Image of male nurse pushing senior woman in a wheelchair in nursing facility

The pandemic’s severe impact on nursing home residents goes beyond cases of infection and deaths. A new study published by the Journal of the American Medicare Directors Association has found that residents’ well-being severely worsened by several measures, including a higher prevalence of depression and unplanned weight loss, which were hastened by the implementation of nationwide visitor and communal activity restrictions. 

Study authors suggest that the COVID-related policies likely contributed to residents’ decline and that policymakers should look beyond case data when trying to capture the pandemic’s full impact on the group. 

The research team for the analysis used Minimum Data Set assessments from Connecticut nursing home residents between 2017 and 2019, and compared that to resident data during the beginning of the coronavirus crisis from March to July 2020. 

Findings showed that the number of all long-term nursing home residents — not just those with COVID-19 — with any depressive symptoms increased by about 6 percentage points after the pandemic’s onset. The share of residents with unplanned substantial weight loss also increased by 6 percentage points. Incidents of incontinence increased by 4 percentage points.  

“The pattern of the results suggests that isolation, potentially stemming from general trends of reductions in direct care provision or from policies that restricted visitors, contributes to the reductions in resident well-being. We found that even residents who did not contract COVID-19 experienced some physical deterioration, indicating that even those who did not get sick were affected,” Mathematica researchers Michael Levere, Ph.D., Patricia Rowan, and Andrea Wysocki, Ph.D. wrote. 

Investigators also concluded “future policy changes to limit the spread of COVID-19 or other infectious diseases should consider any additional costs beyond the direct effects of morbidity and mortality.” 

“[The] 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,” they wrote.