[Contact-restricting measures in care facilities in the context of the COVID-19 pandemic and their impact on residents - a plea].

Abstract

During the COVID-19 pandemic, residents of care homes for the elderly were at a particularly high risk of contracting the virus and dying from it. Strict protective measures were therefore taken, including bans on visits. However, the negative effects of these contact-restricting measures on the mental and physical health, quality of life, right to self-determination and ultimately the dignity of the residents soon became apparent and the question was raised as to whether isolation (confinement disease) was even more harmful to health than the disease itself. Statements on infection control measures in care facilities, studies with the views of those affected (residents, relatives, employees in care facilities) and interviews with residents of care facilities as well as reviews on adverse effects of the protective measures were researched. The search included both so-called "gray literature" and publications from PubMed. The residents suffered greatly from isolation and from the fact that decisions were made about them without consulting them. They complained about the loss of their autonomy and felt that their dignity was violated. The reviews showed that the residents generally experienced loneliness, anxiety, sadness and depression more frequently, and in some cases also physical deterioration. In future, care must be taken to achieve a good balance from a legal and health perspective between protection against infection and protection of the mental and physical health, well-being and quality of life of residents, respect for autonomy, the right to self-determination and the dignity of residents. This requires a broad social discussion in which not only experts from the fields of infectiology but also from the fields of geriatrics, nursing, public health, ethics and law, but in particular also those affected themselves or their representatives, their relatives, are heard and their arguments taken into account.