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Context: The COVID-19 pandemic changed life for everyone, but especially for nursing home residents. In March 2020, the Centers for Medicare and Medicaid Services in the United States enacted nursing home restrictions regarding visitation from outside family/friends and changes to facility activity programmes. Objective: This study explored the nursing home policies and practices that preserved relationships among nursing home residents with spouses/partners. Nursing home social workers shared the effects of COVID-19 restrictions on residents’ relationships with spouses/partners and how they sought to maintain these essential social connections to minimise the detrimental effect on the psychosocial well-being of residents. Methods: The study utilised both an online survey and 10 telephone interviews with nursing home social workers in four southern states. Findings: Twenty-eight percent of participants reported that no visitors were allowed, while 25% allowed couples to visit with one another as usual. The most noted practices to maintain social connections were phone calls, video calls, and ‘window’ visits between residents and family/friends; however, as one respondent noted, ‘It’s just not the same. It’s affected them greatly.’ Interviews revealed further details about the detrimental effects of the COVID-19 restrictions on nursing home residents’ overall mental health and attachment relationships with spouses/partners. Limitations: Study limitations exist in the focus on practices in four south-eastern states, with no inclusion of northern US states. An additional limitation of sampling is discussed. Implications: These results highlight the importance of maintaining social connections between residents and spouses/partners. Policies and practices that enhance relationships and connections under all circumstances should be formalised and all health care team members trained to ensure implementation.

The decision to seek placement in a nursing home may be especially difficult for spouses or partners of the potential nursing home residents. Disruption of the attachment relationship following placement may influence the psychosocial well-being of nursing home residents. Although the responsibility of nursing home staff is to ensure psychosocial well-being, including awareness of the influence that separation can have on a spousal or partner relationship, little is known about services offered for the maintenance of spousal and partner relationships. This study was conducted to identify nursing home practices that had preservation of spouse/partner relationships as the goal. A mixed methods approach utilized both an online survey (81 respondents) with nursing home social workers in four Southern states and ten telephone interviews (from among the respondents). Survey results revealed that 49% of respondents’ facilities had a written policy to preserve these relationships, however, only 22% reported having a specific formal program to carry this out. In the interviews, participants expanded on survey topics and shared that facilitating outings and encouraging participation in routine facility activities were commonly used to preserve relationships. Privacy was discussed as being important in maintaining relationships and also found to be a barrier to doing so. Nursing home social workers can utilize the results in the design and implementation of specific services to preserve relationships and maintain strong attachment between residents and their spouses/partners. These will be best carried out in a coordinated, collaborative manner among multiple disciplines within the nursing home setting.