COVID-19: it is time to balance infection management and person-centered care to maintain mental health of people living in German nursing homes

COVID-19 has hit nursing homes hard

“…In most countries the first wave of COVID-19 mainly killed people in nursing homes. Whereas the nursing home population represents less than 1% of the total population in European countries, nursing home residents accounted for 31-80% of all deaths during the first wave in various countries [1][2][3][4][5]. In fact, the reported COVID-19 deaths may be an underestimate since these deaths have accounted only for two-thirds of excess deaths [6].…”

“…In spring 2020, European nursing homes were locked down and visitors were banned. All group-based cultural and exercise activities were eliminated [2,15], and common spaces such as dining rooms were used as little as possible. This probably limited the spread of infection, and the EUGMS guidance is also based on the same principles to prevent entrance and spread of the virus: active testing among residents, staff and visitors, and isolating subjects who either have symptoms or have been in contact with infected subjects [9].…”

“…After a long quarantine, it has become obvious that social isolation and quarantine also have adverse effects. Residents suffer from loneliness, depression and anxiety [2,16]. Pausing group activities, especially exercise and outdoor activities, has exacerbated development of sarcopenia, frailty, and disabilities [17].…”

“…Pausing group activities, especially exercise and outdoor activities, has exacerbated development of sarcopenia, frailty, and disabilities [17]. The consequence is accelerated cognitive decline [2]. The risks of prolonged isolation should be evaluated against the COVID risks.…”

Burden of COVID-19 on mental health of older adults in a fragile healthcare system: the case of Nigeria: dealing with inequalities and inadequacies

“…In a small study in two of these charity-based homes, a couple of years back, it was reported that 48% of residents had dementia and 17% depression (Baiyewu et al, 1997); there are no recent studies and the situation might have changed now and no information on the effect of COVID-19 on older adults in these facilities is available. Even though we have no information on death rate in nursing homes, various anecdotal reports from countries in Europe indicate increased death rate in the very old and those with dementia who are likely to be residents of nursing homes (Dichter et al, 2020;Wang et al, 2020). However, in a retrospective study, Bianchetti et al reported that patients who died in a COVID-19 treatment facility in Northern Italy are likely to be older and have dementia.…”