What's really happening in care homes?
Updated: Jun 3, 2020
The 'Journal of Dementia Care' held a webinar this week (27 May 2020) entitled:
Effective, practical care and support of people living with dementia in care homes during and after the Covid-19 pandemic
The panel was chaired by Mark Ivory, the journal's Editor, with
Dr Pete Calveley – Chief Executive, Barchester Care
Kara Gratton – Care and Development manager, Milford Care
Lynne Phair – an independent Nurse Consultant
Our Anna Chaplaincy Church Lead, Julia Burton-Jones, took part and sent this report:
Listening to care home insiders talking about their experiences of lockdown in the sector during this webinar was revelatory. For weeks we have imagined what life is like now in our care homes, with occasional glimpses in TV news reports. Pete Calveley, Kara Gratton and Lynn Phair brought us up close to the realities.
This neglected frontline has been battling heroically to keep the frailest and most vulnerable members of our society safe, against all the odds. There was an undeniable sense of having been let down by society, left to find their own solutions and fight for their residents’ rights, with little hope that the so-called ‘recovery plan’ would deliver.
There is a great sensitivity to any paternalism and patronising ‘we know best’ attitudes from outside agencies, witnessed by very basic infection control guidance which took no account of the context and was delivered by people who had not worked in care homes. This reminded me of the need for us all to be humble and respectful of the skill and commitment that resides in the care workforce, in any effort to offer care and support.
Care homes have adapted to the virus amazingly, considering there was no road map for how to respond to a pandemic that endangers the lives of their residents. We heard of homes acquiring devices such as tablets and using Facebook to help families keep in touch, of how homes had been divided up into small households to prevent the spread of infection, had producing pictorial laminated cards to explain the need to use Personal Protective Equipment, PPE (‘It keeps you and us safe, and we are still smiling underneath’) and overcome the communication difficulties caused by wearing masks.
Supporting people in the later stages of dementia is highly skilled work, particularly when it comes to keeping them safe during a pandemic. We heard that, unsurprisingly, some residents had been unwilling to receive support from a person in a mask, that asking those who are highly mobile to socially distance from others was a great challenge, that the vital swab tests were a cause of anxiety and upset for some. Creative ways to engage residents with dementia in infection control were described. If a resident is reluctant to wash their hands regularly and often, staff might invite them to wash cups and saucers (clearly not ones that would be used) or bathe a baby doll they were attached to. Drawing from Montessori principles, Milford Homes were finding that people even in very late dementia retained the ability to read a few clear, simple words, and this was helping them engage and explain what was happening.
There was a remarkable silver lining. In Barchester Healthcare and Milford Care alike, incidents of distress in residents with dementia had seen a marked decline. The panel reflected on why this might be and concluded that the homes were calmer and quieter since lockdown.
Staff are exercising compassionate discretion in allowing close family members to have contact in exceptional circumstances; where a resident is deeply distressed or nearing the end of their life, they are finding ways safely to allow contact. Senior staff fear for their teams, especially in homes which have experienced multiple deaths linked to Covid-19, predicting many will experience Post Traumatic Stress Disorder (PTSD).
A key message for churches and Anna Chaplaincy in the months ahead is that pastoral support for staff and residents alike will be vital, but avoiding patronising and paternalistic approaches, in favour of respect and collaboration, will be essential.
Julia Burton-Jones is a dementia specialist working not only for BRF, but with Rochester and Canterbury Dioceses. Julia is also is a Dementia Friends Champion, and a dementia trainer in a number of care settings.