L’objectif de cette étude est d’explorer le vécu des personnes âgées vivant en Établissement d’Hébergement pour Personnes Âgées Dépendantes (EHPAD), avant et pendant les confinements liés à la crise sanitaire de la COVID-19.

Cinquante et un sujets résidents en EHPAD avec un âge moyen de 87,32 ans et sans trouble neurocognitif majeur, ont répondu à un entretien semi-directif. Les questions portaient sur les conditions d’entrée dans l’institution, sur l’appréciation et leurs attentes concernant l’établissement ainsi que sur leur vécu de la crise sanitaire, en particulier les restrictions associées.

Les entretiens ont abordé la vie institutionnelle, majoritairement perçue de manière négative, ainsi que le deuil du domicile précédent, possiblement lié à l’absence de consentement pour l’entrée en EHPAD, concernée par plus de la moitié des participants. Concernant la crise sanitaire, les réponses ont mis en évidence l’impact négatif des restrictions liées aux confinements et l’importance les relations sociales avec la famille et les professionnels, ainsi que des mesures prises par l’établissement.

Nous avons relevé une diversité d’expériences au sein de l’environnement institutionnel, influencée par de nombreux facteurs, notamment le vécu personnel de chaque individu et son degré d’implication dans la vie de l’établissement. Cette étude qualitative met en avant le ressenti singulier des résidents d’EHPAD avant et durant les confinements, marqué par l’isolement, les restrictions et un sentiment accru de solitude. Malgré ces défis, les liens sociaux, les routines et les activités proposées ont émergé comme des ressources clés d’adaptation et de résilience.

In France, the majority of older adults are accommodated in nursing homes for dependent adults (EHPAD). The primary reasons for institutionalization are functional and cognitive limitations. However, the decision to enter an EHPAD is often not made by the elderly individuals themselves. The transition to an EHPAD is typically a significant emotional, social, and psychological event, marked by the acceptance of loss and a disruption in identity. While this transition can enhance a sense of security, it often leads to increased depression, anxiety, and loss of independence. Previous research has highlighted various challenges for residents, including their perception of the EHPAD as a safe place and the emotional toll of leaving their home, which holds significant personal and identity-related value. The COVID-19 pandemic further exacerbated these difficulties, with strict lockdown measures causing social isolation, which has been linked to increased risks of premature mortality, depression, and cognitive decline. This study focuses on understanding the experiences of older adults in EHPADs, both before and during the COVID-19 lockdowns.

The study included 51 older adults from nursing homes, with an average age of 87.32 years. The participants’ level of dependence was assessed using the GIR scale, with an average score of 4 (partial autonomy). Participants were recruited from eight nursing homes in the Occitanie region during the COVID-19 lockdown periods (April to December 2020). Exclusion criteria included psychiatric or neurological disorders, uncorrected sensory impairments, and legal protection measures. Participants were aged between 70 and 95 years and had been institutionalized for at least 6months. Semi-structured interviews were conducted, consisting of ten questions divided into three parts: entry into the nursing home, assessment of the institution, and experiences during the health crisis and associated restrictions. The interviews lasted between 45minutes and 1.5hours and took place in accordance with health protocols. Sociodemographic data were collected, and then the semi-structured interviews were conducted in person in the participants’ rooms. The study was approved by an ethics committee, and informed consent was obtained from all participants.

The participants of the study were admitted to nursing homes primarily after hospitalization or directly from their homes, due to health issues, widowhood, falls, or loss of autonomy. The majority were admitted quickly, but some waited up to a year. Additionally, a large portion of participants did not give explicit consent for their admission. During the interviews, participants expressed mixed views about life in the institution. Many mentioned negative feelings related to boredom, lack of direction, and a need for freedom, but some positive aspects, such as the feeling of protection and the presence of activities, were also highlighted. They also compared their previous home to the institution, emphasizing the loss of their former living space. Social relationships, particularly with family and staff, were important elements of their experience. Regarding the health crisis, the imposed restrictions were perceived negatively, with feelings of isolation, loneliness, and fear. Social relationships with family remained a major topic, while connections with other residents were less frequently mentioned. However, measures taken by the facility, such as vaccination, were seen as reassuring and strengthened residents’ confidence in the effectiveness of the health protocols. This study explored the experiences of elderly residents in nursing homes, focusing on their daily life in the institution and their experiences during the COVID-19 pandemic, particularly during lockdowns. Residents highlighted various aspects of institutional life, with a prevalent feeling of boredom, linked to the awareness of time passing with aging. While some activities and routines were introduced to mitigate boredom, these structured schedules were seen as helpful for managing psychological distress, such as depression and anxiety. The pandemic disrupted institutional routines, causing insecurity among residents and staff due to evolving restrictions and protection measures. The lack of staff and limited resources also led to a reduction in care time and social interaction, exacerbating feelings of isolation. However, some residents expressed trust in the institution's safety measures, drawing comparisons with previous health crises like typhus, which contributed to their understanding and support for the measures taken. Entering a nursing home is often experienced as a loss of autonomy and identity, compounded by a sense of infantilization.

We observed a diversity of experiences within the institutional environment, shaped by various factors, including each individual's personal history and level of involvement in the facility's life. This qualitative study highlights the unique experiences of nursing home residents before and during lockdowns, characterized by isolation, restrictions, and heightened feelings of loneliness. Despite these challenges, social connections, routines, and organized activities emerged as key resources for adaptation and resilience.