A hard-hitting new report drawing on the voices of Anna Chaplains and Anna Friends paints a picture of what the nation's care workers are really feeling months into the pandemic.
Anna Chaplaincy Church Lead, Julia Burton-Jones, writes in Care Homes and Coronavirus:
'A palpable sense of hurt, dismay and abandonment pervades the sector, over lack of support during the crisis; staff struggling to access personal protective equipment (PPE) and testing, pressured to admit people with the virus from hospitals. During the Journal of Dementia Care webinar (27 May 2020), senior staff spoke of "patronising" attitudes from infection control advisors lacking insight into daily life in care homes. Fear was expressed that staff in homes where many residents died would experience PTSD (post-traumatic stress disorder).'
Julia had canvassed the views and personal stories of more than 40 Anna Chaplains and Anna Friends in the period since restrictions began. Many tell of their frustration at not being able to visit care homes in the usual ways and yet they describe a plethora of means by which they have sought to continue supporting staff as well as residents from a distance.
I urge you to read her full report, which paints a memorable, if disturbing, picture of people doing their best despite adverse circumstances: of residents dying, staff working long hours, of the dying's relatives being unable to attend fully, or to grieve properly for the deceased afterwards because of restrictions on visiting at end-of-life, and such limited funeral arrangements.
Anna Chaplains in regular contact with staff,' writes Julia, 'found teams were facing intense stress. One manager spoke of the "explosion" of cases of Covid-19 that took hold in her home. There were staffing shortages, as team members went off sick with the virus. Anna Chaplains sensed deep fear, especially early in the pandemic. Staff seemed "lost" and "lonely", struggling with the responsibility of being "everything and everyone" to residents. Where they had built up programmes of engagement with the community, including taking residents to church, their good work had been "cut away" by the pandemic.'
Staff stretched to the limit
'Care home staff face many pressures and are stretched to the limit, creating challenges for chaplains in maintaining links. Activities staff are crucial in ongoing contact with residents; spiritual care depends on them. With changes of manager, or turnover in key staff with whom links have been formed, there is a sense of starting over, which is almost impossible during the crisis. Another factor enabling ongoing contact is staff members who are Christians or see the importance of spiritual care; they ensure residents have contact with their churches and sources of spiritual encouragement. It can be hard for Christian staff when professionalism means they cannot talk about matters of faith.
'Anna Chaplains reported residents were missing friends and relatives terribly. Regular visits are a key source of well-being for many. There is a risk skills and abilities will be lost, and deterioration happen faster than would have been the case. Relatives feel the lack of contact deeply, and this has been brought into sharp focus when residents have died alone. A colleague in a partner organisation with parents in a care home faced the trauma of losing them both early in lockdown when visits were heavily restricted. Anna Chaplains were struggling in being unable to visit the homes and interact in person. They felt cut off, worrying about staff and residents, grieving for those who died.
'It was encouraging to hear of the many and varied ways in which churches and chaplains were continuing to offer spiritual care to care homes.'
Regular contact and assurances of prayer
'Team members and local clergy were making a point of being in touch regularly with staff in homes they supported, through telephone calls, text messages, emails or standing at a safe distance at the entrance. The main purpose was to ask after everyone’s welfare, to assure them they were remembered and prayed for by friends from church. Some have chosen to pray regularly by name for each of the residents they know. This assurance of prayer has been an encouragement, it was felt.'
My puppet Oscar has been doing his bit! To see people’s faces light up when they see him through the window is great.
(Anna Chaplain in Rochester Archdeaconry)
New ways of providing worship and spiritual care
'No longer able to worship with residents in person, team members had found news ways to engage them:
Involvement in regular worship services – chaplains are informing staff of the alternative Sunday services the church is providing during lockdown so they can play them on tablets or through smart TVs. We know of several care homes where this is happening. Some churches deliver printed booklets for residents so they can follow the service each week.
Tailored services – some chaplains are creating services at a distance aimed at the residents who normally participate. Examples were given of services recorded and sent into the home on a DVD, or delivered live via Skype, so staff can gather residents to share an act of inclusive worship.
Individual worship and pastoral care for residents - with the support of staff, chaplains are maintaining individual contact with residents, usually through regular telephone calls, though sometimes also using tablets for FaceTime chats. In some cases, this is an informal conversation, but one Anna Chaplain holds a mini service with each person (including a welcome, a Bible story, singing and praying for the person), increasing frequency from monthly to fortnightly. Some deliver prayer cards for staff to use with residents, including prayers for the dying. Where priests had been unable to pray with a dying person at their bedside, they had done so over the telephone, with a staff member sprinkling water.
Letters and cards – several Anna Chaplains are sending encouraging cards on a regular basis to residents they know in the care homes. They include a copy of the Church of England’s Prayers for Use During the Coronavirus Outbreak, copies of which I supply when requested.'
It is very hard for my seniors to access a virtual service if they have no computer or iPad. They are thrilled with the Daily Hope service and shortly we as a church are hoping to put our virtual services onto a freephone telephone call. In the meantime, I deliver Book of Common Prayer (BCP) Morning Worship aimed at seniors via our church website through Chancel or YouTube. I continue to write and video record my homily for the Tuesday service.
(Anna Chaplain in Tonbridge Archdeaoncry)
Supporting care home staff
'Care home staff have endured trauma and stress during the pandemic. Having to adjust to new ways of working, including the use of PPE and the distress this can cause residents with dementia, and losing residents prematurely to coronavirus, will leave a legacy of grief. There is also the risk of moral injury, where staff fear they may have brought the virus into the home or taken it back to their own families. The need for humility, respect and appreciation in relating to staff was emphasised. Many will need to tell their stories and we can listen as they try to process what has happened – surely a core chaplaincy role,' writes Julia.
Yet despite all these difficulties, care staff at one home, for example, wanted to express their thanks to the local church and its Anna Chaplain who have been doing much to support them:
Staff at the home our church supports asked me to pop over. They came out with a hamper full of goodies – notebooks, toiletries, biscuits, Prosecco, and two cards with their thanks to us at church for all that we have done. It was totally humbling as we should have been giving them gifts, but they were clear that we should have the thanks. We had a chat outside. Even a home where only four residents were lost has experienced so much emotionally and physically. I felt for all the staff, they have been through so much and I could see on their faces how it had taken a toll, although they were full of smiles. It highlighted how they appreciate feeling cared about and loved, how staff need to be heard.
(Anna Chaplain in Bromley and Bexley Archdeaconry)
Care Homes and Coronavirus: Anna Chaplaincy and churches' responses, for Rochester Diocese (June 2020).
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