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Reopening the doors of Dutch nursing homes during the COVID-19 crisis: results of an in-depth monitoring

Published online by Cambridge University Press:  05 April 2021

Raymond T. C. M. Koopmans
Affiliation:
Department of Primary and Community Care, Radboud University Nijmegen, Medical Center, Nijmegen, the Netherlands De Waalboog “Joachim en Anna,” Center for Specialized Geriatric Care, Nijmegen, the Netherlands
Hilde Verbeek
Affiliation:
Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
Annemiek Bielderman
Affiliation:
Department of Primary and Community Care, Radboud University Nijmegen, Medical Center, Nijmegen, the Netherlands
Meriam M. Janssen
Affiliation:
Tranzo Department, Scientific Center for Care and Welfare, Tilburg University, Tilburg, the Netherlands
Anke Persoon
Affiliation:
Department of Primary and Community Care, Radboud University Nijmegen, Medical Center, Nijmegen, the Netherlands
Ivonne Lesman-Leegte
Affiliation:
Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
Eefje M. Sizoo
Affiliation:
Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, the Netherlands
Jan P. H. Hamers
Affiliation:
Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
Debby L. Gerritsen
Affiliation:
Department of Primary and Community Care, Radboud University Nijmegen, Medical Center, Nijmegen, the Netherlands
Corresponding

Abstract

Objectives:

On May 11, the Dutch Government allowed 26 nursing homes to welcome 1 visitor per resident, after 2 months of lockdown. The study aimed to monitor in-depth the feasibility of the regulations and their impact on the well-being of residents, their visitors, and healthcare staff.

Design:

Mixed-methods study in 5 of the 26 facilities; the facilities were affiliated to an academic network of nursing homes.

Participants:

Visitors and healthcare professionals.

Intervention:

Allowing visitors using local regulations based on national guidelines.

Measurements:

Digital questionnaire, analyzing documentation such as infection prevention control protocols, attending meetings of COVID-19 crisis teams, in-depth telephone or in-person interviews with visitors and healthcare professionals, and on-site observations.

Results:

National guidelines were translated with great variety into local care practice. Healthcare professionals agreed that reopening would increase the well-being of the residents and their loved ones. However, there were also great worries for increasing workload, increasing the risk of emotional exhaustion, and the risk of COVID-19 infections. Compliance with local regulations was generally satisfactory, but maintaining social distance and correctly wearing face masks appeared to be difficult. Care staff remained ambivalent for fear of infections. In general, allowing visitors was experienced as having a positive impact on the well-being of all stakeholders. Nevertheless, some residents with dementia showed negative effects.

Conclusion:

The complete lockdown of Dutch nursing homes had a substantial impact on the well-being of the residents. The reopening was welcomed by all stakeholders, but provided a high organizational workload as well as feelings of ambivalence among care staff. In the second wave, a more tailored approach is being implemented. However, facilities are sometimes still struggling to find the right balance between infection control and well-being.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2021

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