Exercise instructors and equipment recommended to tackle ‘deconditioning’ among care home residents

Care homes should consider employing exercise instructors and purchasing gym equipment to help rehabilitate residents whose health deteriorated during the coronavirus pandemic, a report has said.

Residents needed ongoing rehabilitation to help them recover from long periods of inactivity and reduced social interaction during and beyond lockdown, according to research from the National Care Forum (NCF) and the University of Leeds.

Older people with confirmed or suspected coronavirus experienced prolonged periods of isolation as they quarantined, while visits were limited from family and friends during the lockdown.

Those who experienced severe symptoms were bed-bound and experienced muscle wastage and physical deterioration, known as “deconditioning”, slowing their recovery.

But the report noted that access to therapy and rehabilitation services for care home residents was “limited and variable” and that more funding and support was needed.

The report comprised interviews with 35 frontline care home and NHS staff in June and July, and 11 senior care home managers in September, examining lessons learned so far during the pandemic.

It recommended that care homes employ exercise instructors who can train care staff and help them access online exercise programmes for older people.

Staff should take “creative approaches” to enhance levels of physical activity, motivate residents to maintain or increase their exercise, and encourage them to exercise in their room when quarantined.

Care homes should also consider buying equipment such as portable exercise bikes designed for older users.

The report said: “Staff had learnt that the post-virus recovery for individuals was unpredictable and varied. Providing rehabilitation for older people was therefore perceived as essential.

“Concerns were raised about the limited access to therapy and rehabilitation services for care home residents pre-pandemic. This needed to be addressed urgently to meet increased demand following Covid-19.

“While acknowledging this required extra resources, participants across care home and NHS settings considered it essential for the older population to be offered ongoing support for recovery post-virus and suggested this required urgent consideration by commissioners.”

Government funds help cover the cost of recovery, rehabilitation and reablement care for up to six weeks following a resident’s discharge from hospital.

Providing longer-term rehabilitation services for all residents, not just those who had recently left hospital, would require increased professional input, commissioning and funding, the report concluded.

But participants also expressed concerns about external health care professionals visiting care homes without testing, and mentioned wider testing problems.

In September, care home managers highlighted “ongoing difficulties” in accessing regular tests, the timeliness of results, results going missing and questions over accuracy.

One care home chief nursing officer told researchers: “This is an opportunity to now be proactive, in particular with the frequency of testing … Testing is hit and miss – not as promised. There is such a delay with obtaining the results.”

Liz Jones, NCF policy director, said: “Many of the suggestions in this research involve actions that can be grasped by the sector; however there are levers and actions needed that are beyond the control of the sector and need support and action from government.

“These include resolving the ongoing testing and personal protective equipment (PPE) supply uncertainties; working in genuine partnership with the sector and putting the individual needs of older people at the heart of policymaking.”

A Department of Health and Social Care spokesman said: “We recognise that Covid-19 has led to significant pressures on the social care sector and we are doing everything we can to support it.

“As part of our pandemic response we have given £3.7 billion to councils in England so they can address pressures on local services caused by the pandemic, including in adult social care, on top of a £1.1 billion infection control Fund and free PPE supply for care homes.

“We know there is a need for a long-term solution for social care and are looking at a range of proposals as part of our commitment to bringing forward a plan that puts the sector on a sustainable footing for the future.”

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