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Original Study - Brief Report| Volume 24, ISSUE 6, P816-820, June 2023

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Long-Term Care Administrator Perspectives on an Essential Family Caregiver Policy

      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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      References

        • Ouslander J.G.
        • Grabowski D.C.
        COVID-19 in nursing homes: Calming the perfect storm.
        J Am Geriatr Soc. 2020; 68: 2153-2162
        • Thompson D.C.
        • Barbu M.G.
        • Beiu C.
        • et al.
        The impact of COVID-19 pandemic on long-term care facilities worldwide: An overview on international issues.
        BioMed Res Int. 2020; 2020: 8870249
        • Wright D.R.
        Center for Clinical Standards and Quality/Quality, Safety & Oversight Group Ref: QSO-20-14-NH UPDATE: 03/10/2021: Guidance for infection control and prevention of coronavirus disease 2019 (COVID-19) in nursing homes (REVISED). March 2020.
        • Canevelli M.
        • Valletta M.
        • Toccaceli Blasi M.
        • et al.
        Facing dementia during the COVID-19 outbreak.
        J Am Geriatr Soc. 2020; 68: 1673-1676
        • Wammes J.D.
        • Kolk D.
        • van den Besselaar J.H.
        • MacNeil-Vroomen J.L.
        • Buurman-van Es B.M.
        • van Rijn M.
        Evaluating perspectives of relatives of nursing home residents on the nursing home visiting restrictions during the COVID-19 crisis: A dutch cross-sectional survey study.
        J Am Med Dir Assoc. 2020; 21: 1746-1750.e3
        • Bolcato M.
        • Aurilio M.T.
        • Di Mizio G.
        • et al.
        The difficult balance between ensuring the right of nursing home residents to communication and their safety.
        Int J Environ Res Public Health. 2021; 18: 1-11
        • Stall N.M.
        • Johnstone J.
        • McGeer A.J.
        • Dhuper M.
        • Dunning J.
        • Sinha S.K.
        Finding the right balance: An evidence-informed guidance document to support the re-opening of Canadian nursing homes to family caregivers and visitors during the coronavirus disease 2019 pandemic.
        J Am Med Dir Assoc. 2020; 21: 1365
        • Abbasi J.
        Social isolation—the other COVID-19 threat in nursing homes.
        JAMA. 2020; 324: 619-620
        • Armitage R.
        • Nellums L.B.
        COVID-19 and the consequences of isolating the elderly.
        Lancet Public Heal. 2020; 5: e256
        • Schlaudecker J.D.
        Essential family caregivers in long-term care during the COVID-19 pandemic.
        J Am Med Dir Assoc. 2020; 21: 983
        • Barber A.
        Essential Caregiver Program aims to reunite families with loved ones in long-term care–being patient. Being patient.
        • Indiana Department of Health Long-term Care Division
        Essential Family Caregiver Program implementation toolkit.
        • Bergman C.
        • Stall N.M.
        • Haimowitz D.
        • et al.
        Recommendations for welcoming back nursing home visitors during the COVID-19 pandemic: Results of a Delphi panel.
        J Am Med Dir Assoc. 2020; 21: 1759-1766
        • Kemp C.L.
        #MoreThanAVisitor: Families as “essential” Care partners during COVID-19.
        Gerontol. 2021; 61: 145-151
        • Verbeek H.
        • Gerritsen D.L.
        • Backhaus R.
        • de Boer B.S.
        • Koopmans R.T.C.M.
        • Hamers J.P.H.
        Allowing visitors back in the nursing home during the COVID-19 crisis: A Dutch National Study into first experiences and impact on well-being.
        J Am Med Dir Assoc. 2020; 21: 900-904
        • Braun V.
        • Clarke V.
        Using thematic analysis in psychology.
        Qual Res Psychol. 2006; 3: 77-101
        • Borkan J.M.
        Immersion–Crystallization: A valuable analytic tool for healthcare research.
        Fam Pract. 2022; 39: 785-789
        • Borkan J.M.
        Immersion/crystallization.
        in: Crabtree B.F. Miller W.L. Doing Qualitative Research. SAGE Publications, 1999: 179-194
        • Wright D.R.
        Nursing home visitation–COVID-19 (REVISED). Center for Clinical Standards and Quality/Survey & Certification Group, Ref: QSO-20-39-NH.
        • Hindmarch W.
        • McGhan G.
        • Flemons K.
        • McCaughey D.
        COVID-19 and long-term care: The essential role of family caregivers.
        Can Geriatr J. 2021; 24: 195-199
      1. Essential caregivers coalition community. Caregiver/support person bills by state.
        • Nazir A.
        • Steinberg K.
        • Wasserman M.
        • Horowitz A.C.
        • Lett J.E.
        Time for an upgrade in the nursing home survey process: A position statement from the Society for Post-Acute and Long-Term Care Medicine.
        J Am Med Dir Assoc. 2020; 21: 1818-1820