This qualitative study was designed to understand the impact of social distancing measures on people with dementia and carers living in the community in England and Wales during a period of social restrictions before the COVID-19 vaccination roll-out. We conducted 12 semi-structured interviews with people with dementia aged 50–88 years, living alone or with a partner, and 10 carers aged 61–78 years, all living with the person with dementia. Three of the interviews were with dyads. Participants were recruited during November and December 2020. We used framework analysis to identify themes and elicit suggestions for potential solutions. We identified three interrelated themes. People with dementia experienced a fear of decline in capabilities or mood and attempted to mitigate this. Carers noticed changes in the person with dementia and increased caring responsibilities, and for some, a change in the relationship. Subsequently, reduced confidence in capabilities to navigate a new and hostile environment created a cyclical dilemma of re-engaging where an inability to access usual activities made things worse. People with dementia and carers experienced neglect and being alone in their struggle, alongside feeling socially excluded during the pandemic, and there was little optimism associated with the upcoming vaccine programme. People found their own solutions to reduce the effects of isolation by keeping busy and being socially active, and practising skills deemed to help reduce the progression of dementia. This and some limited local public initiatives for the general public facilitated feelings of social inclusion. This study adds understanding to existing evidence about the longer-term experience of social isolation several months into the pandemic. It highlights the importance of health and community groups and suggests how services can find ways to support, include, and interact with people with dementia and carers during and after social restrictions.

中文翻译：

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COVID-19 大流行疫苗接种前阶段社会限制对痴呆症患者和护理人员的影响：IDEAL 队列参与者的经验

这项定性研究旨在了解在 COVID-19 疫苗接种推广之前的社会限制期间，社会疏远措施对居住在英格兰和威尔士社区的痴呆症患者和护理人员的影响。我们对 50-88 岁独居或与伴侣同住的痴呆症患者以及 10 名 61-78 岁的护理人员进行了 12 次半结构化访谈，他们都与痴呆症患者一起生活。其中三个采访对象是二人组。参与者于 2020 年 11 月和 12 月招募。我们使用框架分析来确定主题并针对潜在解决方案提出建议。我们确定了三个相互关联的主题。痴呆症患者经历了对衰退的恐惧在能力或情绪上，并试图减轻这种情况。照顾者注意到痴呆症患者的变化和照顾责任的增加，对一些人来说，关系也发生了变化。随后，对在新的和充满敌意的环境中航行的能力的信心下降造成了重新参与的周期性困境，无法进行日常活动使情况变得更糟。痴呆症患者和照顾者经历过被忽视在他们的斗争中孤独，在大流行期间感到被社会排斥，并且对即将到来的疫苗计划几乎没有乐观情绪。人们找到了自己的解决方案，通过保持忙碌和积极参加社交活动以及练习被认为有助于减缓痴呆症进展的技能来减少孤立的影响。这和一些针对普通公众的有限的地方公共倡议促进了社会包容感。这项研究增加了对关于大流行几个月后社会孤立的长期经历的现有证据的理解。它强调了健康和社区团体的重要性，并建议服务如何在社会限制期间和之后找到支持、包括痴呆症患者和护理人员并与他们互动的方法。