Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

Abstract

Introduction COVID-19 has caused unprecedented challenges in nursing homes. In this scoping review, we aimed to describe factors that contributed to the spread and mortality of COVID-19 in nursing homes and provide an overview of responses that were implemented to try to overcome such challenges. Methods The MeSH terms “Nursing homes” and “COVID-19” were searched in MEDLINE Ovid, and English language articles were retrieved that were published between 1 March 2020 and 31 January 2021. Article titles and abstracts were screened by two reviewers, and the results of included articles were grouped by themes. Results The search retrieved 348 articles, of which 76 were included in the thematic review. 8 articles related to COVID-19 disease characteristics (e.g. asymptomatic transmission), 24 to resident-related factors (e.g. comorbidities, nutrition, cognition), 13 to facility characteristics (e.g. physical space, occupancy, for-profit status), 21 to staffing (e.g. staffing levels, staff-to-resident ratio, staff multi-employment), and 10 to external factors (e.g. availability of personal protective equipment, prevailing health and social care policies). In terms of responses, identified themes included widespread testing, isolation and cohorting of residents, staff protection and support, promotion of residents’ well-being, and technological innovations. Conclusion COVID-19 exerted severe challenges on the nursing home population and its staff. Both internal and external factors predisposed nursing homes to an increased propensity of spread. Numerous strategies were employed to attempt to mitigate the negative impacts. Substantial learning occurred that may not only aid future pandemic preparedness but improve quality of care for nursing home residents at all times.

COVID-19 pandemic and mortality in nursing homes across USA and Europe up to October 2021

“…However, there are marked differences in the spread and mortality figures between countries. The factors behind the variations between NHs include resident-related factors, facility and staffing characteristics [ 3 , 5 , 6 ]. It has been suggested that high-quality NHs have lower prevalence of COVID-19 cases than those with lower quality although confounding factors may underlie this [ 7 ].…”

Embedding Physical Activity Within Community Home Support Services for Older Adults in Ireland – A Qualitative Study of Barriers and Enablers

“…Given the impact of the COVID-19 pandemic on long-term residential care and the well-documented preference of individuals to remain living at home, enhancing community-based care services is an emergent priority. 2 , 3 In 2021, an estimated 23.9 million hours of government-funded home support services (termed domiciliary care in some regions) were delivered to over 55,000 people aged 65 years and older in Ireland. 4 State-funded home support encompasses assistance with activities of daily living (ADLs), most commonly personal care 5 and is allocated based on a needs assessment, and is currently not income assessed in Ireland.…”

Best practice approaches to outpatient management of people living with Parkinson’s disease during the COVID-19 pandemic

“…Special attention should be paid to patients returning from high-incidence regions, those who have been in contact with infected people and those recovering from a COVID-19 infection, in case of prolonged viral shedding and asymptomatic infections. Rigorous screening and testing concepts should also be implemented for patients coming from nursing homes, as virus transmission from asymptomatic patients has previously been linked to outbreaks (Byambasuren et al 2020;Borras-Bermejo et al 2020;Giri et al 2021). Whenever possible, the number of people present at in-person appointments should be kept to a minimum and additional nursing personnel should only accompany patients if absolutely necessary.…”