A new study has revealed the extent of the wide-ranging effects of Covid-19 and the lockdowns have had on the mental and physical health of residents and staff in Irelands residential care homes.
Anxiety, grief, fear, isolation, and distress are just some of the words used to describe the impact the ongoing pandemic has had on some of the most vulnerable people and frontline healthcare workers. The adverse effects extended to the families of those whose loved ones were in residential care during the pandemic.
Reduction in the quality of care
A study led by Dr Mary Rose Sweeney from Dublin City University’s School of Nursing, Psychotherapy and Community Health found that there was a reduction in the level/quality of care provision at residential care homes.
This led to significant physical, psychological, and social impacts for residents and their families while staff reported high levels of stress, trauma, and burnout.
According to staff, at least one-third of residents were confined to their own rooms without company during the initial wave of the pandemic.
Impact on families
Not being able to properly visit with family members in care was a huge source of emotional pain for people. Family members were scared and anxious about the wellbeing of their loved ones and they felt helpless and frustrated that they could not do anything to help the situation.
The majority of families involved in the study said they did not perceive themselves to be visitors but rather as continuing their caregiver role in the residential setting.
When family members did visit, many said they could see an acute decline in their loved one’s physical health including weight loss, reduced mobility, pressure sores, dehydration and an unkempt appearance. To see their loved ones this way caused added stress.
“In addition to mental health impacts, the deterioration of residents’ physical health was a strong finding, with family participants expressing shock and distress at this rapid decline,” said Dr Sweeney.
Some of this deterioration may have been Covid-19 related but, in many cases, it resulted from the reduction or absence of usual care.”
According to staff, at least one-third of residents were confined to their own rooms without company during the initial wave of the pandemic.
Although 98% of residents were able to connect remotely with their families, the connection was deemed to be of poor quality and unreliable by many family participants.
Infection rates in care homes could have been reduced
A large number of family carers and staff felt the rate of infection in care homes could have been reduced with more effective and diligent infection control measures.
Respondents felt areas of concern such as residents sharing bedrooms and poorly ventilated common areas were due to years of under-investment in state facilities.
The transfer of those infected with Covid-19 from the acute hospital sector as well as the movement of staff across different sites were considered to be additional factors in increased virus spread.
The pandemic took a personal toll on all frontline healthcare workers including those working in residential care facilities. They suffered mental and physical exhaustion as they tried to support each other and the residents while managing their own fears about the virus.
As well as this, there was anger and worry over the number of care staff who contracted the virus. Respondents felt unsupported and that their wellbeing and safety had not been valued or protected.
The majority of staff put the needs of residents above their own needs while dealing with staff shortages due to illness.
Summary
This study revisited the impact of the pandemic on residential care home residents, staff, and families. The lack of quality care due to staff absence, and the restrictions placed on family visiting led to a marked deterioration in residents physical and mental wellbeing.
Interestingly, the report found that families did not see themselves as visitors, but caregivers.
It goes without saying then that any future restrictions must be balanced with the rights and needs of the resident.
Managers should also advocate for and oversee the introduction of adequate psychological support, debriefing, and practice supervision systems for staff as a matter of urgency.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy