Treatment and Care for Nursing Home Residents with COVID-19: A Qualitative Study

Anita Nilsen,1 Siren Eriksen,2 Bjørn Lichtwarck,3 Adelheid Hummelvoll Hillestad,2 Signe Gunn Julnes,1 Signe Tretteteig,4 Anne Marie Mork Rokstad1,4 1Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway; 2Lovisenberg Diaconal University College, Oslo, Norway; 3The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway; 4Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, NorwayCorrespondence: Anita Nilsen, Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway, Email [email protected]: Coronavirus disease 2019 (COVID-19) placed a significant strain on nursing homes, leading to numerous outbreaks and high mortality rates. This situation created considerable stress and challenges for residents, their physicians and nurses, as well as family caregivers. By understanding these challenges, we can gain new insights and learn valuable lessons. Thus, the purpose of this study is to examine the treatment and care provided to nursing home residents with COVID-19, as experienced by physicians, nurses, and family caregivers.Participants and Methods: This study is a secondary analysis of 35 interviews with physicians, nurses, and family caregivers, each with personal experience caring for nursing home residents diagnosed with COVID-19. The interviews took place from December 2020 to April 2021. We analyzed the transcriptions based on Braun and Clarke’s reflexive thematic analysis model and followed a qualitative descriptive design as outlined by Sandelowski.Findings: The analysis produced three themes: 1) Balancing medical treatment, 2) The need for increased systematic monitoring of vital functions, and 3) Determining the treatment level for nursing home residents. These themes were explored through the unique perspectives of the three participant groups: physicians, nurses, and family caregivers. The findings revealed several challenges related to treatment and care for nursing home residents diagnosed with COVID-19. This applied both to relief of symptoms, monitoring of vital functions, assessment of treatment level and use of advance care planning.Conclusion: Drawing from the experiences of physicians, nurses, and family caregivers, there should be a unified plan at the municipal or national level for competency development in nursing homes to prepare for future crises like pandemics or epidemics. Additionally, the safe engagement of family caregivers and relatives should be given priority.Keywords: alleviation, nursing homes, palliative care, pandemic, safekeeping, systematic mappin

Prospects and constraints of nursing home-based integrated adult day care : Viewpoints of experts

Hämel K, Röhnsch G. Möglichkeiten und Grenzen integrierter Tagespflege in Pflegeheimen: Sichtweisen von ExpertInnen. Zeitschrift fur Gerontologie und Geriatrie. 2019;52(2): 148–156.BACKGROUND: Even when they are in need of care, old people prefer to stay in their community. An appropriate design of nonresidential and residential care services close to people's home is crucial for supporting them. In the model project "Pflege stationar-Weiterdenken!" (Nursing home care-think ahead!) nursing homes offer extended services to old people in the community. This includes integrated day care (ITP), which entails day guests spending the day with residents of the facilities. This article examines the opportunities and challenges arising when designing and implementing this type of cross-sectoral care model.; METHOD: Guided interviews were carried out with 20experts who were either professionals working at the model institutions or involved in the project at the planning and cooperation levels. The data collected were evaluated using thematic coding.; RESULTS: The opportunities and challenges lie at two levels. (1)At the institutional level advantages are greater individual and flexible timeframes of usage and better accessibility of day care for care-dependent people through the integration into residential care settings. The challenges involve administrative and management issues as well as apprehensions among the employees concerning the increased workload. (2)At the level of interaction and social integration experts emphasized the importance of making allowances for the interests and needs of day guests and residents. Furthermore, they confirmed that if this is achieved then integrated day care can improve the social participation of both user groups.; CONCLUSION: From the experts' point of view, the ITP holds the potential for cross-sectoral care for old people in need of care close to their homes. Afinal assessment will require further analysis, especially on users' views