No Visitors Allowed! The Impact of COVID-19 Restrictions on the Psychosocial Well-Being of Nursing Home Residents

Context: The COVID-19 pandemic changed life for everyone, but especially for nursing home residents. In March 2020, the Centers for Medicare and Medicaid Services in the United States enacted nursing home restrictions regarding visitation from outside family/friends and changes to facility activity programmes. Objective: This study explored the nursing home policies and practices that preserved relationships among nursing home residents with spouses/partners. Nursing home social workers shared the effects of COVID-19 restrictions on residents’ relationships with spouses/partners and how they sought to maintain these essential social connections to minimise the detrimental effect on the psychosocial well-being of residents. Methods: The study utilised both an online survey and 10 telephone interviews with nursing home social workers in four southern states. Findings: Twenty-eight percent of participants reported that no visitors were allowed, while 25% allowed couples to visit with one another as usual. The most noted practices to maintain social connections were phone calls, video calls, and ‘window’ visits between residents and family/friends; however, as one respondent noted, ‘It’s just not the same. It’s affected them greatly.’ Interviews revealed further details about the detrimental effects of the COVID-19 restrictions on nursing home residents’ overall mental health and attachment relationships with spouses/partners. Limitations: Study limitations exist in the focus on practices in four south-eastern states, with no inclusion of northern US states. An additional limitation of sampling is discussed. Implications: These results highlight the importance of maintaining social connections between residents and spouses/partners. Policies and practices that enhance relationships and connections under all circumstances should be formalised and all health care team members trained to ensure implementation.