We can’t let them die of loneliness
Care chief wants access for families
The head of Scotland’s care home industry has warned isolating residents could cut more lives short than Covid-19.
Dr Donald Macaskill, the chief executive of Scottish Care, has joined heartbroken families, politicians and health experts to demand people be given more access to their relatives.
Thousands of elderly residents – many of whom are in the final years of their lives fighting dementia and Alzheimer’s – have barely seen loved ones for six months.
And there are fears strict regulations to halt the spread of coronavirus are creating a hidden physical and mental health catastrophe.
Diet and nutrition are affected because people with dementia need encouragement to eat and family often provide that.
The second issue is people haven’t been moving and exercising enough and there’s been a deterioration in weight and physical ability. If families are present, they are a huge help with not letting this happen.
The other huge factor is psychological and I’ve had dozens of emails from people who have said they know mother or father or husband or wife have put their face to the wall.
There is a heck of a difference between living and existing.
At the moment, we’re keeping people alive and keeping them breathing but we’re not giving them life.
One woman I know very well is convinced her husband died of a broken heart. He didn’t contract Covid but he died of the separation and the anxiety and the brokenness.
Couples who have been married for 58 years are being separated – there’s someone who, at 103, is having to decide which children are allowed in to visit.
People with dementia don’t understand why their relatives can’t come every day to see them in their rooms.
Nothing is more fatal than getting the disease but it is about getting the balance right.
If you don’t try to reconfigure and get the balance right in terms of protection and people taking appropriate risk, then we are going to lose more people as a result.
Scottish Government guidelines have been relaxed slightly from full lockdown and families are now able to meet care home residents outdoors under strict conditions.
At the start of the pandemic when threat to life was as great as it was, the actions of lockdown and the fairly strict restrictions were entirely appropriate.
But now, 27 weeks in, when you have had an increased understanding of the virus, we know about the risk of asymptomatic spread, we know staff have to be tested, we know about social distancing, we know about PPE.
So I think we now have got to the stage where we need to have really quite a thorough review of whether we have got the balance between protection and risk right.
Because personally I think we could do things to improve that balance.
We could use testing as a means to allow families greater access.
We should be drawing on international insights, particularly from Canada and from Ireland, where they have got to the stage of family wearing PPE being able to sit alongside and hold the hand of, and touch, their relatives.
This is extremely important towards the end of life.
We can also do more to allow people to see one another in their own rooms and I think the last thing is that we need to do more to build the capacity in care homes to be able to have visitors.
By that, I mean, at the moment, a care home has to get its risk assessment signed off by public health officials, then it needs to undertake the visiting regime. And, at the moment, that risk assessment will only be signed off if visits are supervised and if the room is deep cleaned before the next visit.
That is adding a huge burden on staff, so there is an issue there about how do we maximise the ability of care homes to allow more people to visit?
There are no easy answers to lots of this but there are some things we could do differently and quite quickly, especially as we move into winter.
All of us need to get to the stage where we listen more to families and relatives – a one-size-fits-all approach just doesn’t work.
As we move into winter, we can’t allow a lockdown in the community to disadvantage care homes. If there is an outbreak in the care home, that shouldn’t mean there is a blanket assumption that no visiting can take place.
I am not for a moment saying it is easy and care home staff are battling this every day.
The longer we keep people apart, the more people will be lost to our Covid response rather than to the disease itself.