PRESSURE is building to force care homes to give families access to their relatives.
Campaigners want at least one family member to be given key-worker status, which would allow that person, with the appropriate safeguards, to see and minister to the resident (News, 11 August).
Publication last week of the policy paper Adult Social Care: Coronavirus (COVID-19) winter plan 2020 to 2021 brought little comfort, relatives and associations have said. While the paper recognised the importance of allowing care-home residents to “safely meet their loved ones, especially for those at the end of life”, and encouraged providers to “find innovative ways of allowing safe contact between residents and their family members”, it specified that this should be limited to “a single constant visitor, with an absolute maximum of two per resident”.
It also introduced a requirement that visitors be supervised at all times, something that the Relatives and Residents Association (R&RA) has described as demeaning and unacceptable, and as breaching the Mental Capacity, Human Rights, and Equality Acts, as well as other legislation. “Regardless of age or disability, people must have the right to the dignity of being with family or friends in private,” Judy Downey, who chairs the association, said.
“It seems an extraordinary measure, and speaks volumes about how families and residents are viewed. We fervently hope that the Government will realise this and amend their guidance accordingly.”
The R&RA helpline continued to hear “ongoing heartbreaking experiences of separation from partners or children as a direct result of banned or restricted visits. Of course, safety is important, but residents also need the love and support they rely on for a decent quality of life, and the relationships which make their lives worth living.”
The association is calling for key-worker status for relatives, “and some kind of understanding that we get one chance to die”.
Julia Jones, a co-founder of John’s Campaign, a group that is campaigning for the right of people with dementia to be supported by their family carers, says that the logic is unfathomable. “It’s not that care homes are sealed. Staff come in and out, then continue their daily lives in the community; tradesmen visit to fix things; podiatrists cut toenails; medical professionals make their necessary calls.
“But if you’re ‘just’ the daughter, the husband, the committed partner of a resident — the person who makes their life worth living — you can’t come in.”
The winter plan contains no strategy for meaningful involvements for residents or relatives, she says. “Instead, families on both side of the door must face the grim truth that, as soon as the behaviour of other members of the community makes a local R-rate go up, they will be the first to be banned. The winter-plan instruction is unequivocal: local-authority directors of public health must ‘immediately move to stop visiting’.”
The Alzheimer’s Society warned this week that the plan did not go far enough, and relied on regular testing — which, for care-home staff and residents, has been dogged by delays. It had also not recognised the need to put family carers on an equal footing with key workers, which, the charity argues, will risk further dangerous isolation for residents with dementia.
The strength of feeling in the country on this issue was evident in the deluge of calls to Radio 4’s Any Answers, which followed discussion of the issue on its Any Questions programme last Friday. Caller after caller expressed anguish, especially callers whose loved ones were in homes that had allowed no visitors at all over the summer.
They spoke of the distress of those who were frail and bedridden; those who relied on lip-reading, impossible through windows; the breakdowns in relationships because the resident believed that family members had abandoned them; emotional and mental health “significantly worse than went they went in” to the home, one caller said.
Another, who had started campaigning in March to be able to see her mother, a dementia sufferer, said that it was now too late. “I wrote to every government and independent agency to ask why, once restrictions were eased, my sister and myself could not go in and sit six feet away, but be inside — instead of trussing her up and bringing her outside to sit under a tarpaulin for 15 minutes, which she wouldn’t understand. Sadly, the first time I held my mum’s hand was when she was dead.”
Methodist Homes for the Aged (MHA), one of the biggest providers, has been enabling Essential Family Carer visits for some time, but acknowledges that it is a mixed picture, and that visiting is causing both concern and frustration for relatives, residents, and staff.
The director of chaplaincy and spirituality for MHA, Dr Chris Swift, said on Tuesday: “We very much want to see visits as normalised as possible but can’t — and shouldn’t — ignore the risks. We obviously have homes in local lockdown areas where we can’t have visiting, or where there have been cases either among residents or staff. The list of homes, is, naturally, changing on an almost daily basis.
“Homes have been busy doing their risk assessments to facilitate indoor visiting now the weather is getting cooler, by identifying a suitable room and looking at safe routes, etc. We are also ordering Perspex screens as an additional barrier between a resident and visitors.”
Chaplains were in every residential facility, and had continued to visit throughout, Dr Swift said. It had been a few months since MHA recorded a death attributable to Covid-19, which, in view of the high infection rates in areas of the UK, indicated that the measures to safeguard residents were working.