HT, and oversaw the project. IC and AP collected data in Italy, analysed data and wrote drafts of the manuscript. Italian team members IC, AP, GO, MV, RC contributed to data analysis, and all the authors read through drafts of the manuscript and approved the final manuscript.

Data sharing statement

No additional data available.