ENRICHEnabling Research in Care Homes
Keeping in touch with your care home collaborators through Covid-19
Nisha joined Aston University in September 2016, having spent the previous four years as a Clinical Audiologist, and developing research skills within a medical college.
I have a strong passion for the understanding and enhancement of patient outcomes, from service provision to long term clinical management. This is reflected in my research interests to design interventions that will have direct benefit to patients with concurrent health conditions such as hearing loss and cognitive decline.
I am currently undertaking a part-time PhD to investigate the impact of hearing loss and dementia on social isolation in older adults. In addition, I maintain my clinical status by seeing patients part-time for adult aural rehabilitation and tinnitus management.
In this blog I share my thoughts on how Covid-19 has impacted my research project and the importance of keeping in touch with my care home collaborators at this time.
It’s February 2020 and all is blissful within my PhD bubble. I have been collecting data in two care homes in the West Midlands over the past month, observing and interviewing residents, staff, and visitors. The purpose of my research is to explore the role of social isolation in older adults living with hearing loss and dementia in residential care. Gathering data at these homes has been truly fascinating. I became immersed in the care home environment, and felt an attachment to the residents and staff. From knowing what time morning coffee was served, to participating in Animal Bingo, I had a real sense of the day-to-day lived experience in a care home.
Then came mid-March 2020. I was due to start collecting data at the third care home the following week but there was a growing realisation that this was not going to happen. Very much like the current situation, you could not turn on the television or open social media without seeing a story related to Covid-19 and the imminent lockdown. After half a day of wallowing, imagining all the worse-case scenarios related to my PhD, and generally feeling low, I remembered what I set out to achieve in this PhD. An end to social isolation within care homes. Or at least the beginning to an end.
So I sat with my supervisor and we planned out the next steps. On one hand we felt very fortunate that half of the data had been gathered so I could at least begin analysing. On the other hand, there were so many uncertainties about when I could get back and questions rising such as:
- Would this have an impact on my final deadline?
- Would this have an impact on my publishing plans?
- What is happening to all those older adults residing in care who are no longer allowed any visitors?
This last question hit me the hardest. I still cannot stop thinking about the people who have taken part in my study. They have had a profound impact on my life. Some spoke of such telling loneliness, others reminisced about their working lives and had drawn me in completely. Whilst it’s true that not all care home residents have frequent visitors, the comings and goings of people in and out of the home (including me) create a social buzz that interests the residents. For those living with dementia, the understanding of this pandemic is like no other. Is anyone taking the time and effort to explain the current state of affairs? Are staff spending more or less time with residents because of it?
This research has increased my admiration for care home staff, not only because of their continued roles in COVID-19, but because of the demanding job requirements in return for little financial reimbursement. Having said that, my sadness for residents has also grown. This sadness makes me more determined than ever to complete my data gathering and start plans for the intervention part of my intended research.
So when is a good time to get back in touch with the care homes? Well I already have. I did so before the official rules of staying indoors were enforced. Fortunately I have developed a very good relationship with the care home managers through the Patient and Public Involvement work I carried out, and ongoing email/telephone contact. I therefore had no hesitation in picking up the phone and being honest with them. The summary of the conversation was that I am very eager to get back in to continue the research but the safety of the residents and staff has to come first. They told me they will contact me as soon as they allow visitors back into the home. In the meantime I contemplated telephone/video interviews with staff members and even residents where appropriate. However, this wouldn’t be a responsible use of staff time and would place extra burden on their workload so this was not pursued. I have asked if I can support the care home in any way but without allowing any new persons into the home, there is limited support I can provide.
For now, I will continue with analysing my existing data and adequately preparing for re-commencement of data collection. I of course am not the only researcher in this position, and do strongly believe the care home research landscape will change as a result. On a crude level, the pool of potential participants within a care home environment will certainly lessen should Covid-19 get the better of us. On a deeper level, the priorities of research conducted in care homes may shift towards the social impact of a pandemic on a vulnerable group in society.
But for now, if you haven’t already, please get in touch with your care home contacts. Empathise with their current situation, offer your support, and let them know you’ll be ready to start up again as soon as they are.