THE IMPACTS OF NURSING HOME COVID-19 SOCIAL ISOLATION POLICIES ON RESIDENTS LIVING WITH DEMENTIA

Abstract

Abstract Using reports from 31 nursing home activity directors (AD) from across the United States, we examined responses to COVID-19 social isolation policies/practices in relation to AD’s perceptions of the impact on residents living with dementia (RLWD). AD’s perceptions are particularly valuable because they are generally responsible for bolstering social connectedness. We approached this study from the sociological perspective of personhood (Buron, 2008; Kitwood, 1997) that suggests social isolation may threaten personhood status, lead to increased agitation, and other behaviors as mechanisms to preserve self. Most ADs reported that social isolation protocols began in March 2020 and were still ongoing through the beginning of 2022. Over 90% reported a 50% or more reduction in family member/guest visits, with over 30% reporting a 90% or more reduction in visits. Systemic content analyses were applied to open-ended responses. These patterns suggested ADs had concerns about (1) poor quality care as a result of a) a reduced workforce leading to caregiver burnout, and b) less accountability of caregivers (to families/visitors in their absence) for resident care, and (2) increasing signs of depression and negative behaviors among RLWD. Some ADs felt that Isolation policies disrupted routines of RLWD, leading to confusion and a greater progression of their dementia. Some ADs felt the need to “fill-in” as an attempt to make up for the loss of interactions with family members. The results of this study indicate a need to consider future pandemic policies and potential impacts on residents living with dementia in nursing home settings.