“I Had Never Felt More Alone in My Life as I Did Those Eight Days.” Impact of COVID-19 Visitation Restrictions on Patients and Caregivers

Abstract

Outcomes1. Determine the impact of visitation restriction on caregivers and patients2. Describe ways to improve communication and caregiver involvement to families during times of caregiver separationOriginal Research BackgroundThe impact of restricting hospital visitation during the COVID-19 pandemic on patients and caregivers has not been described.Research ObjectivesWe explored how hospital visitation restrictions affected the health and experience of hospitalized patients and their caregivers.MethodsWe conducted a multimethod cohort study, matching adult patients (N = 100) hospitalized before the pandemic with 100 patients hospitalized after the pandemic. Matching was based on age, gender, and primary diagnosis. Based on chart abstractions, we conducted t tests estimating whether patient outcomes and medical teams’ communication with caregiver varied by status of visitor restrictions. We then conducted and analyzed semistructured interviews with a subset of patients hospitalized under visitor restrictions and their caregivers (N = 13) to understand the impact of visitation restrictions on patient and caregiver experience.ResultsOur chart abstraction revealed that caregivers of patients hospitalized during visitation restriction were more likely to receive no contact from medical teams (36.1% vs 16.5%; P < 0.001) and less likely to receive discharge counseling compared to those hospitalized before visitation restriction (36.5% vs 51.6%; P = 0.04). There were no significant differences in emergency department visits, rehospitalization, or death. Our qualitative analysis revealed that caregivers and patients experienced negative emotional consequences of the separation, such as anxiety, confusion, fear, and conflict with the medical team. Caregivers struggled with a lack of information about their loved ones’ overall psychological state. Although video visits were helpful, many caregivers either were not offered this option or did not have the technological literacy necessary to benefit.ConclusionVisitation restrictions during COVID were associated with lack of communication with caregivers but no significant differences in hospitalizations or ER visits. Interviews indicate that patients’ and caregivers’ unmet information needs due to lack of communication caused negative emotional consequences.Implications for Research, Policy, or PracticeFuture research should explore how to mediate the negative emotional sequelae of caregiver physical separation.