Flu season in care homes: when group activities stop

Every year, between autumn and the end of winter, care homes and inpatient units go through the same sequence. First a cough, then two or three residents with a fever, then the decision: the lounge closes, meals move to the bedrooms, visits are suspended or restricted. It is the right decision when there is an outbreak, and it has a cost that is rarely planned for.

This article is not about how to control an outbreak — that belongs to each institution's infection control team, following the guidance of Portugal's Directorate-General of Health (DGS). It is about the weeks that come with it.

The 2026/2027 vaccination season

Portugal's seasonal vaccination campaign against flu and COVID-19 began on 30 September 2026, at SNS health units, participating community pharmacies and other designated sites. As in previous years, residents of particularly vulnerable settings, such as care homes, and the professionals who work in them are among the groups the vaccination is aimed at. The specific eligibility rules for each vaccine are set out in the DGS guidance for this season and can be checked with SNS 24.

Vaccination does not eliminate outbreaks, but it is one of the measures that matter most in reducing severe illness in the frailest people. For a care home, the practical question in October is simple: how many residents and how many staff are already vaccinated, and who is missing. It is worth having that list ready before the first case, not during it.

When there is an outbreak: isolation and what changes

The measures vary with the pathogen, the size of the outbreak and the guidance in force, but in day-to-day care home life they usually include:

• Room isolation for residents with symptoms and, sometimes, their contacts.
• Suspension of group activities and of meals in the dining room.
• Restricted or suspended visits, or visits under specific rules.
• Dedicated staff for areas or residents, where numbers allow.
• Stepped-up hygiene for hands, surfaces and every shared object.

What is lost in those weeks

An outbreak lasts days or weeks. For someone confined to their room, that can mean:

• Less company. The lounge, shared meals and group activities are, for many residents, the core of their daily social contact.
• Less family. Without visits, the connection happens by phone, if at all — and many residents living with dementia or hearing loss struggle to follow a voice-only call.
• Less movement. Someone who spent the day between their room, the corridor and the lounge now leaves the chair or bed far less. It is the same cost of being still that we described in immobility in hospital.
• Less structure. The day loses the markers that organised it: the time of the activity, Mass, the daughter's visit.

In people living with dementia, this combination can show up as more disorientation and agitation, and it is not always easy to tell that apart from the onset of an infection. A change in behaviour during an outbreak deserves clinical attention, not just patience. We wrote about social isolation more broadly in loneliness and isolation.

Keeping up individual activity, room by room

When the group stops, activity does not have to stop — it becomes individual, shorter and planned room by room. Some ideas care teams use:

• A simple list per resident: what they enjoy, what calms them, who they want to hear from. If each person's “Life story” already exists, now is the time to use it (the free tool is at /ferramentas/).
• Short, regular visits from staff, not only for care. Ten minutes of conversation or music at the same time every day gives the day a structure.
• Personal or easy-to-clean materials: their own photographs, a radio, their own books, simple tasks.
• Whatever movement is possible within the room, guided by physiotherapy: standing, sitting, walking to the window.
• Note who is becoming more inactive or more withdrawn, so those people get priority.

Cleaning the equipment between residents

Any object passed from one resident to another during flu season is an object to be cleaned, and a virtual reality headset is no exception. The general principles are in equipment hygiene and safety:

• Clean before and after every resident, with the product and method set by the institution and compatible with the manufacturer's instructions.
• Use the washable silicone cover over the facial foam: the RVer kit includes one, which can be removed and washed. It does not replace cleaning the rest of the headset.
• Hand hygiene for whoever runs the session, before and after.
• Do not move the same equipment between isolation areas and clear areas unless the infection control team has decided so. In many cases, the right decision during an outbreak is not to take the headset into the room of someone in isolation, or to reserve it for one area.

Where RVer can fit in, and where it can't

RVer does not prevent infections, does not replace vaccination or any infection control measure, and is no reason to make an exception to isolation rules. Where it can fit in is the part that usually goes unplanned: an individual, short, accompanied activity in the bedroom, for residents who are not isolated or where the infection control team allows it, with a place the person knows or a video call with family. For some residents it is a calm moment in an empty week; for others it does not work, and the session stops whenever the person wants.

When family cannot come in, a video call may be the only way for the person to see a familiar face. With RVer, video calls with family take place inside the headset, with the professional alongside, which can help those who struggle to follow a call on a small phone. They need an internet connection; the rest of the content is all on the device and works without it.

It is not for everyone: some residents prefer a simple phone call or do not feel comfortable with the headset, and that choice counts.

In summary

• The seasonal flu and COVID-19 vaccination campaign began on 30 September 2026; care homes and their staff are among the groups it is aimed at.
• During an outbreak, the rules of the infection control team and the health authority always come first.
• When the group stops, company, visits, movement and the structure of the day are lost — and that needs a plan too.
• Individual, short and regular activity, room by room, with priority for those becoming most inactive.
• Any shared equipment is cleaned before and after every resident; the RVer headset has a washable silicone cover for the facial foam.
• Video calls can keep up contact with family when visits stop.

This article is for information only and does not replace DGS guidance, the local health authority's instructions or the institution's infection control rules. For questions about vaccination or symptoms, contact SNS 24 (808 24 24 24); in an emergency, call 112.

RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device in EUDAMED (Basic UDI-DI 56006195127RVERTZ) and with INFARMED (Portugal, CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration.