Nursing home family involvement and activities of daily living during COVID-19: A secondary cross-sectional analysis of electronic health record data.

PURPOSE: Nursing home residents' family involvement changed during COVID-19. We sought to understand whether there was an association between resident family involvement and activities of daily living (ADL) levels. This cross-sectional secondary analysis used electronic health record (EHR) data to compare quarterly resident ADL outcomes from the year before COVID-19 and the first year during COVID-19 among residents who had evidence of family involvement prior to COVID-19. Both ADLs and family involvement serve as key indicators of overall resident well-being.

METHODS

Using retrospective secondary cross-sectional analysis of EHR data, we aimed to understand whether resident ADL levels changed, what types of family involvement were present, and whether ADLs were associated with levels of family involvement.

RESULTS

Our data showed significant ADL differences in mean transfer score and a negative correlation between instrumental support and eating. There was a significant increase in family decision-making support during COVID-19, while intrafamily conflict and emotional support decreased.

IMPLICATIONS: These findings have policy and practice implications related to understanding family-wide nursing home experiences. An increased focus on family involvement factors may improve the outcomes for nursing home residents and their families.