The Adverse Effects of the COVID-19 Pandemic on Nursing Home Resident Well-Being

Objective

Quantify the effects of the COVID-19 pandemic on nursing home resident well-being.

Design

Quantitative analysis of resident-level assessment data

Setting and Participants

Long-stay residents living in Connecticut nursing homes

Methods

We used Minimum Data Set assessments to measure nursing home resident outcomes observed in each week between March and July 2020 for long-stay residents (e.g., those in the nursing home for at least 100 days) who lived in a nursing home at the beginning of the pandemic. We compared outcomes to those observed at the beginning of the pandemic, controlling for both resident characteristics and patterns for outcomes observed in 2017 to 2019.

Results

We found that nursing home resident outcomes worsened on a broad array of measures. The prevalence of depressive symptoms increased by 6 percentage points relative to before the pandemic in the beginning of March—representing a 15 percent increase. The share of residents with unplanned substantial weight loss also increased by 6 percentage points relative to the beginning of March—representing a 150 percent increase. We also found significant increases in episodes of incontinence (4 percentage points) and significant reductions in cognitive functioning. Our findings suggest that loneliness and isolation play an important role. Though unplanned substantial weight loss was greatest for those who contracted COVID-19 (about 10 percent of residents observed in each week), residents who did not contract COVID-19 also physically deteriorated (about 7.5 percent of residents in each week).

Conclusions and Implications

These analyses show that the pandemic had substantial impacts on nursing home residents beyond what can be quantified by cases and deaths, adversely affecting the physical and emotional well-being of residents. Future policy changes to limit the spread of COVID-19 or other infectious disease outbreaks should consider any additional costs beyond the direct effects of morbidity and mortality due to COVID-19.