Staff Perceptions of Compassionate Care Visits for Nursing Home Residents During Restricted Visitation

Abstract

Aim: To describe compassionate care (CC) visits during visitation restrictions from the perspective of nursing home (NH) staff.

Background: During the COVID-19 pandemic, guidance was implemented to restrict visitation in NH communities to protect both residents and staff from risk of infectious outbreak. As a result, many NHs instituted “CC visits” to allow visitation for vulnerable residents. However, it is unclear how CC visits were defined, operationalized, and how their associated benefits and risks were perceived by staff.

Methods: We conducted an exploratory qualitative descriptive study using semistructured interviews and analyzed data using directed content analysis among NH direct care staff.

Results: From June 2021 through March 2022, we recruited nursing, social work, and activities NH staff participants (N = 24). Most were female (88%), White (79%), and had more than 3 years of experience working in NHs (79%). We found three main thematic categories and associated subthemes: (1) Appropriate Use of CC Visits (visits for residents experiencing imminent death, to support resident’s psychosocial needs, and for family members exhibiting concern for the resident); (2) Benefits of CC Visits (resident and staff physical and psychosocial benefits); and (3) Risks of CC Visits (resident and staff risks of facilitating visits and contracting illness). In this study, benefits of CC visits outweighed risks.

Conclusions: In this study, we describe how NH staff describe CC visits, their use during the COVID-19 pandemic, and associated risks and benefits. This includes when visitation could be provided to residents and the impact it had on the resident’s well-being.

Implications: This study highlights the need to consider the physical and psychosocial consequences of social isolation of NH residents.

Impact: Study findings can be used to provide guidance in future public health emergencies when visitation restrictions are instituted.

Reporting Method: We have adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines.

Patient or Public Contribution: Direct care NH staff including social workers (SWs), nursing staff, and activity directors between the ages of 18 and 89 years old were English speaking and willing to participate in a semistructured interview outside of work hours participated in this research. Potential participants contacted members of the study team by phone or email to express their interest in study participation. After confirming eligibility and willingness to participate, an email link was sent to participants with the electronic information/consent sheet using the Qualtrics web-based survey platform (Qualtrics, Provo, Utah). Once participants consented to participate, they were directed to an electronic demographic questionnaire and risk perception survey. At the end of the risk perception survey, participants could indicate if they were willing to be contacted for a semistructured interview to discuss restricted social activities and visitation mandates in NHs. Interviews were scheduled via Zoom video conference during a time outside of work hours. Following participant verbal consent, interviews were audio-recorded. Participants were given a $30 electronic gift card.