Shocked about death in care homes **MNHQ content warning**

[happyandsingle]

Just this.Cannot believe how care home residents and staff have been thrown to the wolves.
Everything focused on the NHS it's like the elderly didnt matter.
Feel ashamed how we treat our elderly and even if the government act now in my opinion it's to late as to many lives have been lost.
To think the goverment need to be held accountable for this.

@Cantory It’s sad but I would be a hell of a lot more sad about a young person dying. And when you say “died before their time” - what exactly IS their time? If a 95 year old who lives in a care home dies from Covid-19, how much “before their time” is that? Maybe if they are in a care home - meaning they need around-the-clock care, it is reasonable to think that they have had “their time”?

These people cannot all be looked after in hospitals - there isn’t enough room. Until recently there haven’t been enough tests. The government was 100% right in prioritising those who are young/independent/have a decent chance of survival.

I find it kind of grotesque how some people think life should be eked out until people are just husks of their former selves, and how cowardly people have become about death after a good, long life - it didn’t used to be like this.

I guess the care staff deaths along with those decrepit old folk are collateral damage for many too.

@EmeraldShamrock I am sorry to hear about your mum. 69 is no age these days and is certainly not the age range I was talking about.

It’s criminal. If we are fortunate we all become old. This is what we have to look forward to if we are lucky.

Hang your heads in shame.

I’ve worked as a carer in peoples houses and in a care home. And my father in law was in a care home before he died. Most are expensive, council tenants get a discount, then my father in law had to pay more to. subsidise them. He wasn’t rich but paid a lot more as he was in a church estate flat and had a small amount of savings. It was about £1000 a week just for bed and board, no nursing. The care workers were paid a pittance and given very little training. The owners of a lot of these homes make massive profits and knew in January what was happening in China. They had plenty of time to get in protective clothing and they should have had some in stock at that time for protection against flu as well. The nature of care work obviously makes social distancing very difficult. A lot of care workers are agency staff, so work both in homes and private houses, so there is always the chance of contamination from clothes and bad hygiene practises. Also the problem of people being sent home from hospital without checks for the virus. We saw the same problem in Italy and Spain, so considering all the above problems and the age of people in most care homes it’s not surprising really how the virus has spread so quickly in care homes.

@frothandbubble Way to minimise talking about 95 year olds.

@frothandbubble You are basically saying people when they need a care home should just be left to die or killed.

And government pays for a lot of people in these care homes. They have a duty of care. A duty of care they have ignored.

@Cantory Killed? Who said anything about saying they should be killed? I’m not discussing this with you anymore - what a ridiculous thing to say.

@frothandbubble You said if someone lives in a care home maybe they have had their time. Do you really not see the logical conclusion of saying that the life of anyone living in a care home has no value at all?

I think disabled people and old peoples lives have value. And as someone who is disabled myself, I don't think because you need some physical help that makes your life not worth living or without value.

I don't think it's surprising or a scandal that a lot of people in care homes have died. I think it is very sad but inevitable and not preventable.

Most people in care homes have dementia (that is statistically correct). They don't understand restrictions, they wander, they can't be isolated in their rooms. Staff have to be in close proximity to multiple residents to give care. Therefore if it gets in it will spread and people will die.

It could get in via staff and via new residents. There WAS a drive to clear NHS beds and discharge to care homes. It was thought that had to be done to avoid hospitals being overwhelmed and scenes like Italy and New York. It hasn't been that bad but no-one knew that at the time. The care home companies took the generous cash incentives offered to take new residents. No-one was forced but they may have been bribed.

There was NO availability of tests at that point to test everyone. It was restricted to positive travel history. Now that there are more tests the advice has changed and everyone is being tested before discharge and advice is to isolate if possible. That just wasn't possible at the start there were no tests. None for NHS staff either.

There's a whole lot of 20:20 hindsight on this thread. Care home owners no more realised how bad this would be in January than anyone else did. In January people were still going on ski holidays to Italy not stock piling ppe.

In the NHS standard ppe for most of us is the plastic apron and gloves and paper face mask. When they say PPE that's what is meant not a hazmat suit or an air filter mask or a gown. We have none of that. Social care have got the same as most non acute NHS settings.

The reason a lot of care (not all but a lot) in care homes is poor is woeful funding. The standard rates the LA pay wouldn't get you a room in a Travelodge let alone all your care costs and food. Only private operators in rich areas where people sell their homes to pay are 'raking it in' most are just able to cover costs. Therefore staff are all on minimum wage and get very little training. Staff turnover is very high. And yet people moan about how unfair it is to have to sell their homes to pay for care and resisted a tax to pay for care. A further example where people expect something for nothing ie a hard job to be done to a high standard but for no money and they should not have to pay.

So yes there is a scandal in care homes and it's the scandal of underfunding because people vote for Tory governments to keep their taxes low.

@WokeUpSmeltTheCoffee Strange to talk about how we can see what should be done in hindsight when there were posters on MN weeks ago pointing out lots of old people in acre homes were going to die.
No it was not inevitable that lots of people in care homes would die.

We could see elsewhere that people in care homes were vulnerable. The UK could have made a plan to protect them. That includes not discharging people from hospital to care homes if they had covid 19 and ensuring enough PPE.

There was time to prepare, but we did not prepare.
Yes 70% of people in care homes have dementia or memory problems, 30% do not. Many still enjoy life. Of course keeping them in their rooms is difficult, which is why sending back to a care home a resident with covid 19 expecting that person not to infect others, was never a realistic plan.
The truth is their lives were seen as expendable.

If you live alone and have dementia or memory problems you may be encouraged to go into a care home because although you can still enjoy life you pay turn on the oven and put a pizza in then wander away forgetting about it until the smoke alarm goes off. Or you come home and leave your keys in the door overnight. You can be at real risk of harm alone with a level of dementia that may not even be detectable to a stranger you are chatting to, but puts you at risk.

My father has mild memory problems. If you met him you would not think he had any issues. He gets out and about and enjoys life, but he has my mum. If he goes into the kitchen to get something my mum has to go in and just check he hasn't done anything dangerous by mistake. Such as putting the electric kettle on the gas hob and turning the gas on.

When people think of dementia and memory problems they think of the very final stages when the person no longer recognises anyone. But if my father lived alone he would quickly end up in a care home as he would burn the house down. It is sad that some people on this thread see his life as having no value at all.

The care home situation is a very good example of why private healthcare, much touted as the "solution" to the NHS, doesn't work in some sectors. (It might be fine for cosmetic dental work, say, but not for chronic conditions or the care of the vulnerable.)

A friend of mine works in a care home via an agency. One night shift there was NO PPE and a very poorly resident was coughing and spluttering over my friend for hours - the resident was so ill that my friend stayed with her. The next morning, the PPE finally arrived; the nurse my friend handed over to was furious at the situation. That nurse had done their job; they'd ordered masks weeks ago, when COVID-19 (as it has become) was first making waves in China.

Their initial order was CANCELLED by the financial manager as it wasn't deemed essential. The nurse put in a direct order. And was threatened with disciplinary action by the manager of the home who, like the finance bod, was NOT a trained or registered nurse.

More and more of these stories will start seeping out of the woodwork, I suspect. Nursing staff aren't allowed to wear their own masks usually, either. To be honest, I've been surprised at the home-made scrubs not having been turned down since the people making them can't possibly be on the NHS Approved Supplier Framework.

I'd anticipate when this first wave is over we will see a mass exodus of staff from the health industry, especially qualified nurses, and lots of early retirements, given the demographics of the typical nursing cohort.

(Luckily on this occasion it turned out not to be COVID-19.)

@racoon I too think we will see a mass exodus of nurses.

2 weeks ago the people dying now were already infected.

Policies would have needed to be put in place 4 weeks ago at least ie when lockdown had barely started and most people really did not realise how bad this would be.

Known positive patients were not being sent back to care homes. Known positive patients who have been hospitalised either died or were no longer infectious having been hospitalised for longer than the infective period. You can test positive and have a cough for many weeks after having Covid but you are no longer infectious from about 1 week after temp comes down. The issue was patients no-one knew were positive. There was not enough supply of tests until very recently to test everyone. You can say there should have been more tests but there weren't.

Locking down care homes means no visitors for residents which causes distress and not even medical visits ie GP, CPN, district nurse. This means people might suffer or die of other things. Some care homes did lock down early, some decided it was too extreme to do that for the above reasons. Those who locked down early didn't always avoid infections and deaths anyway.

I absolutely think the lives of people with dementia matter or why else would I spend my time caring for them? I do see it very much as about quality not quantity though and this seems to be what my patients and their relatives want too.

However dementia is a terminal illness every bit as much as cancer or MND. It is a mistake to equate a decision not to resuscitate someone or put them on a ventilator or in some cases transfer to hospital with any value judgement of the persons life. It is a clinical weigh up of how effective a given treatment will be vs how burdensome and unpleasant it may be for the person. For many people with fairly advanced dementia in a care home a decision not to transfer to hospital is correct as it would be futile and only cause distress. For other people it would be right to transfer but I cannot really think of many situations where anyone with a terminal illness would be offered resuscitation or ITU whatever that illness might be. Nonetheless it would always be weighed individually and discussed with the person (if able) and family.

@WokeUpSmeltTheCoffee People were saying care home plans needed to be put in place over a month ago on MN. I presume not people who are experts, but we could all see what was happening in other countries. So strange that government experts could somehow not see what need to be done.
In reality none of it is rocket science. The government just thinks people in care homes are expendable. That is the truth.
And so do some people on this thread.

And nobody has suggested ventilation or resuscitation for people with advanced dementia, no one.
We are saying that patients in hospital should not have been discharged to care homes for covid 19. They should have received appropriate medical care and that may have been palliative care, and prevented from infecting others at their care home.
And care home staff should have had proper PPE.

None of this is controversial stuff, it is basic infection control.

I read ina South Korean paper that they are starting to do regular testing on care homes by putting all saliva samples into one overall sample. If a positive is returned for that care home they then retest individuals to trace exactly who in the care home has it. Thus is where we need to be, testing efficiency, regularly. Getting on top of this thing. It is not on that people in care homes have been left out of figures.

The problem is that they are privately owned and run. Guidance was issued in February but many ignored it. I drive past 2 large care homes on my journey from work and drove past on 24th March and both were still serving dinner to large groups of residents sat 8 or so round a table up to 30 or 40 crammed into their dining room. I was shocked then that the owners weren’t doing more to separate them out. My SS is disabled and in a care home for adults with learning disabilities and they were flippant about it until we made a fuss and asked them to keep him separated as he is high risk. Again they didn’t stop visitors until end of March when schools closed and BJ did his lockdown speech even though they were advised to do it way before that. However I do agree that more could’ve been done by government to push this but how could they with private businesses that’s totally different to the NHS

Whoever said care home residents should be kept in their own rooms, evidently has no idea about dementia - and many care home residents are there because of that.,
Such a person will not understand or remember instructions no matter how many times they’re told, and would very likely become very distressed, agitated or even violent, if locked in. Many such people have a need to pace or wander up and down and the only way to prevent it is to lock them in, tie them to a chair, or drug them into a stupor.
None of which, needless to say, is accepted practice in a care home.

Strange to talk about how we can see what should be done in hindsight when there were posters on MN weeks ago pointing out lots of old people in acre homes were going to die

Depressingly, some are still saying similar, but in terms of it being an acceptable 'price' of lifting lockdown

Aren’t most cars homes privately owned?
How is the government responsible for them?

WTAF?

The government is responsible for the. In the same way as it is for other vulnerable members of society - and if it can provide support to businesses with furlough and soft loans, and with food deliveries etc, then it can for the most vulnerable in residential care.

But posts like this and others are symptomatic if not valuing the elderly and leaving them at the bottom of the pile

I imagine part of the problem is if carer's were on a higher decent wage fees at the home would increase.