COUNTING THE HUMAN COST OF COVID IN A NURSING HOME
THE OWNERS OF CHERRY GROVE NURSING HOME SPEAK ABOUT THE HORROR OF COPING WITH 10 COVID DEATHS, THE INCREDIBLE WORK THEIR STAFF DID, AND LIGHT AT THE END OF THE TUNNEL, WRITES DAVID LOOBY
TOM CUMMINS has seen it all in his 30 years working in hospitals and nursing homes, including war zones, but nothing prepared him for the tsunami of death and anguish that arrived when Coronavirus got into his nursing home in early April.
Over the following two weeks he lost ten residents, both he his wife Siobhan and his mother contracted the illness, and his staff at Cherry Grove Nursing Home were fire-fighting a situation that was so fluid, so unpredictable, that it changed on an hourly basis.
In total around half of the nursing home’s 49 residents contracted the virus, along with several staff members. Since May 23 Cherry Grove is Covid-free but its shadow still haunts the frontline staff who fought it over several long weeks in April and May.
Tom, said: ‘At the beginning of April it hit like a tsunami. The strange thing about it is that it changed several times as it progressed. You would be given one instruction from public health and then that could change hour by hour. It was a matter of trying to contain it.’
Tom said it is impossible to say exactly where ‘it’ came from with 100 per cent certainty, (preferring to idenify the illness which wreaked so much damage to him, his residents and business, in the abstract noun).
‘I would have a degree of certainty that it came through an outside agency, like a hospital or a clinic associated with the hospital. Staff and patients contracted it. It was wildfire. They had it before we even knew they had it. I was confident we had this under control. We followed all of the guidelines and we had someone coming into the unit several times a week. We had two of them come in and had outside units, wash stations outside and the local postman will even say he loved coming here because he could use that safely.’
Hand sanitising stations were placed throughout the nursing home. ‘We even had foot-baths for cleaning the soles of shoes. Every step was taken to ensure the protection of residents and staff. This was how seriously we were taking it, but a lot of people got it and sadly some people died.’
Ten residents at Cherry Grove Nursing Home died during April and early May and Tom said nobody who walked the corridors of the family-run nursing home in those weeks will ever be the same again.
He said other nursing homes have not been transparent about what happened inside their doors, but he has. ‘We are not the only nursing home in the county to have had Covid.’
He said residents are treated like family members at Cherry Grove and losing some of them was heartbreaking.
‘I tell my staff to remember that when they come to work they are coming into someone’s home when they enter a room. Me and Siobhan were left to do the pronouncements of deaths (having learned how through the HSE Land website forum) – because we were advised CareDoc couldn’t come in to pronounce them dead.’
Describing the process as horrific, Tom said: ‘I come from a farming background and I would go back from nothing. The images will stay with me forever. I can see it now as clearly as back then. I told Siobhan: “You are not doing any of these”, no matter how bad it was for me and I was down with Covid myself.’
Tom and Siobhan were among the Cherry Grove staff to be tested for Covid on Good Friday.
‘Siobhan was out for three and a half weeks with it and ended up in hospital. I wasn’t too bad. It affected her a lot worse. I had a high temperature and awful pains in my legs. I would still be running on only 85 per cent, even six weeks on. Anything physical or any shape like strimming, I’m worn out much quicker. I have three girls all working here and they escaped it.’
Both Tom and Siobhan had been set up to work from home but when the pandemic hit, they ended up joining their staff on the frontlines.
‘It was a nightmare. I’ve never seen anything like it. We were out in Saudi in an American air base working as nurses and we saw the casualties come in after bombs were dropped and that pales into insignificance compared to this. I remember one nurse said to me: “We can’t do anything for them”.’
He said the way the virus affected residents was so unpredictable.
‘Some of them got it and you’d imagine they would have gone with it but they rallied through. The staff did an absolutely fantastic job.’
Staff have provided residents with outstanding care and have shown tremendous commitment to meeting the clinical, health, and social care needs of our residents during this most challenging time.
‘Some residents should have gone with the Covid but they pulled through. There are a good few success stories, more than bad. Some of them you just looked at them and wondered how the hell they pulled through at all.’
He said the nursing home staff were fully supplied with PPE but the timing of the testing was the main issue.
‘Good Friday was the worst time for testing. If you were planning to have a tsunami at the absolute wrong time it was a long bank holiday weekend when there were less staff around from the HSE. The HSE were in contact with us that weekend and the contact increased as the weekend went on.’
The nursing home’s director of nursing staff was in regular contact with family members.
‘That happened shortly after it started and he maintained contact throughout. We were very upfront with the families when anyone tested positive. If you are upfront with people and tell them how it is rather than hide behind something people appreciate it. Otherwise you’ll get caught.’
Some family members called to the window of their parent, trying to see them. ‘No one came in but they would have attempted to call to the windows of residents’ rooms. We had to tell them to go. It was absolutely horrendous. It affected me personally. I had it, my wife had it, but what most people don’t know, my mother Breda – who is 94 – had it so I can fully empathise with everyone. My family are calling me all the time enquiring about her.
‘Even still it’s very difficult. I am getting emails on a daily basis and I deal with them every day; a lot of people requesting to come in. All I tell them is you don’t want to get this and you don’t want to be responsible for your mother, father, brother or sister getting it off of you. So many people are going around that are asymptomatic: you can’t be certain you don’t have it.’
He said: ‘For our residents, we acknowledge and appreciate the loss of loved one’s physical presence, personal touch and visits. Within our local community, county, and the country we owe a great debt of gratitude to the wonderful staff working in our nursing homes.’
He said some people were forceful and should have known better.
‘One person told me: “At the end of the day it’s your fault”. There are people who have not idea what it was like; who’ll never know. If they had some insight into the medical grounds [maybe they would have acted differently].’
People were allowed visit a loved one who was dying from Covid. ‘If people had someone at the end of their life, that has to
OVER TWO WEEKS TOM LOST TEN RESIDENTS, BOTH HE HIS WIFE SIOBHAN AND HIS MOTHER CONTRACTED THE ILLNESS, AND HIS STAFF AT CHERRY GROVE NURSING HOME WERE FIRE-FIGHTING A SITUATION THAT WAS SO FLUID, SO UNPREDICTABLE, THAT IT CHANGED ON AN HOURLY BASIS
be respected by everyone. Some visitors dropping off items for loved ones in our drop off box, they’d see someone else coming in and ask the question so we’d have to take them to one side and say the person is actually dying.’
The cruelty of the strict rules around visiting seemed unfair to Tom during the crisis but in hindsight he believes they were right.
‘Most definitely yes. In the heat of the moment I would have said no.’
Throughout the nightmare weeks of late April, early May. Tom’s feet never touched the ground as he managed an emerging nightmarish reality, sometimes arriving at the Home at 4 a.m. to pronounce a resident deceased.
‘You’re feet were never on the ground. You didn’t feel your feet at all; couldn’t even find a footing. It was a whirlwind. It reminded me of the boy with his finger in the dam trying to keep the floodwaters out. It was fire-fighting all the time.’
He said there were staff who shone through. ‘They were invaluable and outshone themselves. Without them we wouldn’t have gotten through. There would have been staff who would have been in the shadows previously and they surprised everyone with their fortitude. They were heroes.’
As for criticism of so-called wealthy nursing home owners by some TDs, Tom said it was unbelievable how they reacted.
As for last week’s lifting of restrictions prohibiting family members from visiting loved ones at nursing homes, Tom said that was welcome, cautioning, however, that Covid-19 remains a fact of life in Ireland for the coming days, weeks and months ahead.
‘This is not going to go away. This is in the world now and it is a totally different world. I think Covid has just changed everyone’s perception on social etiquette. Irish people are sociable by nature and very touchy feely. We love to shake hands and to hug and love the craic and being in close proximity of one another. Things will be vastly different because you still have a lot of people who are going to maintain social distancing as this has had a huge psychological impact on people.’
He said despite the tough measures adopted by the National Public Health Emergency Team the figures tell the story of their success.
‘Today there were only nine confirmed cases and four people died. If the government hadn’t done what they did at the time imagine the numbers. A lot of people are giving out: let them give out! We have survived and we’re getting through it and we are almost there. The way I look at it is [that] one death is too many.’
Among the learnings Tom has taken from Covid-19 are warning signs: ‘The number of residents that would have had unusual accidents and incidents 24 to 48 hours prior to the onset of symptoms was a real indicator of Covid setting in, with its associated weakness coming on. How rigid one has to be with residents in protecting them from the transmission of
Covid from one to another. The importance of social distancing and how it remains on surfaces. Cough etiquette and education surrounding hygiene.’
He said many people never realised the severity of the illness.
‘We will never recover from this as a nursing home. On an emotional level we will never forget it. We grieve the loss of some of our residents to Covid-19. May we extend our deepest condolences to their families and friends. Our prayers and thoughts are with you.
‘I am a nurse 32 years and have worked in hospitals in Waterford and abroad and this has been the worst I have ever seen. I still don’t know everything there is to know about it and I am urging people not to give up on it. We have to protect ourselves; everyone has a responsibility.’
Tom praised the exceptional team in Cherry Grove who are focussed on enhancing the lives of residents by providing great care, comfort and support.
‘This too has been a particularly difficult and traumatic time for our staff as they have a deep emotional connection with all residents. In truth, this experience will never be forgotten. Thank you also to the families of residents and the extended community for your continued support during these challenging times. We have had exceptional support throughout this time from the HSE, Public Health Department, local General Practitioners, and local representatives, support agencies, suppliers.’
Tom said the local community in Campile, Horeswood and surrounding areas were outstanding, offering collections and deliveries, housing accommodation, donations for residents and staff, letters of support and encouragement, including one from Scotland with no connection to the area which was extremely uplifting to Tom, Siobhan and all the staff.
He praised the proactive deeds of the nursing homes representative organisation Nursing Homes Ireland who engaged with the health authorities with regard to easing of visitor restrictions, with the advice of government and NPHET (the National Public Health Emergency Team) critical in this regard.
‘We are turning towards slowly building up resources and resilience of residents and staff alike, our focus now is restoring health and wellness - physically, mentally, emotionally and spiritually. Various supports such as physiotherapy, nutritional therapy, occupational therapy, mental health supports, pastoral care, visiting, will be added and offered slowly in a consistent, considered and planned approach based on official guidelines and residents’ needs. We look forward to your continued support in ensuring the continued safety and welfare of our residents and staff.’
June 8 marked a new beginning for Cherry Grove.
‘As of May 23 the Home is Covid-free and our first new resident arrived here today (June 8). Covid-19 testing of residents and staff has confirmed such. We take this opportunity to extend our thanks to residents, relatives and staff,’ Tom said.
I AM A NURSE 32 YEARS AND HAVE WORKED IN HOSPITALS IN WATERFORD AND ABROAD AND THIS HAS BEEN THE WORST I HAVE EVER SEEN