Long-term care: A modicum of contact despite infection control

People who are permanently dependent on care in homes for the elderly or disabled are currently at particular risk of falling into social isolation because of the contact restrictions to combat the Covid-19 pandemic. In addition to visits by relatives, contacts with other residents and service providers are also often restricted. As justified as such measures are to contain the current spread of infection, the living situation of those affected deteriorates considerably.

With the most recent amendment to the German Protection against Infection Act, the legislator has explicitly stipulated that in spite of all protective measures a minimum level of social contact must always be guaranteed in homes for the elderly or nursing homes as well as in facilities for the disabled. However, this only provides hints as to which concrete contact regulations meet both, infection control requirements and the individual demands for social participation. Therefore, the German Ethics Council would like to support the implementation of the legal requirements in the field of long-term care by a few ethical clarifications concerning the minimum level of social contact that must be guaranteed even under pandemic conditions.

In its Ad hoc Recommendation, the German Ethics Council demands, among other things, to focus less on the number and frequency of social contacts and more on their quality when determining a minimum level of contacts. In addition, it must always be answered individually which restrictions regarding the type and frequency of social contacts affect the quality of life of an individual person with care needs, and in what way. Wherever this is justifiable, those living in long-term care facilities should select their contact persons themselves.

In addition, forms of virtual contact should be made possible and services provided which contribute to the integration, participation and quality of life of those living in long-term care facilities. However, it is emphasised that virtual contact should complement and not replace physical contact.

The Ethics Council points out that facilities are often dependent on additional personnel in order to ensure a modicum of social contacts and to provide stimulating activities. Furthermore, it states how important it is to strengthen the care sector, especially in times of a pandemic.

The German version of the Ad hoc Recommendation “A Modicum of Social Contact in Long-term Care during the Covid-19 Pandemic” is available on the German Ethics Council website at https://www.ethikrat.org/fileadmin/Publikationen/Ad-hoc-Empfehlungen/deutsch/ad-hoc-empfehlung-langzeitpflege.pdf. An English translation will be published soon.