Why are care homes being so badly hit?

[ssd]

I know the elderly are very vulnerable and PPE is inadequate, but is there any other reasons? How is covid happening in all these care homes?

From another thread.

Meanwhile in Canada...

www.nytimes.com/2020/04/16/world/canada/montreal-nursing-homes-coronavirus.html

The deaths in Canada were discovered late last week at Résidence Herron, a private home for seniors in Montreal, after the local health authority, alarmed by staff shortages and the spread of coronavirus at the home, took control of the residence.
They found dehydrated residents lying listless in bed, unfed for days, with excrement seeping out of their diapers.
“I’d never seen anything like it in my 32-year nursing career,” said Loredana Mule, a nurse on the team. “It was horrific — there wasn’t enough food to feed people, the stench could’ve killed a hors
After she left the home, she said, she collapsed in her car and wept.
A skeleton staff of two nurses had been left to care for a private residence with nearly 150 beds, she said. The remaining staff had fled amid the outbreak of the coronavirus, leaving patients, some paralyzed or with other chronic illnesses, to fend for themselves

DustyMaiden

Not all care homes are for people at the end of their lives.

There are many registered homes for 18-65 year olds who have mental health or learning disabilities or other physical needs.

One local authority in the UK insisted that everyone with Autism was to have an enforced DNR without the consent of their families in the light of COVID.

Deliberately introducing Covid into care homes is not “natural”. Neither is insisting young people with autism would not be resuscitated.

It’s calculated. And it will save the government a lot of money if it succeeds.

I think it is heartbreaking. Residents are so vulnerable and can’t have visitors (which I totally understand) and many will die without having seen their loved ones for weeks, possibly without being able to understand why.

I think they should have been tested before being discharged to their homes - presumably the government wanted to keep beds free for those who the hospitals were more likely to be able to help? Was that the thinking?

People are put in care homes at the end of their life because they are too frail to care for themselves.

Depends on the home. A lot of care homes are residential--some of the residents might need a little help with personal care but mainly it's for meals, help with medications and social activities. These residents generally have years to live and aren't 'frail.'

@RoosterPie, yes, that was the thinking--on paper anyway. Cynical me thinks they didn't care or wanted it to spread to care homes for economic reasons.

Maybe carehome residents had cv before going into hospital without being tested or the same staff were working in carehomes the community and hospitals. Maybe visitors were spreading it. At least in a nursing home you have registered nurses who have experienced and knowledge about looking after ill residents. In a residential home you are at the mercy of community nurses and the papers report gp havent been able to see sick residents.

I think there's a lot we aren't being told that will all come out in the wash several years down the line probably. If it has been caused by discharges from hospital of untested cases or ones that become positive later on I don't think they'd make a different decision in retrospect - this is akin to the treatment decisions made in italy effectively, just a quiet way of refusing to treat a group of individuals in hospital.

As the government has said, there are two epidemics - in hospitals and care homes, not in the community. I know of two cases in acquaintances, 1 a cancer survivor taken to hospital with a fever, tested negative but put on covid ward, later tested positive and died. 2 a current cancer patient taken to hospital with a fever this week, tested negative but placed on covid ward while awaiting results. What happens next?

Depends where you live. In my CCG you don't get admitted to an elderly care home unless carers coming in 4 times is not enough.

So you need 24 hr care essentially.

I was thinking in terms of care homes for the elderly.
@NameChange84. Has it been suggested that the virus has been introduced deliberately into care homes?

As PPs have already said, it must be extremely difficult, if not impossible to ensure social distancing is carried out properly in care homes. Unless all residents are to be confined to their own rooms, I don't see how they can be kept 2 metres apart from others.
The lack of ppe is also an issue. I confess, I was amazed about three weeks ago when I heard a caller to the local radio station complaining about the lack of ppe. The caller complained hat tge government had not supplied any ppe to the home, who h he stated charges 'only' around £1750 a week. The presenter asks whether the care home was council run or private. T was private home, so the presenter suggested that it was therefore the responsibility of the owners to supply the equipment. At this point the caller admitted that he WAS the owner but didn't see why his profit should suffer in order to buy ppe. That said it all for me.

4 times daily I meant to say. Apparently I keep leaving out key sentences

@DustyMaiden

Yes:

www.theguardian.com/commentisfree/2020/may/08/care-home-residents-harvested-left-to-die-uk-government-herd-immunity

Yep. Some private home owners dont give a toss about their residents or staff. Years ago they thought it was an easy gig to set up a home, charge a fortune, pay shit wages. They are the first ones who complain about having to pay the minimum wage while they enjoy their fancy lifestyles.

Because much of the world doesn't have homes for the elderly , they look after their elderly in the extended family home , so therefor they do not have the vulnerable grouped together as much

Because much of the world doesn't have homes for the elderly , they look after their elderly in the extended family home , so therefor they do not have the vulnerable grouped together as much

Most of the world doesn't have large numbers of people over 80 at all, either in or out of care homes

much of the world lives in traditional/undeveloped societies where it is possible to care for the small numbers of elderly in an extended family setup

Sadly this approach is not feasible in modern cultures
I would not want to live in a traditional society, because that would mean giving up the benefits and conveniences of a modern technologically advanced culture

It's really no mystery OP is it?

The residents are very weak and vulnerable to illness, living in close quarters, with social distancing impossible and many different people coming and going daily (the staff). Those are the absolute perfect conditions for most viruses including covid. It's hardly a conspiracy.

Care Homes vary in provision. Some are converted from old buildings, and others are purpose built. (Often have more space, and separate rooms, etc)
Also, if the resident has dementia, but otherwise fairly fit, then they often wander about. My mother walked into another residents room, and took their medicine (years ago, long before lockdown), resulting in a hospital visit.
It is not practical to ventilate someone in their 90s. It is a very invasive procedure, with the patient sedated.
So once in a Care Home, with very few exceptions, it is easy to spread. The Carers will be doing a lot of intinate care (cleaning their teeth, washing, bathing, helping them to the toilet, etc).
It is not very easy to isolate residents.

Over 60% of care home residents died if the flu virus in UK in 2017/2018.

Can you back up this statement, please, as I find it very hard to believe. I know 17-18 was a bad season for flu, but since there are around 400,000+ people thought to be living in care homes, 60% of them dying of flu would be an excess of 240,000 deaths. Since there were "only" 50,100 excess deaths in that period, 15,000 of which were attributed to flu, I think your statistic is well out.

Minimising the issue (by saying "this is not as bad as flu in 17/18) is not helpful - particularly when backed up with erroneous fingures.

Because much of the world doesn't have homes for the elderly , they look after their elderly in the extended family home

You mean women look after the elderly. You win some and you lose some as cultures change, we've lost the extended family/elderly care thing but we've gained women not being domestic slaves. It's not so simple as saying "oh why can't we all care for our loved ones at home".

My niece is in a residential/care home for people with learning difficulties and have just heard that someone in there has got covid19 They are not testing the rest of the residents including my niece and how the hell did it get in there in the first place? the residents havent been out for weeks so its obviously the carers bringing it in

Over 60% of care home residents died if the flu virus in UK in 2017/2018.

This is absolutely untrue for the care home organisation I work for, and I don't work for a small one. 17/18 was nothing out of the ordinary for us.

Do you mean that 60% of the people who died from flu in 17/18 lived in a care home? That might possibly be true, if the 15,000 excess deaths figure calculated by @Oakmaiden is correct

Also worth saying here, as we seem to only ever hear the worst - in my organisation we've had twice as many people recover as did from the virus, so even among this very vulnerable group this still isn't a guaranteed death sentence.

Twice as many people recover as die, not as did.

" I know the elderly are very vulnerable and PPE is inadequate, but is there any other reasons? How is covid happening in all these care homes?"
We'll, it doesn't come from nowhere. As they cannot have visitors then can only realistically become infected by:

1. Hospital patients with Covid-19 being discharged to the care home rather than being nursed to a successful (or otherwise) conclusion in hospital.
   i.e. piss poor decision taken by hospital staff.

2. Staff and carers infecting them.
   e.g.
   Lack or inadequate PPE;
   General poor standard of hygiene or care.

There has been a failure to hospitalise them due to trying to save the NHS from being overwhelmed. I know that many will have co-morbidities but plenty are in care homes as a result of mobility issues. Some who would benefit from non-invasive oxygen therapy aren't being hospitalised so that they can receive the treatment they deserve.

@user200000000

Because people were discharged from care homes without being tested.

Which is a bloody disgrace and proves to me this government don't give a toss about the elderly and were willing to sacrifice them 'because they were going to die soon anyway'.
Tests are carried out in hospitals though. Has there actually been a Govt directive that the elderly shouldn't be tested? Can the Govt even tell hospital staff what to do and not do? I'd be very surprised if that was the case.