ABSTRACT
OBJECTIVES: Characterize the implementation, benefits, and challenges of an Essential Family Caregiver (EFC) program, a novel policy implemented in long-term care (LTC) settings during the COVID-19 pandemic in Indiana. Characterize LTC administrator perspectives on family/caregiver involvement in the LTC setting. DESIGN: Semi-structured qualitative interviews. SETTING AND PARTICIPANTS: Administrators from 4 Indiana LTC facilities. METHODS: In this qualitative study, a convenience sample of 4 LTC administrators was recruited. Each participant completed 1 interview during January to May 2021. Following transcription, a thematic analysis approach with 2 cycles of qualitative coding identified relevant themes. RESULTS: Four LTC administrators participated, representing both urban and rural nonprofit nursing homes. Participants spoke positively of the program despite implementation challenges including perceived infection risk, policy interpretation, and logistical challenges. The psychological impact of isolation for nursing home residents was emphasized as a critical consideration alongside physical health concerns. LTC administrators desired to support resident well-being while maintaining good standing with regulatory agencies. CONCLUSIONS AND IMPLICATIONS: Based on a limited sample, Indiana's EFC policy was viewed favorably by LTC administrators as a tool to balance resident and family psychosocial needs with infection-related health risks. LTC administrators desired a collaborative approach from regulators as they worked to implement a novel policy. Consistent with participant desire for broader caregiver access to residents, more recent policymaking has reflected growing recognition of the critical role of family members not only as companions but also as care providers, even in a structured care environment.