Impact of visitation restrictions on the mental health of family caregivers during the COVID-19 pandemic: A mixed methods study.

AIM: To examine the mental health conditions of family caregivers residing away from their loved ones who experienced visitation restrictions during the coronavirus disease 2019 pandemic. DESIGN: A mixed-methods design applying the Kessler Scale-10 for the quantitative measurement of psychological distress and an open-ended question for qualitative analysis. METHODS: The participants were recruited from care facilities between February and September 2021. This cross-sectional study included 197 family caregivers who were utilizing formal residential care services for their loved ones. Using thematic analyses, open-ended responses regarding the impact of visitation restrictions were coded. These themes were then examined to determine thematic patterns across caregiver characteristics. RESULTS: Thirteen themes were identified regarding the impact of visitation restrictions. Many participants reported primary harmful effects as follows: 'inability to confirm the type of care and lifestyle assistance provided to an older relative' and 'difficulty communicating with an older relative because of the inability to converse face-to-face'. Younger age, being employed, poor sleep, poor relationship quality with the care recipient and experiencing harmful effects from the visitation restrictions were associated with psychological distress. CONCLUSION: Our findings suggest that to maintain positive mental health after a care transition, it is important for family caregivers to take part in the care of their loved ones and ensure information sharing between the care recipient's family and institution. IMPACT: These findings suggest that both residents and family caregivers living outside facilities may feel distressed due to separation. Therefore, institutional care staff needs to consider how to adjust facility procedures or communication with family caregivers. PATIENT OR PUBLIC CONTRIBUTION: The comments obtained from the participants in this survey helped to shape the study design and are expected to contribute to the further development of quality facility care.

Predictive Factors of Negative Spillover From Caregiving to Employment Among Japanese Family Caregivers With Older Relatives in a Care Facility.

This cross-sectional study included 211 employed family caregivers with older relatives living in care facilities in Japan. Using multiple linear regression analysis, we examined the caregiving context after institutionalization of an older family member. Specifically, we examined predictors of negative spillover from caregiving to employment among family caregivers. The outcome was the extent of negative spillover. Primary predictors included caregiver characteristics and postinstitutionalization caregiving contexts such as caregiving tasks and dissatisfaction with institutional care services. Among all caregivers, 134 (63.5%) were female, and approximately half of all caregivers reported satisfaction with institutional care services. We found that dissatisfaction with institutional care services and being a female each had a main effect on greater negative spillover. However, they did not have any interacting effect on negative spillover after the institutionalization. Negative spillover did not terminate when older family members were institutionalized. Higher satisfaction with institutional care may reduce negative spillover.