Psychosocial changes during COVID-19 lockdown on nursing home residents, their relatives and clinical staff: a prospective observational study

Abstract

Background Previous works have observed an increase of depression and other psychological disorders on nursing home residents as a consequence of coronavirus disease 2019 (COVID-19) lockdown; however, there are few studies that have performed a comprehensive evaluation of all people involved in nursing homes environment. The objective of the work was to analyse the impact of lockdown on psychosocial factors of nursing home residents, relatives and clinical staff and how these variables have influenced residents’ survival. Methods A prospective study was designed. Evaluations were performed at three different times: a) at the beginning of Spanish confinement, in March 2020; b) just before the second wave of the pandemic, with relaxation of security measures but in lockdown, and c) in January–February 2021, at the end of the second wave, when visits were already allowed. The study was conducted on three different nursing homes. Three hundred and one residents, 119 clinical staff and 51 relatives took part in the study. Anxiety and depression were evaluated in all participants. A scale on the meaning of suffering was also performed. In addition, burnout status was also determined in the clinical staff. Results All participants showed lower depression during lockdown, while at the beginning and at the end of the confinement, these values were significantly increased. In residents, these changes were dependent of cognitive status (p = 0.012). Anxiety was significantly higher in residents. The evolution of anxiety was similar than with depression, with lower values during confinement, although clinical staff showed higher anxiety levels at the beginning. The feeling of suffering was significantly lower in the clinical staff than in resident and relative groups. Residents’ survival was dependent of cognitive status (p = 0.018) and voluntary confinement (p < 0.001). Conclusions During the first COVID-19 lockdown, psychological wellbeing of residents cared in nursing homes, their relatives and staff did not seem to be seriously affected. Previous mental health in relatives and staff together with a resilient approach to the adversity might partly be protecting factors. The lack of consequences on residents’ anxiety, depression and perception of social support may reflect the special attention and care they received. Finally, as in the current study only data of the first two COVID-19 waves were analysed, its findings might be partly generalized to all the pandemic.

Effects of COVID-19 Lockdown on Nutritional, Functional and Frailty Biomarkers of People Living in Nursing Homes. A Prospective Study

“…Finally, depression and other psychological traits were not measured in this study, and they could be contributory to some of the biomarker, frailty, and functional outcomes. However, our previous study did not show a significant modification of psychological well-being of nursing home residents during this lockdown (Oliveira et al, 2023).…”

“…To note, an elevated degree of dependence, measured both by functional capacity and frailty status, was associated with higher mortality during confinement. Although, in our opinion, the prompt response of nursing homes to COVID-19 disease-related stressors and social restrictions, as we were able to show previously (Oliveira et al, 2023), could have allowed such changes to be small and potentially reversible, it will be necessary to develop new prevention strategies centred on the person in order to avoid the harmful effect of confinement on elderly population. These interventions may require of having more spaces for the free movement of the resident to prevent loss of functional capacity in future pandemics.…”

“…The confinement was the way in which the health authorities tried to minimize social interactions between the community environment and the elderly. This implied an isolation that prevented the elderly from leaving their own rooms for several weeks (Oliveira et al, 2023). Three different nursing homes from the “Amigos de la Paz” association took part in the study.…”

National cross-sectional survey on psychological impact on French nursing homes of the first lockdown during the COVID-19 pandemic as observed by psychologists, psychomotor, and occupational therapists

“…Additionally, instituting systems for regular emotional monitoring would enable early detection of emotional needs and difficulties, facilitating prompt and targeted intervention such as social support ( 16 ). Finally, integrating psychologists specialized in evidence-based therapies like CBT could enhance available resources to provide adequate and tailored psychological support to residents, healthcare staff, and families in care facilities.…”

“…However, the study also emphasized strong resources like social connections, spirituality, and gratitude. Another study conducted by Oliveira et al ( 16 ) demonstrates that during the initial lockdown in Spain, the psychological well-being of NH residents was considered. The study indicates minimal psychological impact on residents, caregivers, and families due to significant resilience capacities (protective factors).…”