Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
J Am Med Dir Assoc. 2023 Jun;24(6):816-820. doi: 10.1016/j.jamda.2023.02.014. Epub 2023 Mar 17.
Characterize the implementation, benefits, and challenges of an Essential Family Caregiver (EFC) program, a novel policy implemented in long-term care (LTC) settings during the COVID-19 pandemic in Indiana. Characterize LTC administrator perspectives on family/caregiver involvement in the LTC setting.
Semi-structured qualitative interviews.
Administrators from 4 Indiana LTC facilities.
In this qualitative study, a convenience sample of 4 LTC administrators was recruited. Each participant completed 1 interview during January to May 2021. Following transcription, a thematic analysis approach with 2 cycles of qualitative coding identified relevant themes.
Four LTC administrators participated, representing both urban and rural nonprofit nursing homes. Participants spoke positively of the program despite implementation challenges including perceived infection risk, policy interpretation, and logistical challenges. The psychological impact of isolation for nursing home residents was emphasized as a critical consideration alongside physical health concerns. LTC administrators desired to support resident well-being while maintaining good standing with regulatory agencies.
Based on a limited sample, Indiana's EFC policy was viewed favorably by LTC administrators as a tool to balance resident and family psychosocial needs with infection-related health risks. LTC administrators desired a collaborative approach from regulators as they worked to implement a novel policy. Consistent with participant desire for broader caregiver access to residents, more recent policymaking has reflected growing recognition of the critical role of family members not only as companions but also as care providers, even in a structured care environment.
描述在印第安纳州 COVID-19 大流行期间在长期护理 (LTC) 环境中实施的新型政策——基本家庭护理员 (EFC) 计划的实施、效益和挑战。描述 LTC 管理者对家庭/护理员在 LTC 环境中参与的看法。
半结构式定性访谈。
印第安纳州 4 家 LTC 设施的管理人员。
在这项定性研究中，招募了 4 名 LTC 管理人员进行方便抽样。每位参与者在 2021 年 1 月至 5 月期间完成了 1 次访谈。转录后，采用两轮定性编码的主题分析方法确定了相关主题。
4 名 LTC 管理人员参与了研究，他们代表了城市和农村非营利性养老院。尽管存在实施挑战，包括感知的感染风险、政策解释和后勤挑战，但参与者对该计划给予了积极评价。隔离对养老院居民的心理影响被强调为与身体健康问题同等重要的关键考虑因素。LTC 管理人员希望在维护与监管机构良好关系的同时，支持居民的幸福感。
基于有限的样本，印第安纳州的 EFC 政策受到 LTC 管理人员的好评，认为这是平衡居民和家庭心理社会需求与感染相关健康风险的一种工具。LTC 管理人员希望监管机构采取协作的方法，因为他们正在努力实施一项新政策。与参与者希望更广泛的护理人员能够接触到居民的愿望一致，最近的决策制定反映出越来越认识到家庭成员的关键作用，他们不仅是陪伴者，而且是护理提供者，即使在结构化的护理环境中也是如此。
