University of Hertfordshire

From the same journal

By the same authors

COVID in Care Homes – Difficulties and Dilemmas in Healthcare Delivery

Research output: Contribution to journalEditorial

  • Adam Gordon
  • Claire Goodman
  • Wilco Actherberg
  • Robert O Barker
  • Eileen Burns
  • Barbara Hanratty
  • Finbarr Martin
  • Julienne Meyer
  • Jos Schols
  • Karen Spilsbury
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Original languageEnglish
Article numberafaa113
JournalAge and Ageing
Early online date13 May 2020
Publication statusE-pub ahead of print - 13 May 2020


COVID-19 has caused excess mortality in care homes 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. The optimum frequency of blanket testing has not been established. Given false negative rates for swab tests of up to 51%, carers should have a low threshold for isolating residents for a full 14 days. Isolation causes psychological and physical harm to residents and this must be balanced against the protection offered. Both blanket testing and widespread isolation challenge safe staffing in care homes and additional staffing may be necessary to support care homes with additional staff. PPE supply for care homes during the pandemic has been insufficiently responsive – when an outbreak occurs, care homes need access to additional supplies within hours. Advance care planning is important in the response to COVID-19 in care homes. It must be individualised and, although care homes staff must always play a role, healthcare professionals will often have to lead. Senior support is particularly important in remote advance care planning, required when residents or relatives are shielding. COVID-19 has provided impetus for augmented care in care homes, including oxygen and subcutaneous fluids – it is important to invest in frameworks and competencies if such care is to be sustainable. COVID-19 has seen care home mortality rates increase up to tenfold in some instances. This has a psychological impact upon staff and provision of psychological support is essential.


© 2020 Oxford University Press. This is a pre-copyedited, author-produced PDF of an article accepted for publication in Age and Ageing following peer review. The version of record [Adam L Gordon, Claire Goodman, Wilco Achterberg, Robert O Barker, Eileen Burns, Barbara Hanratty, Finbarr C Martin, Julienne Meyer, Desmond O’Neill, Jos Schols, Karen Spilsbury, Commentary: COVID in Care Homes—Challenges and Dilemmas in Healthcare Delivery, Age and Ageing, afaa113] is available online at:

ID: 21418012