Families are restricted from visiting hospitalized loved ones. What does this mean for at-home care?

Michigan News 8/20/20

While necessary to help prevent the spread of COVID-19, an unintended side effect of barring hospital visitors during the pandemic has been families’ loss of learning how to care for ill or injured loved ones at their bedside.

In collaboration with a large team of researchers, doctors, nurses and health care providers, the University of Michigan’s Richard Gonzalez is studying how family caregivers are impacted by losing this bedside education. The study is called HEART.

Gonzalez is the center director of the Research Center for Group Dynamics at the Institute for Social Research and the Amos N. Tversky Professor of Psychology and Statistics and professor of marketing, and integrative systems and design.

Hospitals have restricted family members from visiting their loved ones. What effect does this have on patient outcomes?

Under normal circumstances, when families are allowed to be at the bedside, they are able to watch how different professional care staff come in, whether it’s nursing staff or respiratory care or the physician. They get to see how to help someone sit up in the bed, how to help them get up to go to the bathroom, and how to determine if they’re experiencing some discomfort.

Being by the bedside also allows the family to acclimatize to the patient’s changing condition, so when the patient comes home, the family can better manage care. When the patient comes home, if the family wasn’t at the bedside, they might not know which symptoms are serious, which ones are expected or which ones are signals that something else is going on.

There are also advocacy roles that families play when they’re at the bedside. They learn effective strategies to get help in the hospital, so when the patient comes home, the families can then apply that learning, whether it’s on a web-based health care portal or on a phone call.

The pandemic has also changed the discharge process. There used to be an elaborate discharge procedure where the family as well as the patient would sit down with the discharge nurse. These discussions might last an hour and a half, and during these discussions, patients and caregivers are given all kinds of information and the ability to ask questions. Now under COVID, these conversations have been altered, in some cases, dramatically. For some patients, this might mean receiving one sheet of paper with a phone number to call if they have any questions. The pandemic has undermined the traditional discharge process. Without the right resources, patients might be more likely to end up back in the hospital.

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