A Review of the Medical Ethics Surrounding COVID-19 Lockdowns in Personal Care Homes and the Impacts on Those Living with Dementia
DOI:
https://doi.org/10.5203/jcanpa.v2i6.880Keywords:
COVID-19, Dementia, Personal Care Homes, Pandemics, Mental Health, Lockdowns, Older AdultsAbstract
The impacts of the COVID-19 pandemic on personal care homes has played out daily in the media headlines across the country. Although Manitoba seemed to avoid the worst of this early on in the pandemic, recently the province has seen a disturbing surge in overall case levels (Government of Manitoba, 2020). This rise in COVID-19 cases in Manitoba has forced personal care homes to once again lockdown and restrict not only all visitor access but also limit social interaction among the residents themselves. When looking at this situation broadly, locking down all personal care homes seems to be like the obvious decision to make. Residents in personal care homes represent one of our most vulnerable populations and the virus has been shown to spread quickly with serious medical impacts to this group. Significant virus spread in these personal care homes could easily overwhelm our healthcare system and lead to unnecessary deaths. Clearly the decision to lockdown the personal care homes can be readily justified as a means of protecting not only this vulnerable group but also supporting the larger community who either provide healthcare or are requiring healthcare for other non-COVID-19 related reasons. While the above is true, the decision to do this is far from being straight forward. The impacts of these lockdowns are far reaching and go way beyond just the containment of the virus. There is a fine balance between maintaining the emotional and mental well-being of an individual living with dementia and managing the physical health of the greater population.
References
Alzheimer Society of Canada. (2020). Dementia numbers in Canada. Retrieved from https://alzheimer.ca/en/about-dementia/what-dementia/dementia-numbers-canada?gclid=Cj0KCQiAkuP9BRCkARIsAKGLE8VCVXts8vkFj-0aY22MGVsEbx0Re9x2GSdw8yVGMg5JjWJefGZ_I5saAr34EALw_wcB
Ballweg, R., Brown, D., Vetrosky, D., & Ritsema, T. (2018). Physician assistant: a guide to clinical practice (6th ed.). Elsevier.
Beauchamp, T., & Childress, J. (2013). Principles of biomedical ethics. New York: Oxford University Press.
Bennett-Woods, D. (2017). Concept 42: Ethics. In J. Giddens, Concepts for nursing practice (2nd ed., pp. 405-412). St. Louis: Mosby Elsevier.
Cagnin, D., Di Lorenzo, R., Marra, C., Bonnani, L., Cupidi, C., Lagana, V.,…Bruni, A.C. (2020). Behavioral and psychological effects of coronavirus disease-19 quarantine in patients with dementia. Frontiers in Psychiatry, 11, 1–15. https://doi.org/10.3389/fpsyt.2020.578015
Canadian Association of Physician Assistants. (2020). CAPA Code of Ethics. Retrieved from https://capa-acam.ca/about-pas/code-of-ethics-of-the-physician-assistant-profession/#:~:text=It%20is%20based%20on%20the,for%20persons%2C%20justice%20and%20accountability.
Davidson, P.M., & Szanton, S.L. (2020). Nursing homes and COVID‐19: We can and should do better. Journal of Clinical Nursing, 29(15-16), 2758–2759. https://doi.org/10.1111/jocn.15297
Government of Manitoba. (2020). COVID-19 Updates. Retrieved from https://www.gov.mb.ca/covid19/updates/index.html
Holwerda, D., Deeg, D., Beekman, A., Tilburg, T., Stek, M., Jonker, C., & Schoevers, R. (2014). Feelings of loneliness, but not social isolation, predict dementia onset: results from the Amsterdam Study of the Elderly (AMSTEL). Journal of Neurology, Neurosurgery and Psychiatry, 85(2), 135–142. https://doi.org/10.1136/jnnp-2012-302755
Iaboni, C., Cockburn, A., Marcil, M., Rodrigues, K., Marshall, C., Garcia, M.A.,…Flint, A.J. (2020). Achieving Safe, Effective, and Compassionate Quarantine or Isolation of Older Adults With Dementia in Nursing Homes. The American Journal of Geriatric Psychiatry, 28(8), 835–838. https://doi.org/10.1016/j.jagp.2020.04.025
Malheiro, F., Figueriedo, A., Magalhaes, J., Teixeria, P., Moita, I., Moutinho.,…Ferreira, E. (2020). Effectiveness of contact tracing and quarantine on reducing COVID-19 transmission: a retrospective cohort study. Public Health (London), 189, 54–59. https://doi.org/10.1016/j.puhe.2020.09.012
Manca, D., De Marco, M., & Venneri, A. (2020). The Impact of COVID-19 Infection and Enforced Prolonged Social Isolation on Neuropsychiatric Symptoms in Older Adults With and Without Dementia: A Review. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.585540
Muntsant-Soria, A., & Gimenez-Llort, L. (2020). 419 - Brain atrophy asymmetry in dementia is worsened by social isolation: A translational neuroscience approach in times of coronavirus pandemic (COVID-19). International Psychogeriatrics, 32(S1), 135–135. https://doi.org/10.1017/S1041610220002720
Oberle, K., & Bouchal, S. R. (2009). Ethics in Canadian nursing practice: Navigating the journey. Toronto, ON: Pearson Prentice Hall.
Pellegrino, E., & Thomasma, D. (1988). For the patient’s good: The restoration of beneficence in health care. Oxford: Oxford University Press.
Schwartz, D. (2018). Enteral Nutrition and Dementia Integrating Ethics. Nutrition in Clinical Practice, 33(3), 377–387. https://doi.org/10.1002/ncp.10085
Statistics Canada. (2020). Population estimates quarterly. Retrieved from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1710000901
Wilkins, J.M. (2017). Dementia, Decision Making, and Quality of Life. AMA Journal of Ethics, 19(7), 637–639. https://doi.org/10.1001/journalofethics.2017.19.7.fred1-1707
Xiang, L., Ho Lam Lai, P., Bao, L., Sun, Y., Chen, J., Dunkle, R., & Maust, D. (2020). Dual Trajectories of Social Isolation and Dementia in Older Adults: A Population-Based Longitudinal Study. Journal of Aging and Health, 89826432095369–898264320953693. https://doi.org/10.1177/0898264320953693
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