Nursing homes (NHs) have been among the care settings most affected by both the virus itself and collateral damage through infection protection and control measures (IPC). However, there is a paucity of research regarding disaster response and preparedness of these institutions. The present study aimed to analyze disaster response and management and to develop prospective strategies for disaster management in NHs. A qualitative survey including (i) residents, (ii) nursing staff, (iii) relatives of residents, and (iv) NHs' medical leads was performed. Data were collected by 45 in-depth interviews. Our results indicate that the shift from resident-centered care towards collective-protective approaches led through the suspending of established care principles to an emergency vacuum: implementable strategies were lacking and the subsequent development of temporary, immediate, and mostly suboptimal solutions by unprepared staff led to manifold organizational, medical, and ethical conflicts against the background of unclear legislation, changing protocols, and fear of legal consequences. IPC measures had long-lasting effects on the health and wellbeing of residents, relatives, and professionals. Without disaster preparedness protocols and support in decision-making during disasters, professionals in NHs are hardly able to cope with emergency situations.

Academic Teaching Department of Dermatology Venereology and Allergology Bolzano Central Hospital 39100 Bolzano Italy

Department of Applied Social Sciences Faculty of Humanities Charles University 182 00 Prague Czech Republic

Department of Psychiatry Bolzano Central Hospital 39100 Bolzano Italy

Department of Public Health Medical Decision Making and HTA University of Health Sciences Medical Informatics and Technology 6060 Hall in Tyrol Austria

Faculty of Education Free University of Bolzano Bozen 39100 Bolzano Italy

Institute of General Practice and Public Health Provincial College for Health Professions Claudiana 39100 Bolzano Italy

Nonprofit Organization Forum Prevention 39100 Bolzano Italy

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