Commentary: COVID in care homes—challenges and dilemmas in healthcare delivery

Adam Gordon , Claire Goodman, Wilco Actherberg, Robert O Barker , Eileen Burns , Barbara Hanratty , Finbarr Martin , Julienne Meyer, Jos Schols, Karen Spilsbury

Research output: Contribution to journalEditorialpeer-review

49 Citations (Scopus)
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The COVID-19 pandemic has disproportionately affected care home residents internationally, with 19–72% of COVID-19 deaths occurring in care homes. COVID-19 presents atypically in care home residents and up to 56% of residents may test positive whilst pre-symptomatic. In this article, we provide a commentary on challenges and dilemmas identified in the response to COVID-19 for care homes and their residents. We highlight the low sensitivity of polymerase chain reaction testing and the difficulties this poses for blanket screening and isolation of residents. We discuss quarantine of residents and the potential harms associated with this. Personal protective equipment supply for care homes during the pandemic has been suboptimal and we suggest that better integration of procurement and supply is required. Advance care planning has been challenged by the pandemic and there is a need to for healthcare staff to provide support to care homes with this. Finally, we discuss measures to implement augmented care in care homes, including treatment with oxygen and subcutaneous fluids, and the frameworks which will be required if these are to be sustainable. All of these challenges must be met by healthcare, social care and government agencies if care home residents and staff are to be physically and psychologically supported during this time of crisis for care homes.
Original languageEnglish
Article numberafaa113
Pages (from-to)701-705
Number of pages5
JournalAge and Ageing
Issue number5
Early online date13 May 2020
Publication statusPublished - 1 Sept 2020


  • COVID-19
  • Nursing homes
  • Older people
  • Pandemic
  • Long-Term Care/methods
  • COVID-19 Testing
  • Humans
  • Coronavirus Infections/diagnosis
  • Pandemics/prevention & control
  • Betacoronavirus/isolation & purification
  • Health Services Needs and Demand
  • Homes for the Aged/organization & administration
  • SARS-CoV-2
  • Clinical Laboratory Techniques/methods
  • Pneumonia, Viral/epidemiology
  • Quarantine/organization & administration
  • Aged
  • Nursing Homes/organization & administration
  • Delivery of Health Care/organization & administration


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