Care home visiting restrictions may reduce quality of care

Researchers from LTCcovid, a website documenting the impact of COVID-19 on people who rely on long-term care and those who provide it, carried out a rapid review of evidence on the impacts of visiting policies in care homes during the COVID-19 pandemic.

Researchers examined published studies and scientific journals that report on the effect of visitors on infections in care homes, the wellbeing impact of closing care homes to visitors and the impact of closing care homes to family and other visitors on quality of care.

The investigation found that a ‘substantial’ amount of care was being provided by unpaid carers and volunteers in care homes prior to the pandemic, and concluded that visiting restrictions may have resulted in reductions in quality of care or additional tasks for care home staff.

They found no scientific evidence that visitors introduced COVID-19 infections, but noted that during the peak of the pandemic most countries did not allow visiting.

They also found evidence that care home residents experienced greater depression and loneliness and demonstrated more behavioural disturbance during the period that included visitor bans.

Researchers said: ‘Given that there were already low rates of social interactions among residents and loneliness before the COVID-19 pandemic, the evidence reviewed suggests that visiting restrictions are likely to have exacerbated this further.

‘While there is no scientific evidence identifying visitors as the source of infections this is likely to reflect that most care homes did not allow visitors during the initial peaks of the pandemic. A pilot re-opening homes to visits under strict guidelines did not result in any infections.

‘Allowing visitors in facilities where there are no COVID-19 cases is important to support resident wellbeing. Safeguards to reduce risk of COVID-19 infection have been described, including visits through windows/glass, outdoor visits, and well-ventilated indoor spaces, screening of visitors, use of masks and other PPE and hand hygiene and cleaning.

‘In addition, it is important to recognize and support the provision of unpaid care, particularly for people who pre-COVID had a history of regular visiting to provide care (e.g. feeding, grooming, emotional support).

‘They should be classified as essential workers, provided training and PPE, and be allowed to visit regularly and provide care, interacting as closely with residents as staff.’

Click here to read the full review.

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