A unique disaster response in aged residential dementia care: Can the experience inform future care models?

Abstract

Aims and ObjectivesTo understand how staff who chose to live‐in with residents in a level 3 dementia care unit perceived the experience, in particular, their perceptions of how residing on site affected resident well‐being.BackgroundCOVID‐19 has been especially devastating in aged residential care (ARC) facilities. In March 2020, when the threat became realised in New Zealand, one residential dementia care facility implemented a unique response to the imminent threat of COVID‐19. Eight staff members made the decision to live on site during the lockdown, ensuring residents’ risk of contracting the virus was significantly reduced as carers would not go outside of the facility.DesignA qualitative descriptive inquiry.MethodsSeven staff who chose to live‐in, and the facility manager, participated in semi‐structured, face‐to‐face interviews at the ARC. Audio‐recorded interviews were transcribed verbatim and analysed using a thematic analysis approach. COREQ guidelines were adhered to in the reporting of this study.ResultsAn overarching motif which emerged from the findings was the articulation of an ‘all in this together’ attitude which fostered feelings of camaraderie and collaboration which enhanced the experience for staff individually, and as a group. Themes identified were as follows: (a) A ‘safe’ but challenging choice, (b) Benefits for the staff and (c) Positive outcomes for the residents.ConclusionThis crisis inadvertently brought about an enhanced ‘dementia‐friendly’, person‐centred communal environment.Relevance to clinical practiceThis study identified themes that deepen our understanding of caring for vulnerable populations during a pandemic and beyond. Given the success of this ‘live‐in’ innovation, consideration must be given to applying these findings more generally when planning care models for best outcomes for residents receiving rest home level dementia care. How we care for people in disaster situations reflects the heart of the caring workforce, but such innovation may be extended to usual care where indicated.

Impact of the first wave of COVID‐19 on the health and psychosocial well‐being of Māori, Pacific Peoples and New Zealand Europeans living in aged residential care

“…A recently published New Zealand study exploring staff experiences of living-in with people with dementia in an ARC facility during COVID-19 lockdown found an increase in the quantity and quality of interactions between the staff and residents. 21 They also observed a reduction in falls and some positive changes in residents' behaviour including improved mood. A previous review concluded that residents have a better mood and delayed functional dependence when staff treat and interact with them empathically and humanely.…”

“…Our findings suggest the COVID‐19 pandemic and the associated national response may affect different ethnic groups differently. A recently published New Zealand study exploring staff experiences of living‐in with people with dementia in an ARC facility during COVID‐19 lockdown found an increase in the quantity and quality of interactions between the staff and residents 21 …”

Increased care-need in older long-term care insurance users after the 2018 Japan Floods: a retrospective cohort study based on the Japanese long-term care insurance claims

“…The issue of how to protect vulnerable people and reduce economic losses due to natural disasters is an important issue worldwide [35]. Although various disaster preparedness measures for the vulnerable older residents have been proposed [36][37][38], the preparedness for post-disaster care is largely ignored. New guidelines for the care of older residents during and after disasters incorporating the results of this study are needed.…”

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“…Loneliness and severe depressive symptoms appeared to increase in New Zealand European residents, but not in Māori and Pacific residents (although this is likely due to disproportionate numbers of respective residents) (Cheung et al, 2022). Moir et al, (2021) reported a bolstering of person-centred care which resulted from care staff moving into the ARC facility for the duration of the lockdown.…”

“…This ranges from (lowest to highest needs) self-contained solo and/ or assisted living apartments, rest homes, and hospitals/ respite. Some villages include a specialized secure dementia unit with specially trained staff (Moir et al, 2021). These arrangements reflect the different level of support a resident may need.…”