Impact of the initial response to COVID-19 on long-term care for people with intellectual disability: an interrupted time series analysis of incident reports.
Lockdown cut total incidents in ID homes at first, but aggression soon returned, so keep behavior plans running during any future crisis.
01Research in Context
What this study did
Green et al. (2020) tracked incident reports in English long-term care homes for people with intellectual disability.
They compared weekly reports before, during, and after the first COVID-19 lockdown.
The team used an interrupted time-series design to spot sudden changes in trend.
What they found
Total incident reports dropped right after lockdown began.
Aggression incidents soon bounced back to pre-pandemic levels.
Medication errors stayed low for the whole study period.
How this fits with other research
Asif et al. (2024) extends this picture by showing Latino caregivers in Texas worried most about food and supply shortages while the English homes focused on internal incidents.
Ruggerini et al. (2004) saw medication errors fall after adding a psychiatrist to one ID facility; Green et al. (2020) saw the same drop, but credited tighter pandemic checks rather than new staff.
Salb et al. (2015) counted falls in one home and also found steady incident tracking useful, backing the value of routine data the 2020 paper relied on.
Why it matters
You can’t assume lockdown keeps people safer across the board. Build behavior-specific plans: keep aggression protocols active even when visit rules tighten, and keep the medication safeguards that worked. Use your own incident log; a simple weekly count lets you spot problems early without extra staff.
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02At a glance
03Original abstract
BACKGROUND: The lockdown-measures in response to COVID-19 taken by long-term care organisations might have impacted problem behaviour and behavioural functioning of people with intellectual disability. This study tested changes in reported incidents, in particular regarding aggression, unexplained absence and, for contrast, medication errors. METHODS: Metadata on weekly incident and near-incident reports from 2016 to June 2020 involving over 14 000 clients with mild to serious intellectual disability of 's Heeren Loo, a long-term care organisation for people with intellectual disability, were subjected to interrupted time series analysis, comparing the COVID-19 with the pre-COVID-19 period. RESULTS: The imposition of lockdown-measures coincided with a significant drop in incidents (total, P < .001; aggression, P = .008; unexplained absences, P = .008; and medication errors, P < .001). Incidents in total (P = .001) and with aggression (P < .001) then climbed from this initial low level, while medication errors remained stably low (P = .94). CONCLUSION: The rise in incidents involving aggression, against the background of generally lowered reporting, underlines the need for pandemic control measures that are suitable for people with intellectual disability in long-term care.
Journal of intellectual disability research : JIDR, 2020 · doi:10.1111/jir.12778