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Care home staff are ‘in psychological recovery’

05 June 2020

MHA online service to grieve for 400+ residents and carers

THE care-homes provider Methodist Homes (MHA) is to release a special service online on Sunday 14 June, to reflect the pain caused by the loss of 413 residents and three staff at their homes.

The director of chaplaincy and spirituality at MHA, the Revd Dr Chris Swift, said last Friday that, at the height of the pandemic, there had been 20 deaths a day. This was particularly devastating, since most of them had been in a small number of homes.

The general situation now was “improving, or less bad”. Staff could cautiously be described as in psychological recovery, though they were anxious about a second wave. “They are in two stages, at least, of that process, which is quite exhausting for them,” he said.

“It does feel as if it is getting more under control at the moment; but it has been a rough ride. I asked the manager of one home with mortality well into double figures, how many of those residents would she have expected might have died [in normal circumstances] during this period? She had discussed it with her staff group, and the conclusion was one. It is impacting on people we would have expected to live months — and possibly years — longer.”

The speed of death had also taken managers by surprise, allowing, in some cases, no time to prepare staff and families. Some chaplains have been able to go into the homes and minister directly to residents and staff; others have provided virtual and other support. The possibility that they might be asymptomatic carriers had also weighed on the staff’s minds, Dr Swift said.

Care homes, however well intentioned and however skilled, were not a clinical environment, he said. “What we have tried to do in care homes for so long is to make them a non-clinical environment, not measured to the same degree of infection as a ward would be.

“Consequently, it’s a big home full of older people with underlying health conditions, and people with dementia who inevitably wander purposefully round the building. We have tried to manage this situation as effectively as possible, but it is challenging. One manager described the experience of Covid in the home as being like ‘wildfire’.”

Dr Swift emphasised that hundreds of residents had developed coronavirus symptoms but had recovered. These included at least one centenarian, who was hospitalised and later returned to the home. But there would inevitably be “a long mental-health and spiritual dimension to all this” for the staff. Financially, too, the homes faced costs of millions of pounds for continuing supplies of PPE and the impact of low occupancy.

The Guardian reported last week that a “high-impact” lockdown of care homes, in which staff would be accommodated on site, was proposed by Public Health England on 28 April. It was rejected by the Government, despite earlier demands from the National Care Forum (NCF) for “a ring of steel” to be put around care homes (News, 1 May).

Official UK figures suggest that about 16,000 care-home residents are confirmed or suspected to have died from Covid-19. A key factor was the discharge from hospital early on of patients with the virus.

In an online comment article, the Revd Janet Henderson, a state-registered nurse and former hospice spiritual- and pastoral-care manager, writes: “Back in March, incredulous care workers were listening to their distressed managers coming out of meetings in which plans to ‘safely’ discharge elderly people from hospital into care homes had been outlined. . .

“All our experience of working with the elderly, plus our gut instinct, told us something was amiss. What was being suggested was risky, dangerous, and, to say the very least, taking a capricious liberty with the lives and manner of death of vulnerable people. I am not writing this with the benefit of hindsight. At the time many of us made protests. I wrote to my MP and the CQC [Care Quality Commission].

“Had we known then that patients who might be, or were, infected with Covid-19 would routinely be sent to care homes where there was no particular expertise in nursing highly contagious diseases, no PPE, and no facilities for isolation, we would have shouted a lot louder.

“Had we known that GPs would not be allowed to visit, and no provision would be made for proper palliative care in some cases, we would have swung from the trees and yelled.”

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