As you go about your living where we can enjoy half price meals, meet up with friends at a pub, go for a walk or a drive and all the other things we enjoy doing, spare a thought for people who live in care homes and having to follow domiciliary care policies and procedures. The quality of their lives has been decimated by the restrictions imposed on them as a result of the coronavirus restrictions.
Representative of charities have told a committee of MPs that care residents feel as if they are in prison amid seemingly endless coronavirus restrictions on their activities and visitors, with a number “losing the will to live”.
One charity told the MPs that its helpline had been told that someone in a care home felt they would “rather die than carry on living like this”.
Achieving a balance
The all-party parliamentary group on coronavirus heard from groups working with care residents who said “there needed to be a better balance between protecting vulnerable people from COVID-19, and the mental and physical toll of strictly limited visits and lack of interaction”.
The hearing on the wider impact of coronavirus on older people found that as well as serious difficulties amid the peak of the lockdown, such as access to food and cash, many were facing long-term problems including grief from the death of a partner, often exacerbated if they could not be with them at the time.
The evidence session, part of a wider inquiry by the all-party group into the way coronavirus has been handled by the government, heard particularly harrowing details about the continued effect of people inside care homes.
Confusing guidance
Judy Downey, who chairs the Relatives and Residents Association, a charity that speaks up for people in care, said some care homes had tried very hard to maintain contact between residents and relatives, for example through newsletters and regular calls.
But the “confusing” guidance affected them all, even though 60% of homes had experienced no coronavirus cases, she explained: “I think for a lot of people, they’re thinking they must preserve life at all costs, without actually valuing what makes life worth living.
“What makes life worth living for most people? It’s interaction with the people they love, and doing things they like, and all of that has gone. And it’s not necessarily because there’s COVID present.
“Sometimes there was, and sometimes there might be, but it’s people living in a kind of hideous limbo. Some people are saying to us that their relative would rather die than carry on living like this.”
Care home is like a prison
Helen Wildbore, the director of the charity, said care home residents had suffered the “double isolation” of having restricted visits from relatives, and less interaction within the home.
“Sadly, many of the callers to our helpline have been telling us that the current situation in care homes is now very much like a prison, with such restricted visiting, residents unable to leave the grounds of the home, and limited interactions with other residents and staff.”
Under rules for English care homes, visits from relatives should be time-limited, and only from a “single constant visitor”, to limit the possible spread of COVID.
But Wildbore noted that other areas of life for older people, such as the NHS, had very different regulations: “We heard from somebody today whose father has broken their hip and gone into hospital, and they’ve been able to go in daily to visit him. Once he goes back into care those restricted visits will come back into play.”
Time to review the guidance
The government has been severely criticised for its guidance to care homes in the past, that led to so many deaths. They are in danger of taking their eye off the ball again and should urgently review the guidance taking account of localised risk, rather than adopting a blanket approach to all care homes. Given that 60% of care homes have experienced no coronavirus cases, why is the overall guidance still applying to them?
Summary
The current restrictions on care homes is blighting the quality of lives of residents to such a degree that some feel it is like living in a prison and are losing the will to live. One could argue that the government is erring on the side of prevention, but it makes no sense to have an overarching policy for all care homes where some have never experienced coronavirus. What is needed is a localised approach that takes account of the prevailing coronavirus conditions in the community where the care home is located.
I would agree with the representatives of the charities that a balance needs s to be struck between risk and the impact of these restrictions on residents’ quality of life. In care homes as in other walks of life, we really need to find an effective and humane way of managing the virus.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy