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Is it time to unlock care homes and allow visitors?

Across society in England we are seeing a growing tension among the population and the government between the protection of people from the coronavirus (COVID 19) and the need to reduce the impact of the lockdown. On the one hand we have those who can see the damage being done to our economy which will cost thousands of jobs, and those who caution the government not to ease the lockdown too quickly.

It seems to me that in the end, there will need to be a trade-off of the risk. We cannot sustain lockdown indefinitely and the strategy of protecting us all from the virus at any cost may result in far more deaths, because of unemployment and mental health issues.

Unlocking care homes

The trade-off of risk applies equally to care homes. Senior social care leaders have recognised the risk of continuing with the lockdown. They are calling on ministers to prioritise unlocking care homes amid growing concerns that mental health problems are contributing to the deaths of residents.

Most care homes have been closed to visitors since the lockdown began, to prevent the spread of COVID-19, but many fear the lack of contact with loved ones has had serious consequences on residents’ mental and physical wellbeing.

The Relatives & Residents Association (RRA), a care charity, said at least half of all calls to its helpline were from people concerned about the mental health of elderly relatives in care homes.

“We need urgent action to prevent a mental health crisis in care,” Helen Wildbore, the RRA’s director, said. “We’ve seen visits from family and friends being restricted, and that ends a crucial source of emotional support for people, but it also ends the normal oversight that those family members have.”

Putting energy and imagination into opening up care homes

“We need to put the same energy and imagination into opening up care homes as we’re putting into opening up the great British pub,” said Vic Rayner, executive director of the National Care Forum, which represents non-profit care homes.

Those with dementia are unable to understand why familiar faces have gone, and many go into a decline.

Although there have been several announcements by the government about easing lockdown restrictions for the wider population, the guidance for care homes has not been updated since April.

James Bullion, president of Adass, which represents social services directors, said: “We can’t ease the restrictions upon the rest of society while keeping people with care and support needs locked down indefinitely.

“There must be a plan for home care, care homes, those who have been discharged from hospital without a care assessment, people with mental health conditions, people with learning disabilities and autism, and families in which a member is being shielded. This is about human rights and individual lives.”

Reliance on a Whatsapp call

Pat Benson’s 92-year-old father, Benjamin, started living in a nursing home in Northumberland nearly three years ago to treat his Alzheimer’s. “It’s terribly worrying,” she said. “In the very early days, I was doing window visits. And the home pulled that because they said there was a risk from the airborne virus.”

Now she has to rely on a daily Whatsapp call. “He does seem to recognise my face,” she said. “But he can’t speak to me. And he’s sleepy, he’s lethargic, he’s lost weight.”

Some homes have allowed visitors. Sara Livadeas, chief executive of the Fremantle Trust, a charity running care homes in Buckinghamshire, said it had already allowed garden visits and was considering setting up a visiting room with a Perspex screen.

She said: “We don’t expect government to have all the answers. What we want them to do is to let us work out the best way to do things.”

Summary

There is growing concerns that mental health problems are contributing to the deaths of residents in care homes. The government is being asked to prioritise the unlocking of care homes. But as long as there is concern about the death rate in care homes, the government will err on the side of caution.

The chief executive of the Fremantle Trust seems to have accepted the need for a trade-off of risk, and not waiting for change in government strategy. She has no doubt carried out her own risk assessments and through the use of her own imagination is allowing visitors to the gardens of her care home. Whose to say that the government has all the answers.

Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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