‘Many in nursing homes died deaths that certainly could have been prevented’
After more than 1,000 deaths in homes, they are finally reopening to visitors – but hard questions are being asked about the response to the virus in our care facilities for elderly
FOR almost three months they have been locked down, deprived of the simple joys they had found in life’s later years. The tables in the dining room were empty.
The bingo room was silent. They were confined to quarters, quarantined against a virus that has attacked the elderly harder than anyone else.
At a stage when the rest of the nation came together with their nearest and dearest, they spent most of their time by themselves, in their rooms, without visitors.
Next week, however, hundreds of older people will finally be reunited with loved ones as nursing homes begin to open their doors once again to visitors.
The phased re-opening of facilities that no longer have an outbreak will be subject to a number of stringent rules – visitors will be limited to daytime visits of less than 30 minutes, each visitor will be allowed a maximum of one visit per week, and surgical masks must be worn in some cases.
Despite the rules, for the residents, who have been living behind closed doors for so long, the joy of reconnecting will mark a return to some semblance of normality.
However, the battle against Covid-19, particularly in nursing homes where it has taken more than 1,000 lives, is far from over.
“We must not forget what happened,” said Amanda Phelan, Professor of Ageing and Community Nursing at Trinity College Dublin.
“This can happen again. If it happens again, there is potential for nursing homes to be at risk. How will a second surge impact on them?
“They will have to be really cautious when letting visitors in, given what we know about how infectious this virus is and what happened in the sector before. There will undoubtedly have been local issues that could have been done better, but on the whole, I think they have a better grip now on what should be done.”
Ms Phelan points out that the crisis was not unavoidable.
Ireland had a head start in learning from the experience of Italy in the second half of February that older people were especially vulnerable to the disease.
“The stress in the nursing homes has been huge because there was a reactionary rather than proactive approach from the start,” she said.
“The surge was in the nursing homes and when you look at the statistics, they should have been given more prominence.
“The policies [on how to deal with the virus] have been changing almost weekly.
“It’s very stressful if you are running a nursing home that something was OK last week and it’s not this week.
“But that’s also part of an evolving process in terms of learning more about the virus itself. Infection control if different everywhere because of Covid-19.”
Nursing Homes Ireland CEO Tadhg Daly has previously said there were “gaps in the preparation by the State” in the early stages of the pandemic.
He added: “What we have to do now is learn the lessons and make sure we are ready for any future pandemic or second wave.”
Responsibilities
He was responding to comments by the head of the Health Service Executive (HSE), Paul Reid, who last month said there were obvious gaps in the clarity of responsibilities in the overall governance and oversight of private nursing homes during the virus outbreak.
Even though the number of new deaths from the coronavirus has been decreasing, the legacy of the pandemic in this country is already bound up in nursing homes.
To date, there have been 1,030 Covid-related deaths in residential care facilities.
It accounts for 63pc of the total deaths.
Some 900 of these were residents of nursing homes, which represents 55pc of all deaths.
After such a toll, the nation faces a reckoning over its care of the elderly, regardless of what happens in coming months.
As the loved ones of those who have died are left counting the cost, calls have been made for a probe into what may have gone wrong.
Families have called for an investigation into the deaths of 22 residents at Dealgan Nursing home in Dundalk, Co Louth.
A staff member at St Mary’s Nursing Home in the Phoenix Park, Dublin, has made a protected disclosure.
Sinn Féin’s Pearse Doherty has called for an inquiry into The Rock nursing home in Co Donegal, where almost half of residents died from the virus.
“Unfortunately, I don’t think anyone will be held accountable,” Sinn Féin’s health spokesperson Louise O’Reilly told the Irish Independent.
“I do think that when the families come to terms with what has happened, they will want answers. They deserve answers.
“For a lot of them, who are still grieving, the enormity of it all hasn’t sunk in yet. They are still dealing with their loss.
“I think an inquiry into what happened is inevitable and unavoidable at this point.
“If there isn’t an independent probe into what happened, we will have a situation where this is taken up as a campaign by grieving families.
“I don’t believe this can just be swept under the carpet.
“Lessons should be learned and while it is good that visits are being started again in many of these facilities, we can’t forget about the deaths that have occurred.”
This week, Dr David Nabarro of the World Health Organisation said, internationally, 25pc of Covid-19 fatalities are from long-term residential care settings, including care homes.
Ireland’s figure, as stated above, is 63pc.
Dr Tony Holohan, the country’s chief medical officer, argues that unlike many other countries, Ireland has reported comprehensively on probable deaths and confirmed deaths, thus making comparisons unfair.
But even factoring in Ireland’s approach to counting cases, the comparative figures are stark.
Last week, Dr Holohan said that the time was right to allow visitors back into nursing homes.
His recommendations have now paved the way for some of the most vulnerable in society to arrange a joyful reunion with their loved ones.
For those who have died from Covid-19, and the friends and family who used to visit them, there will be no such joy, said Marcus De Brun, who quit the Medical Council over the handling of the pandemic in the homes.
“It’s a pity that there is so little being said on behalf of these people who have died,” he said.
“Many of them died deaths that certainly could have been prevented.
“A lot of people think these people were going to die anyway so it’s not a big deal.
“On average, 15 years of life expectancy was taken away, according to a recent UK report on those who died in nursing homes.
“In the nursing home I work in, I would have one or two deaths in a six or 12-month period – we had 15 in two and half months.
“It’s been horrible, like a warzone.
“You are watching someone in the bed, arching their back, struggling for a breath and you essentially have nothing to offer them.
“It’s a terrible tragedy but you wonder if there is a general attitude towards older people in society.
“If over 1,000 children had died we would be living in a completely different reality now in terms of accountability,” he said.
‘It has been horrible, like a war zone... it’s a terrible tragedy’