A qualitative 5-country comparison of the perceived impacts of COVID-19 on people living with dementia and unpaid carers

Background: Emerging evidence shows an impact of the COVID-19 pandemic on people living with dementia and informal carers, without any evidence-based global comparison to date. The aim of this international study was to explore and compare the perceived impact of COVID-19 and associated public health restrictions on the lives of people living with dementia and informal carers and access to dementia care across fve countries. Methods: Informal carers and people living with dementia who were residing in the community in the UK, Australia, Italy, India, and Poland were interviewed remotely between April and December 2020. Participants were asked about their experiences of the pandemic and how restrictions have impacted on their lives and care. Transcripts were analysed by researchers in each country using inductive thematic analysis. Results: Fifteen people living with dementia and 111 informal carers participated across the fve countries. Four themes emerged: (1) Limited access and support; (2) Technology and issues accessing remote support; (3) Emotional impact; and (4) Decline of cognitive and physical health reported by carers. Whilst variations were noted, the pandemic has indirectly afected people with dementia and carers across all fve countries. The pandemic removed access to social support services and thus increased carer burden. Remote services were not always provided and were very limited in beneft and usability for those with dementia. As a result, carers appeared to notice reduced cognitive and physical health in people with dementia. Particular diferences were noted between India and Poland vs. the UK, Italy, and Australia, with less impact on care provision in the former due to limited uptake of support services prepandemic based on cultural settings. Conclusions: The pandemic has amplifed dementia as a global public health problem, and people afected by the condition need support to better access vital support services to live well.