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COVID-19 in Long-term Care Facilities – Challenges and Ressources in German Nursing Homes and Home Care Services

Project status
Karin Wolf-Osterman
Institution web page
Host institution
University of Bremen, Faculty 11 Human and Health Sciences, Institute for Public Health and Nursing Research
Team members
Karin Wolf-Ostermann Heinz Rothgang Dominik Domhoff Anna Carina-Friedrich Viktoria Hoel Franziska Heinze Benedikt Preuß Annika Schmidt Kathrin Seibert Claudia Stolle
Project Summary

In a multi-phase study, cross-sectional as well as longitudinal observational data on challenges and ressources of long-term care facilities in Germany during the COVID-19 pandemic are collected through an online-survey of directors of nursing and nurse managers. Since april 2020, two phases of data collection have been conducted. Responses for t1 (april to may 2020) include 824 nursing homes, 701 home care services and 96 daycare facilities. Responses for t2 (january to february 2021) inculde 385 nursing homes, 442 home care services and 80 daycare facilities. Next to descriptive statistics on prevalence of COVID-19 among residents and nursing staff, results include numbers on changes in the utilization of nursing care services during the pandemic, on availability of protective gear, on implementation of infection control guidelines and on the use of information and communication technologies (ICT) to support social participation of residents and orgnaization of care processes.

Outputs / Expected Outputs

Results of this study contribute to the knowledge base on the specific challenges and needs of long-term care facilities, their residents and staff during the COVID-19 pandemic. Furthermore, the results can be used to initiate support by political actors and inform political decision making as well as national preparations for future comparable events. So far, results for t1 have been published differentiated for nursing homes and home care services/daycare in different journals. In addition, results on ICT use as well as an article on professional, scientific and health-servives related consequences are being published as book sections. Data from t2 is currently being analyzed.

Project website


Care in times of Corona: Results of a cross-sectional study in German home care services (Article in German)
Background: People in need of care are particularly affected by the COVID-19 pandemic due to their age and previous illnesses. At the same time, a large number of daily contacts between nursing staff and those in need of care increase the risk of transmission of the disease. Aim: The study aims to illustrate (I) to what extent home care services and semi-residential care facilities are affected by COVID-19, (II) human and material resources, (III) the care situation of those in need of care and (IV) the organizational handling of the situation and outline support requests to politicians. Methods: More than 12,000 home-care nursing services and semi-residential care facilities were invited to participate in an online survey with quantitative and qualitative elements, 701 nursing services (response rate 7,3 %) and 96 semi-residential facilities (response rate 3,5 %) took part. Results: Almost a third (30,1 %, 189 / 627) of the nursing services surveyed are affected by confirmed or suspected cases of COVID-19 among clients. About half of the services report a reduced use of SGB V (47,6 %, 288 / 605) or SGB XI services (59,7 %, 375 / 628). Two thirds of the semi-residential facilities (65,6 %, 63 / 96) say they are currently closed due to the pandemic. Likewise, half of the nursing services (45,8 %, 253 / 552) reported that care with reduced use of services was at risk / unstable or even not ensured. Conclusions: The results show that the situation of care-dependent people served by home-care services in the present pandemic – and also with a view to a possible second wave – should receive increased attention particularly with regard to unstable / risky care arrangements.
Long-term care during the Corona pandemic – Main results from a nationwide online survey in nursing homes in Germany (Article in German)
Background: As a highly vulnerable group, people in need of long-term care are particularly affected by the COVID-19 pandemic. Due to their care-dependency, measures of social distancing can only be carried out to a very limited extent. In ad-dition, the social and health consequences of reduced contacts are particularly high for nursing home residents. Aim: The study aims to describe the extent to which nursing homes are affected, the human and material resources of nursing homes, the organizational handling of the situation, and their requests for public support. Methods: More than 7,000 nursing homes were invited to participate in an online survey with quantitative and qualitative elements. Data analysis applies descriptive sta tistics. Results: 824 nursing homes participated in the survey. One in five nursing homes has at least one confirmed case of SARS-CoV-2 among its residents and / or employees. The initial lack of protective equipment has now decreased, but the facilities still have to cope with additional corona-related care needs with reduced staff. Nursing homes have banned contacts between residents and relative to an extent that now has to be reduced again. Nursing homes demand the provision and ex-ternal financing of protective equipment as well as the systematic and regular testing of nursing staff and the provision of uniform guidelines for action throughout Germany. Conclusions: As about half of all deceased people with COVID-19 have been living in nursing homes, the support of nursing homes in their attempt to restrict the pandemic requires highest attention.
Care Homes and COVID-19: Results of an Online Survey in Germany (Article in English)
About half of all COVID-19 deaths in Germany are of care home residents. This is similar to findings from other Western countries. Like in those countries, care homes are the most important hotspot for COVID-19 deaths. It is likely that the absolute number of deceased care home residents in Germany is lower than in other countries because COVID-19-related mortality is generally lower than in many other countries, not so much because there is better protection in care homes than elsewhere. 80 percent of all care homes do not have even one SARS-CoV-2 case among their residents. Of those that have cases, one third have eleven cases or more. Once the virus enters thefacility, it seems to be difficult to prevent further spreading. At the beginning of the pandemic, care homes suffered from severe shortages of personalprotective equipment and surface disinfectants. Since then, the situation has improvedconsiderably but some shortages still persist. In order to protect their residents, care homes restricted all physical contact to persons outside the care home. Consequently, this restriction in itself has endangered the mental health of residents. These measures should be replaced by provisions that allow contactwithout significantly increasing the risk of infection. When the survey was conducted, residents and employees were only tested if they showedsymptoms. As the results only return a few days later, most of the infections had happened by then. In order to restrict the spreading of the virus, it is therefore important to introduceregular serial testing of all care home employees, all visitors and those residents that move in or return from hospital.


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COVID-19 in Long-term Care Facilities – Challenges and Ressources in German Nursing Homes and Home Care Services