{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T02:57:02Z","timestamp":1774580222145,"version":"3.50.1"},"reference-count":46,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T00:00:00Z","timestamp":1641254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organisation for Health Research and Development","doi-asserted-by":"publisher","award":["50-56300-98-533"],"award-info":[{"award-number":["50-56300-98-533"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Union\u2019s Horizon 2020 research and innovation programme under the Marie Sk\u0142odowska-Curie (Leading Fellow)","award":["707404"],"award-info":[{"award-number":["707404"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Social distancing measures imposed because of the COVID-19 pandemic presented challenges to the health and wellbeing of people with dementia, family carers, and healthcare professionals. This study investigated the impact of these measures on all involved in the care for people with dementia. For this qualitative study, 20 family carers and 20 healthcare professionals from home care and long-term care (LTC) participated in a semi-structured interview. Interviews were analysed using an inductive thematic analysis approach. For people with dementia, the social distancing measures resulted in a deterioration of physical health. The impact on their emotional state and behaviour depended on the stage of dementia. Family carers experienced difficulty coping with visiting restrictions, anxiety regarding safety, and changes in carer burden. Healthcare professionals had an increased workload, and felt guilty about adhering to restrictive measures. Differences between home care and LTC were reported (i.e., societal initiatives focussed on LTC, scarcity of activities for community-dwelling people with dementia, use of personal protective equipment more intrusive for home care). The social distancing measures had a negative impact on persons with dementia, their family carers, and healthcare professionals. More attention is needed for community-dwelling people with dementia and family carers in times of social isolation.<\/jats:p>","DOI":"10.3390\/ijerph19010519","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T03:41:32Z","timestamp":1641440492000},"page":"519","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["The Impact of Social Distancing Due to the COVID-19 Pandemic on People with Dementia, Family Carers and Healthcare Professionals: A Qualitative Study"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7836-431X","authenticated-orcid":false,"given":"Hanneke J. A.","family":"Smaling","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bram","family":"Tilburgs","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Radboud University Medical Center, Radboud Institute for Health Science, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9227-7135","authenticated-orcid":false,"given":"Wilco P.","family":"Achterberg","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6796-6246","authenticated-orcid":false,"given":"Mandy","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,4]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention (2021, April 14). Provisional COVID-19 Death Counts, Available online: https:\/\/data.cdc.gov\/NCHS\/Provisional-COVID-19-Death-Counts-by-Sex-Age-and-S\/9bhg-hcku."},{"key":"ref_2","unstructured":"Comas-Herrera, A., Zalaka\u00edn, J., Lemmon, E., Henderson, D., Litwin, C., Hsu, A.T., Schmidt, A.E., Arling, G., and Fern\u00e1ndez, J.-L. (2020). Mortality Associated with COVID-19 in Care Homes: International Evidence, LTCcovid. Org, International Long-Term Care Policy Network."},{"key":"ref_3","first-page":"900","article-title":"Allowing visitors back in the nursing home during the COVID-19 crisis: A Dutch national study into first experiences and impact on well-being","volume":"21","author":"Verbeek","year":"2020","journal-title":"JAMDA"},{"key":"ref_4","unstructured":"Government of the Netherlands [in Dutch: Rijksoverheid] (2021, July 06). Coronavirus Timeline [in Dutch: Coronavirus tijdlijn], Available online: https:\/\/www.rijksoverheid.nl\/onderwerpen\/coronavirus-tijdlijn."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1017\/S1041610220001040","article-title":"The effects of the COVID-19 virus on mental healthcare for older people in The Netherlands","volume":"32","author":"Gerritsen","year":"2020","journal-title":"Int. Psychogeriatr."},{"key":"ref_6","first-page":"30","article-title":"Dealing with COVID-19 in Dutch nursing homes","volume":"6","author":"Schols","year":"2020","journal-title":"J. Nurs. Home Res."},{"key":"ref_7","unstructured":"Low, L.-F., Hinsliff-Smith, K., Sinha, S., Stall, N., Verbeek, H., Siette, J., Dow, B., Backhaus, R., Devi, R., and Spilsbury, K. (2021). Safe Visiting at Care Homes during COVID-19: A Review of International Guidelines and Emerging Practices during the COVID-19 Pandemic, LTCcovid. Org, International Long-Term Care Policy Network."},{"key":"ref_8","first-page":"977","article-title":"Safe visiting is essential for nursing home residents during the COVID-19 pandemic: An international perspective","volume":"22","author":"Low","year":"2021","journal-title":"JAMDA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"652833","DOI":"10.3389\/fnagi.2021.652833","article-title":"Caring for People with Dementia Under COVID-19 Restrictions: A Pilot Study on Family Caregivers","volume":"13","author":"Carbone","year":"2021","journal-title":"Front. Aging Neurosci."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Hanna, K., Giebel, C., Tetlow, H., Ward, K., Shenton, J., Cannon, J., Komuravelli, A., Gaughan, A., Eley, R., and Rogers, C. (2021). Emotional and Mental Wellbeing Following COVID-19 Public Health Measures on People Living with Dementia and Carers. J. Geriatr. Psychiatry Neurol., 0891988721996816.","DOI":"10.1177\/0891988721996816"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jalz.2016.07.150","article-title":"The worldwide costs of dementia 2015 and comparisons with 2010","volume":"13","author":"Wimo","year":"2017","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1177\/1471301218773842","article-title":"A cross-sectional study of family caregiver burden and psychological distress linked to frailty and functional dependency of a relative with advanced dementia","volume":"19","author":"Abreu","year":"2020","journal-title":"Dementia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1097\/JGP.0b013e3181bf9f0f","article-title":"Incidence of depression and anxiety in the spouses of patients with dementia: A naturalistic cohort study of recorded morbidity with a 6-year follow-up","volume":"18","author":"Joling","year":"2010","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s11920-013-0367-2","article-title":"Caregiver Health: Health of Caregivers of Alzheimer\u2019s and Other Dementia Patients","volume":"15","author":"Richardson","year":"2013","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1093\/geront\/42.4.497","article-title":"Burden among Family Caregivers of Persons with Alzheimer\u2019s Disease in Nursing Homes","volume":"42","author":"Tornatore","year":"2002","journal-title":"Gerontologist"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"103968","DOI":"10.1016\/j.ijnurstu.2021.103968","article-title":"Family involvement in the Namaste care family program for dementia: A qualitative study on experiences of family, nursing home staff, and volunteers","volume":"121","author":"Smaling","year":"2021","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3118","DOI":"10.1111\/j.1365-2702.2009.02878.x","article-title":"Seeking connection: Family care experiences following long-term dementia care placement","volume":"18","author":"Bramble","year":"2009","journal-title":"J. Clin. Nurs."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.3389\/fpsyg.2020.01684","article-title":"The Psychological Impact of the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study","volume":"11","author":"Giusti","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_19","unstructured":"Nederlandse Zorgautoriteit (2020, November 03). Analysis of the Consequences of the Corona Crisis for Long-Term Care [In Dutch: Analyse van de gevolgen van de Coronacrisis voor Langdurige zorg]. Available online: https:\/\/puc.overheid.nl\/nza\/doc\/PUC_319794_22\/1\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e053235","DOI":"10.1136\/bmjopen-2021-053235","article-title":"COVID-19 management in nursing homes by outbreak teams (MINUTES) study: Study description and data characteristics. A qualitative study","volume":"11","author":"Smaling","year":"2021","journal-title":"BMJ Open"},{"key":"ref_21","unstructured":"Rothgang, H., Wolf-Ostermann, K., Domhoff, D., Friedrich, A.C., Heinze, F., Preuss, B., Schmidt, A., Seibert, K., and Stolle, C. (2020). Care Homes and COVID-19: Results of an Online Survey in Germany, LTCcovid. Org, International Long-Term Care Policy Network."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1001\/jama.2020.13484","article-title":"Social isolation\u2014The other COVID-19 threat in nursing homes","volume":"324","author":"Abbasi","year":"2020","journal-title":"JAMA"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1111\/jan.14467","article-title":"Competing crises: COVID-19 countermeasures and social isolation among older adults in long-term care","volume":"76","author":"Chu","year":"2020","journal-title":"J. Adv. Nurs."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1001\/jamainternmed.2020.1661","article-title":"Meeting the care needs of older adults isolated at home during the COVID-19 pandemic","volume":"180","author":"Steinman","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1017\/S1041610220001088","article-title":"Mental health of people living with dementia in care homes during COVID-19 pandemic","volume":"32","author":"Velayudhan","year":"2020","journal-title":"Int. Psychogeriatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"573367","DOI":"10.3389\/fpsyt.2020.573367","article-title":"Effectively Caring for Individuals with Behavioral and Psychological Symptoms of Dementia During the COVID-19 Pandemic","volume":"11","author":"Keng","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Simonetti, A., Pais, C., Jones, M., Cipriani, M.C., Janiri, D., Monti, L., Landi, F., Bernabei, R., Liperoti, R., and Sani, G. (2020). Neuropsychiatric symptoms in elderly with dementia during COVID-19 pandemic: Definition, treatment, and future directions. Front. Psychiatry, 11.","DOI":"10.3389\/fpsyt.2020.579842"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1038\/s41582-020-00450-z","article-title":"The effects of the COVID-19 pandemic on people with dementia","volume":"17","author":"Numbers","year":"2021","journal-title":"Nat. Rev. Neurol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"533","DOI":"10.3233\/JAD-201430","article-title":"Needs of Dementia Family Caregivers in Spain During the COVID-19 Pandemic","volume":"80","author":"Carcavilla","year":"2021","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_30","first-page":"76","article-title":"Generic qualitative research in psychology","volume":"20","author":"Percy","year":"2015","journal-title":"Qual. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/160940691401300119","article-title":"Generic qualitative approaches: Pitfalls and benefits of methodological mixology","volume":"13","author":"Kahlke","year":"2014","journal-title":"Int. J. Qual."},{"key":"ref_32","unstructured":"Alzheimer Nederland (2021, November 12). Factsheet cijfers en feiten over dementie [Factsheet Numbers and Facts about Dementia]. Available online: www.alzheimer-nederland.nl\/factsheet-cijfers-en-feiten-over-dementie."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/j.1365-2524.2009.00850.x","article-title":"Integrated dementia care in The Netherlands: A multiple case study of case management programmes","volume":"17","author":"Minkman","year":"2009","journal-title":"Health Soc. Care Community"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1177\/0020731420915658","article-title":"For-Profit Nursing Homes in the Netherlands: What Factors Explain Their Rise?","volume":"50","author":"Bos","year":"2020","journal-title":"Int. J. Health Serv."},{"key":"ref_35","first-page":"181","article-title":"An international definition for \u201cnursing home\u201d","volume":"16","author":"Sanford","year":"2015","journal-title":"JAMDA"},{"key":"ref_36","unstructured":"Verbeek-Oudijk, D., and van Campen, C. (2017). Ouderen in Verpleeghuizen en Verzorgingshuizen: Landelijk Overzicht van Hun Leefsituatie in 2015\/\u201916, Sociaal en Cultureel Planbureau."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1177\/1049732307307031","article-title":"Choose your method: A comparison of phenomenology, discourse analysis, and grounded theory","volume":"17","author":"Starks","year":"2007","journal-title":"Qual. Health Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1177\/1525822X05279903","article-title":"How many interviews are enough? An experiment with data saturation and variability","volume":"18","author":"Guest","year":"2006","journal-title":"Field Methods"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1177\/160940690600500107","article-title":"Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development","volume":"5","author":"Fereday","year":"2006","journal-title":"Int. J. Qual."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"585686","DOI":"10.3389\/fpsyt.2020.585686","article-title":"Psychosocial effects of corona measures on patients with dementia, mild cognitive impairment and subjective cognitive decline","volume":"11","author":"Bakker","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.3389\/fpsyt.2020.585540","article-title":"The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia: A review","volume":"11","author":"Manca","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"113294","DOI":"10.1016\/j.psychres.2020.113294","article-title":"High depression and anxiety in people with Alzheimer\u2019s disease living in retirement homes during the covid-19 crisis","volume":"291","author":"Altintas","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/ageing\/afab012","article-title":"\u2018Getting back to normality seems as big of a step as going into lockdown\u2019: The impact of the COVID-19 pandemic on people with early to middle stage dementia","volume":"50","author":"Talbot","year":"2021","journal-title":"Age Ageing"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1080\/13607863.2018.1525605","article-title":"\u2018For me at 90, it\u2019s going to be difficult\u2019: Feasibility of using iPad video-conferencing with older adults in long-term aged care","volume":"24","author":"Moyle","year":"2020","journal-title":"Aging Ment. Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12912-021-00732-x","article-title":"Consequences of the Covid-19 virus on individuals receiving homecare services in Norway. A qualitative study of nursing students\u2019 reflective notes","volume":"20","author":"Eide","year":"2021","journal-title":"BMC Nurs."},{"key":"ref_46","first-page":"e290","article-title":"Investigating what works to support family carers of people with dementia: A rapid realist review","volume":"39","author":"Parkinson","year":"2017","journal-title":"J. Public Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/1\/519\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:00:04Z","timestamp":1760364004000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/1\/519"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,4]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["ijerph19010519"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19010519","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,4]]}}}