Insights From The Frontline of COVID-19 in Residential Care Settings for Older People in The Republic of Ireland: A Mixed Methods Study

Abstract Background The COVID-19 pandemic had a disproportionate effect among residents, family members and staff in residential care settings for older people in Ireland relative to other health care settings, particularly in wave one of the virus. The purpose of this study was to explore the COVID-19 pandemic as it was experienced by people on the front line of the virus - residents, family members and staff in residential care settings for older people in the Republic of Ireland (ROI). Method A 2-phased mixed methods cross-sectional study was conducted. This consisted of a survey administered anonymously online shortly after the 1st wave of the virus (June - August 2020), via our nursing and health care networks, advocacy organisations for older people and on social media targeting - staff, residents and family members. Family members who took part in the survey were invited to take part in phase 2 - qualitative one-to-one interviews which were conducted shortly after wave 2 of the virus (November - December 2020). ResultsSeventy-six staff members completed the survey as well as 28 family members and 2 residents. Eleven family members took part in the qualitative interviews. Good infection control protocols, good governance/management structures, being prepared and agile responses were important factors in determining better outcomes. Isolation, loss of connectedness (to family, staff members and other residents) as well as a reduction in the level/quality of care provision led to significant adverse impacts for both residents and their families. Staff reported high levels of stress, trauma and burnout. A strong theme emerging from the qualitative element was the important role that family members typically have in supplementing care provision which suddenly and completely ceased during the pandemic. This caused huge distress amongst family members and physical decline and mental anguish amongst residents. ConclusionsThis is the first research study to explore the experiences of residents, family members and staff who were at the front line of the pandemic in residential care settings in ROI when the pandemic struck. This study provides valuable insights which could be used by staff in residential care settings, policy makers/implementers in further waves of the pandemic or in future communicable disease outbreaks. The rights and needs of residents must be carefully balanced with infection control and prevention measures. Strategies to ensure that residents and staff are appropriately supported during future waves of the pandemic should now be implemented.