No more visits. Informal care in nursing homes prior to the outbreak of Covid-19

Amid the spread of the Covid-19, restrictions on external visits to nursing home residents were widely implemented. Such measures may affect the well-being of the institutionalized elderly, notably by depriving them of care that would be otherwise be provided by relatives and friends. There is little quantitative evidence about informal care receipt by residents in `normal times’. The aim of this study is twofold. First, it investigates quantitatively the importance of informal care in nursing homes, the forms it takes and its determinants outside the corona-crisis. Second, based on the findings, it discusses the likely implications of the Covid-19 restrictions on visits for nursing home residents. It relies on a sample representative of the French 60+ population living in nursing homes (N=3,223) from the 2016 CARE-Institutions survey. Over 80% of residents receive informal support. Relatives are primarily involved in help with the activities of daily living), which generally comes along with moral support. Residents are mostly helped with administrative tasks and activities related to mobility and the outside. Both the probability to receive informal care and its intensity highly depend on having close relatives alive (partner, children, siblings), age and health status. Loss of informal care due to visit bans may undermine the well-being of residents and entail medium- run adverse effects, in terms of further activity restrictions and deterioration of mental health. Policy makers should factor in the usual role of informal caregivers when assessing the benefits and costs of restrictions on visits for nursing home residents.