Abstract
Objectives
Characterize the implementation, benefits, and challenges of an Essential Family Caregiver
(EFC) program, a novel policy implemented in long-term care (LTC) settings during
the COVID-19 pandemic in Indiana. Characterize LTC administrator perspectives on family/caregiver
involvement in the LTC setting.
Design
Semi-structured qualitative interviews.
Setting and Participants
Administrators from 4 Indiana LTC facilities.
Methods
In this qualitative study, a convenience sample of 4 LTC administrators was recruited.
Each participant completed 1 interview during January to May 2021. Following transcription,
a thematic analysis approach with 2 cycles of qualitative coding identified relevant
themes.
Results
Four LTC administrators participated, representing both urban and rural nonprofit
nursing homes. Participants spoke positively of the program despite implementation
challenges including perceived infection risk, policy interpretation, and logistical
challenges. The psychological impact of isolation for nursing home residents was emphasized
as a critical consideration alongside physical health concerns. LTC administrators
desired to support resident well-being while maintaining good standing with regulatory
agencies.
Conclusions and Implications
Based on a limited sample, Indiana's EFC policy was viewed favorably by LTC administrators
as a tool to balance resident and family psychosocial needs with infection-related
health risks. LTC administrators desired a collaborative approach from regulators
as they worked to implement a novel policy. Consistent with participant desire for
broader caregiver access to residents, more recent policymaking has reflected growing
recognition of the critical role of family members not only as companions but also
as care providers, even in a structured care environment.
Keywords
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Article info
Publication history
Published online: March 17, 2023
Footnotes
This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.
KU is the founder and chief medical officer of Probari, a health care start-up that provides clinical support services in nursing homes. The other authors declare no conflicts of interest.
Identification
Copyright
© 2023 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
