Lessons Learned from a Pandemic: Personhood and Caregiver Stress in Nursing Home Dementia Care

Year 2025, Volume: 8 Issue: 2, 61 - 77, 30.12.2025

Bill Buron , Timothy Killian

https://doi.org/10.51819/jaltc.2025.1655384

https://izlik.org/JA93CJ85GB

Abstract

This study examined how the COVID-19 pandemic altered the sociologic, individual, and biologic personhood of residents living with dementia in nursing homes, guided by Buron’s (2008) Personhood Model for Dementia Care (PMDC). The aim was to describe how pandemic-related disruptions reshaped daily routines, relationships, and biologic comfort. The research team used a descriptive qualitative design. Activity directors from nursing homes across the United States completed an online survey containing closed- and open-ended questions. Quantitative items documented facility characteristics and the extent of pandemic restrictions. The team analyzed qualitative responses using thematic analysis and organized the findings according to the PMDC domains. Directors observed marked erosion in sociologic personhood as prolonged visitation restrictions, isolation, and the loss of communal activities narrowed residents’ social worlds. Individual personhood weakened as turnover and shifting routines reduced staff familiarity with residents’ histories and preferences. Biologic personhood declined through missed care, appetite loss, diminished grooming, and behavioral signs of distress. Chronic understaffing, rigid policies, and limited family oversight intensified these losses, although staff occasionally preserved personhood through simple relational gestures such as gentle touch, eye contact, and personalized interactions. The findings highlight the need to embed personhood-preserving practices into staffing structures, emergency planning, and everyday routines. Strengthening staff resilience, supporting consistent assignments, improving interdisciplinary communication, and enabling safe family involvement during crises are essential steps. The PMDC offers a practical framework for rebuilding long-term care systems that uphold identity, comfort, and dignity for residents living with dementia.

Keywords

Dementia , Personhood , Nursing Homes , COVID-19 , Long-Term Care , Caregiving , PMDC

Ethical Statement

The authors of this paper are committed to upholding ethical research practices through data collection, informed consent, and the adherence to ethical guidelines.

Supporting Institution

The University of Tulsa and University of Arkansas

Thanks

This research was supported by The University of Tulsa, Office of Research & Sponsored Programs (ORSP) Faculty Research Grant.

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