Friends and Family Are Important Caregivers for Residents at Nursing Homes

Friends and Family Are Important Caregivers for Residents at Nursing Homes

NEW YORK (Reuters Health) – More than half of nursing home residents receive help from family and friends, underscoring the importance of allowing these informal caregivers to visit even during a pandemic, researchers have found.

Their analysis of data from two nationally representative health studies from 2015 and 2016 also revealed that a large number of seniors in residential-care facilities received a lot of help from friends and family.

“We generally assume that when a loved one moves to an assisted-living facility or a nursing home, their needs for care are met by paid staff, relieving the burden on family and friends,” said Dr. Rachel Werner, executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania, in Philadelphia.

“Our study challenges that assumption, finding that family and friends continue to provide substantial amounts of care in these facilities,” Dr. Werner told Reuters Health by email. “These informal caregivers make up an invisible workforce.”

The new findings, published in Health Affairs, spotlight issues with locking out families and friends from nursing homes, said co-author Dr. Norma Coe, co-director of the Population Aging Research Center, Perelman School of Medicine at the University of Pennsylvania.

“Visitation policies should account for the health of the residents – this includes balancing COVID risks, social benefits of visiting, the physical help caregivers provide, and staff capacity,” Dr. Coe told Reuters Health by email.

“It would also depend on the ability of the nursing home to assess these risks – an inability to require vaccinations or do rapid testing of visitors has hampered the many facilities ability to assess these risks and adopt informed mitigation efforts,” she said. “Like most things during COVID-19, there are no easy answers, but a calculated assessment of these risks and benefits would likely have led to adoption of policies other than universal visitor bans for many months on end.”

To explore the extent to which family and friends contributed to the care of those living in nursing homes and residential-care facilities, the two researchers turned to data from two nationally representative surveys: the Health and Retirement Study (HRS) and the National Health and Aging Trends Study (NHATS).

Overall, HRS and NHATS included data on 396 nursing home residents and 429 seniors in residential-care facilities. The data showed that more than half of nursing home residents received help from informal caregivers across three important activities: 65% for household activities, 52% for mobility needs, and 61% for self-care.

For older adults who had needs that were addressed by family and friends, the amount of time put in by informal caregivers were 65 hours per month if they lived in a residential-care facility and 37.4 hours per month if they lived in a nursing home.

Drs. Werner and Coe report that although the “hours of informal care per month were lowest among nursing home residents” – as compared to community-dwelling seniors and those living in residential care – “they remained substantial and were roughly equivalent to an extra full-time shift of care per month.”

The new study is “really interesting,” said Dr. John Rowe, a professor of health policy and aging at Columbia University’s Mailman School of Public Health, in New York City.

“It’s very significant,” Dr. Rowe told Reuters Health. “Previous information on the kind of informal care being provided to older persons basically has been focused on home care and didn’t really look at care in residential communities and nursing homes.”

“In a nursing home, the nurse can’t be there every minute,” Dr. Rowe said. “So a lot of people rely and family and friends to visit and help them change their clothes, get them to the toilet and help them pay their bills.”

Those informal caregivers aren’t just helping older people with their daily activities of living, Dr. Rowe said, they are also supporting seniors psychologically and personally. “That is very, very significant, especially when visitations are restricted.”

There are two important types of fallout that occur when family and friends aren’t allowed to visit, Dr. Rowe said. “These chores aren’t being done any more and the connection, the psychological and social support, is much less,” he added.

One thing that should also be considered is the impact of pandemic restrictions on family and friends who can’t help out anymore. “We have a 30% prevalence of anxiety and depression in the community now and when people can’t take care of a family member they will become more depressed and anxious,” Dr. Rowe said. “So, I would be worried about those family members, too.”

SOURCE: Health Affairs, online January 4, 2022.

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