PICo

Although there is little social and political controversy about the need to ensure high-quality, inpatient care for the elderly, it is largely unclear how this can be achieved.

Even before the Covid-19 pandemic, the strained staffing and material resource situation in inpatient care for the elderly became clear. The Federal Employment Agency reported unfilled vacancies in the care professions in 2021. During the Covid-19 pandemic, carers in geriatric care experienced further significant staff shortages as well as reallocations and frequent stand-ins for colleagues who were ill; in addition to the already difficult conditions of daily care work, there were further physical and psychological stresses. This also includes the increased deaths of residents, the complex care of infected people under strict hygiene requirements and caring for the dying or people with dementia without their relatives.

As a result of the Covid-19 pandemic, carers in retirement homes were no longer just working under tense conditions, but sometimes under extremely stressful ones. The particularly high psychological strain on carers in residential care for the elderly has already been demonstrated by studies. The number of long-term illnesses with psychological causes such as burn-out, post-traumatic stress disorder, anxiety and depression continues to rise. This has sometimes led to more people leaving their jobs and reducing their working hours, sometimes resulting in precarious working conditions.

In addition, other strategies for reducing stress need to be analysed and ideally supported. These include coping strategies that people use to solve problems and tasks in a targeted manner and to protect themselves from the consequences of stress. These coping strategies are intended to reduce the stress experienced and the resulting inner state of tension. In this sense, it is important in nursing care to strike a balance between self-care (i.e. strategies that reduce one's own stress and focus on needs) and caring for others (i.e. caring support for residents).

However, especially in view of the mental stress associated with carrying out nursing work during the Covid-19 pandemic, it is not only carers who are called upon to cope with everyday professional life. Other perspectives and relevant structures that affect the ability to apply coping strategies need to be addressed. These include, on the one hand, the professional identity of carers as an ever-present aspect of their own actions and coping strategies and, on the other hand, social perception and structural conditions.

The aim of the project Professional Identity and Coping Strategies of Carers in the Face of the Corona Crisis (PICo) is to develop recommendations on how high-quality inpatient care for the elderly can be guaranteed even under high stress levels such as those experienced during the corona crisis.

These recommendations will be developed in an interdisciplinary and multi-perspective manner and presented as scenarios. The focus is on the actions that serve to cope with individual stress and the question of how these can be sustainably preserved, protected and supported by structural and social measures.

Course of the PICo project

The main question of the project is:

Which coping strategies have proven themselves in the short, medium and long term in view of the professional identity of professional carers and the particular stresses caused by the corona crisis and can be used in the event of future stress peaks?

The PICo project addresses the challenges from two perspectives. On the one hand, it focuses on the appointments of carers, their stress and coping strategies as an internal perspective of the profession in the care home setting. To this end, carers are interviewed using a factorial survey (FS). The second part uses the results of the first study as the basis for a two-step consensus procedure. The results should help to develop interdisciplinary, multi-perspective and scenario-based recommendations on coping strategies for stress peaks. Qualitative analysis methods will be used for this.

At the same time, the media, political and social perception of the appointment will be included.

The professional identity of carers is central to both approaches. This must be located between self-demand, internal perception, external demands and everyday practice that is actually realised. From the carers' point of view, it is also important to constantly assert their identity. This broad basis and participation of various stakeholders should ensure that the scenic recommendations are meaningful and widely agreed upon.

Two major events are planned as part of the project. They will be accompanied by a targeted public discourse on the project, its results and possible scenarios.

The aim of the virtual expert conference is to further develop the core set of coping strategies. The set is taken from the factorial survey. Special attention will be paid to the feasibility and acceptance among users as well as to hindering and promoting factors.

Participants of the expert conference work in small groups and meet several times in between to exchange ideas in the whole group. The invited experts should join the discussion as opinion leaders. The selection of experts is based on gaining the greatest possible diversity of people who differ according to their involvement, participation and commitment, but who also work in different proximity/distance to the practical nursing area of responsibility and/or take responsibility for implementation.

The idea is for experts from each level to participate:

• Micro level = practical carers
• Meso level = practical carers with personnel responsibility, senior carers
• Macro level = representatives of funding organisations, health insurance company representatives
• Meta level = experts on the coping strategies of carers in residential care for the elderly.

Further information in our event overview.