The pandemic’s effect on nursing home residents goes well beyond cases and deaths, a new study from policy researchers has found.

Investigators from Mathematica used Minimum Data Set assessments for all nursing homes in Connecticut to measure long-stay resident outcomes for each week between March and July 2020. Outcomes were compared with those observed between the same months each year from 2017 to 2019, controlled for resident characteristics and outcome patterns. 

Resident outcomes worsened on a broad array of measures, the researchers found. These included a 15% increase in the prevalence of depressive symptoms, a 150% increase in unplanned substantial weight loss, an increase in episodes of incontinence, and significant reductions in cognitive functioning, according to Andrea Wysocki, Ph.D., MPP, and colleagues.

The findings suggested that loneliness and isolation played an important role in these changes, Wysocki added. For example, although unplanned substantial weight loss was greatest for those who contracted COVID-19 (20% of residents observed each week), approximately 7.5% of residents who were not infected also showed related physical deterioration each week. 

In addition, the finding of increased incontinence suggests that “something beyond just fear and despair” must have contributed to changes in well-being, she and her colleagues wrote. Staffing shortages and a reduction in direct care are potential contributors, they said.

“Future policy changes to limit the spread of COVID-19 or other infectious disease outbreaks should consider any additional costs beyond the direct effects of morbidity and mortality due to COVID-19,” Wysocki and colleagues wrote.

“Our findings highlight the importance of being responsive to the recommendations made by the independent Nursing Home Commission and other stakeholders to put person-centered care at the forefront of any new guidance for nursing homes to respond to the COVID-19 crisis,” the authors concluded.

The study was funded by the Connecticut Department of Public Health and published online as a pre-proof in JAMDA.