Experiences of Triage and Social Distancing in Residential Nursing Homes During the Covid-19 Epidemic: A Group Interview with Relatives

In order to protect older adults and their rights, social distancing, isolation, and quarantine were the key measures put in place to slow down the spread of Covid-19. Yet several studies have highlighted the importance of contact and emotional support from families for residents of nursing homes. The purpose of our research was to find out how the relatives of nursing home residents perceived and understood the residents’ social isolation, health and social care, and access to health care services during the pandemic. A qualitative descriptive research paradigm with a social constructivist approach was used. A purposive sample of relatives was invited to participate, with 25 out of 34 of those who were invited deciding to participate in the study. The method of formal natural group interviews was used to conduct a single group interview. The interview guide comprised five open-ended questions with prompts. Three experts facilitated the group interview, which was recorded. Transcripts were analysed using qualitative content analysis and thematic synthesis. Ethics approval was obtained by the lead investigator’s home institution. Thematic synthesis yielded two main themes: “The unethical triage of residents’ access to health care in hospitals” and “The paternalism of the authorities and health care professions towards residents and their relatives”. Overall, the approaches of those in charge of nursing homes were perceived as paternalistic and detrimental to the health and quality of life of nursing home residents during the pandemic. There was a lack of communication between the facilities and residents’ relatives. The findings support those reached by other international studies on the issues experienced by long-term care facilities for older adults during the pandemic. The paternalism towards residents and their relatives manifested itself in ignoring the supportive role of relatives, the restriction of movement and contact, and triage without knowledge of the residents and their relatives. The findings highlight the need for clear guidelines and evidence-based protocols on how to implement measures in nursing homes during an epidemic and mitigate the negative consequences that a pandemic can bring.