Long-term care facilities in the United States have accounted for 40% of deaths related to coronavirus disease 2019 (COVID-19). Restriction of in-person visitation has heightened mental health challenges among nursing home residents, and limited evidence exists in the literature concerning nursing home residents' experiences since the COVID-19 outbreak first began. The current study used a qualitative design to obtain data from residents within two nursing homes in New York. Interview data were transcribed verbatim and analyzed using reflexive thematic analysis. Four major themes emerged: Emotional Reactions to Lockdown , Mixed Feelings and Attitudes Toward Nursing Home Staff and Family, Need for Support and Connection, and Desire to Be Informed and Involved . Results show that nursing home residents are emotionally burdened and suggest a critical need to provide ongoing support to prevent mental health concerns. Future research should develop interventions to help manage adverse emotional outcomes. [ Journal of Gerontological Nursing, 49 (4), 27–32.]

The impact of loneliness and social isolation on health is a significant concern among people residing in long term care. Researchers have begun to design and test interventions to lessen the burden of these impacts on the individual as well as our already strained healthcare system. The purpose of this review is to synthesize types and outcomes of interventions designed to reduce loneliness and isolation among long term care residents. Six databases: CINAHL, PUBMED, Cochrane, Web of Science, PsycInfo, and Embase were searched to identify studies leveraging the use of various interventions for alleviating feelings of loneliness and isolation within long term care residents. Multiple keywords were used including loneliness, social isolation, long-term care, nursing home, treatment, and strategies. Articles were screened if they were published between 2012 and present. Twenty studies were included in this systematic review. All studies have a small sample size. Only four studies were randomized controlled trials. Interventions included laughter therapy, adaptive sports, social robotics, horticultural therapy, spirituality, electronic cognitive behavioral therapy, music therapy, virtual reality, expressive arts, telephone discussions, video conferencing, peer mentoring, and animal assisted therapy. The majority of the interventions demonstrate a significant improvement in alleviating feelings of loneliness and social isolation, while some interventions also show improvement in quality of life and physical ability. However, some studies have a high attrition rate. Future research is needed to utilize a more rigorous design with a large sample size. Participant engagement should be considered as part of the intervention activities.

Nursing home residents and staff have accounted for roughly 40% of Coronavirus-related deaths in the U.S. The burden of caring for vulnerable residents coupled with isolation policies has taken a significant emotional toll among direct health care staff in long term care facilities. This study explores nursing home staff’s experiences in caring for residents during the COVID-19 pandemic. A qualitative descriptive approach with a semi-structured guide was used to conduct individual interviews. We recruited nursing home staff employed during the COVID-19 pandemic in long term care facilities located in New York State. Interviews were recorded, transcribed verbatim, and then analyzed using Braun and Clarke’s Reflexive Thematic analysis. Twelve nursing home staff were interviewed. Participants consistently refer to failure-to-thrive as an extremely concerning problem because many residents demonstrate decreased appetite and poor nutrition, inactivity, and depressive symptoms due to social isolation. They also often feel frustrated and overwhelmed due to uncertainty and shortages of staff. Five main themes were identified, including doing their best to manage residents’ failure-to-thrive, working as a team, keeping family members informed and connected, struggling to balance competing personal and professional demands, and needing support to reduce stress and build strength. Our study findings indicate that nursing home staff experienced a high level of stress and identified failure-to-thrive caused by isolation and loneliness as a common phenomenon among nursing home residents during the COVID-19 pandemic. Interventions are urgently needed to reduce isolation and loneness in nursing home residents and to provide support for staff.