Coronavirus and care homes

[WinnieHarlow]

Having just read the awful situation where 15 residents in a care home have died, surely allowing loved ones to visit could exacerbate this situation? Its a dreadful situation. Is a solution to seek alternative accommodation for the loved one in care, until Covid is over?

@Muchtoomuchtodo again - the article expresses it better than I can, please read it.

@lljkk

Didn't that 70yo? woman get arrested for removing her 94 yo mother? People in care homes very often need 24/7 care. They can't be cared for in private homes unless you have a lot of people in your household who would be willing to do lots of personal care for them.

No. She was arrested for assaulting a care home worker. The case was more complex than reported in the media.

@RiaRoth I’m not ignorant, I don’t think you - or anyone else posting is ignorant either. You sounds like you have a fantastic cate home, and I don’t doubt that many, many homes are providing outstanding care. But what about the homes that are not, and the care homes that are failing and not coping? What is the best thing for the residents if the government are not providing what is required, why is temporary care in the home not a viable option for at least some residents?

I was very surprised that my Dad’s care home has started allowing 2 visitor to resident sessions in gazebo in the car park from today (as they did from June until a month ago, when they completely locked down again). This was with consent of the Local Authority even though we’re in lockdown in England.

They’ve only achieved this by regular COVID-19 testing of staff & residents, no visitors/gifts/food parcels for 28 days etc. They have build a double glazed Pod in the car park ready for 1-1 sessions & limited physical contact (we presume).

On the downside, only 1 person in total will be nominated to visit him in the Pod; in my personal circumstances, I have a twin who also lives locally so have to decide who is The Chosen One.

Saw him today for the first time in weeks which was brilliant & heartbreaking (especially when my sister joked he’d have to pick his favourite for pod visits - I am not the chosen one lol). Temp checks, questionnaires, masks, hand washing before the resident is brought out.

Dad is mentally OK but has complex physical needs after a stroke; having provided physical & personal care for him I know it’s hard, hard work (I too have a disability) and he is definitely in the right place. Juggling my own physical health needs, family commitments & full time work made me exhausted, and with the LA seeing he was warm/fed/loved offered nothing in support (they are simply underfunded). No one should judge anyone who has to admit an elderly relative into a care environment & it is most definitely not like looking after a newborn, child or anything else. It broke me.

The guilt my sister & I had on putting him into the home he is in now was massive, but after 4 years he’s thriving.

Today he looks relaxed, warm, fed, loved & as fit as a flea in his wheelchair! The staff are excellent & it’s like an extended, professional, caring family. I’ll miss him when the 1 to 1 starts, but just to see him today was fantastic.

I want everyone to do their bit & stop thinking the rules do not apply to them so families like us can finally touch & smell & kiss our Mums & Dads & Grans & children & ... As not to is simply heartbreaking.

Quite. She was arrested for assaulting a member of the care home staff, her mother has dementia and judging by the comments made by the home and police at the time a DoLs is in place. And the daughter didn't have POA for health and wellbeing. Not quite "arrested for taking her mum home"

[quote WinnieHarlow]@RiaRoth I’m not ignorant, I don’t think you - or anyone else posting is ignorant either. You sounds like you have a fantastic cate home, and I don’t doubt that many, many homes are providing outstanding care. But what about the homes that are not, and the care homes that are failing and not coping? What is the best thing for the residents if the government are not providing what is required, why is temporary care in the home not a viable option for at least some residents?[/quote]
I did make suggestions re care homes

Temporary care at home is just a naive suggestion. It is like saying lets empty the hospitals and hospices and care for people at home. All Residents are in a care home for a reason, it is not a matter of making them a nice cup of tea and a chat. Many of them have complex needs from personal care, physical care and dementia care all need professionals and equipment to deal with this.

The governement needs to step up and offer more testing. Many care homes have shown it can be done (usually privately owned ones) so money needs to be available to help them. It would cost more to temporary move residents into homes

The guilt my sister & I had on putting him into the home he is in now was massive, but after 4 years he’s thriving

^^This is key, care homes are not the pits of horror. Good homes are thriving, vibrant, age health appropriate places. I also suffered huge guilt but to see the progress Mum has made in her care home is astounding. She has not been sent there to die she is there to live every last minute of her life despite her failing health. I could not match this at home ever.

@WinnieHarlow

I also have a close friend who works, and cares for her elderly Dad who has repeated water infections, falls, has dementia. It’s incredibly hard work for her - but she has chosen this over a care home in Covid times.

She must have help. You can't care for someone with complex needs 24 hours a day on your own. When my father was in a nursing home, he needed two nurses to take him to the toilet. Are you really suggesting that anyone could take that job on by themselves? At best you'd employ a live-in carer, but even that doesn't work if the person needs two carers, and is only possible if your house is big enough.

My MIL is at home and has four care visits a day. That is an option but you need a very reliable service - there was someone posting on here just a few days ago about being left because the agency was short-staffed that particular day.

@RiaRoth so there care in the community article I linked to is naive?

The government does need to step up more, but this was clearly not adequate/happening for the 15 residents that died in Wales.

And the idea that caring for an elderly relative is like caring for a newborn is naive in the extreme, even if the newborn has additional needs.

@cologne4711 I explained earlier that I was caring for an elderly relative following an operation for rectal cancer. I found caring for her no more demanding than caring for a newborn was my analogy She herself wanted to go into a care home after the procedure.

@WinnieHarlow

Gather a list of all residents deprived of their liberty in care homes and hospitals your area. Contact each resident and ask them how they are doing and whether they have any relatives they could live with while this virus persists. Explain that you will contact these relatives and friends. An inability to talk to you about relatives and friends should not prevent you from contacting them. Contact the relatives and friends and ask whether they can provide interim accommodation. This may be a life-saving measure. In ordinary times, people may not be willing to provide such accommodation, but the whole country is stepping up and people are volunteering to help others in so many ways. A “coronavirus planning check list” is provided below, to guide conversations you have with relatives. You can also direct them to the government guidance for those who provide unpaid care to friends or family. Contact homeshare and shared lives services in your area and ask for their support to help you move people out of care homes. It may not be possible for an occupational therapist to conduct an assessment in the relative or friend’s home, so this will have to be done via video conferencing. Much can be done in this way, asking questions about whether the home is barrier-free, has stairs and so on. Likewise, any training that the relative or friend requires to enhance their capabilities to meet their loved-one’s needs can be done via video conferencing. Telephone the registered manager of each care home in your area, and advise them to reach out to residents’ families and friends to make arrangements to get residents out on a temporary basis. Reach out to families and friends of care home residents directly. Put out public information to people who live in the area (for example through social media and local radio and television) advising families to contact their loved-ones in care homes and make arrangements wherever possible, to offer interim accommodation and care. Frame the message in a positive way: this is an opportunity to save a life and make a real difference. Speak to colleagues about how the local authority could provide funding for professional care staff to go into the home of the relative or friend to support their loved-one. Inform care home residents’ relevant person’s representatives (RPRs) and independent mental capacity advocates (IMCAs) of the steps that you and colleagues are taking and ask for their urgent assistance. Where there is any dispute (in other words, if there is some solution that could work but the local authority thinks it is not in the person’s best interests), it is incumbent on the local authority to make an application under section 21A of the Mental Capacity Act 2005 to the Court of Protection as a matter of urgency. When an application is made, involve the RPR and send them a copy of all of the documents and make sure they get in touch with a solicitor. In these times, it would be useful if the local advocacy service contracted by the local authority is able to perform the function of a litigation friend in the Court of Protection. This will be a much quicker process than the court inviting the Official Solicitor to act as litigation friend. If this is not part of the contractual arrangement, work with colleagues in other departments of the local authority to amend the contract and provide additional funding.

That article was dated April, it’s now seven months later and we are doing all that to the best of our ability!

It’s a very complex situation and unhelpful for people who are privileged to be able to give up employment and care for someone who clearly doesn’t have complicated care needs.

A very prominent lawyer in the field has advised the Coronavirus legislation will see many legal challenges in the future - article 8 of the human right acts vs article 2.

@shuyler Exactly!!! That’s why I’ve posted it! And no - that HASN’T happened, and the overall response here is that I’m ridiculous/naive/ignorant to suggest that it was ever a viable option! See the Guardian article I’ve also linked to.

If it HAD happened - and procedures were put in place for it to happen, I think lives could have been saved through this second wave.

[quote WinnieHarlow]@shuyler Exactly!!! That’s why I’ve posted it! And no - that HASN’T happened, and the overall response here is that I’m ridiculous/naive/ignorant to suggest that it was ever a viable option! See the Guardian article I’ve also linked to.[/quote]
Clearly not every point has happened in every area but you are naive if you think local authorities haven’t been working their way through those tasks. Your knowledge of the system isn’t as great as you think which is fine, except you are teaching your granny how to suck eggs.

@WinnieHarlow

If it HAD happened - and procedures were put in place for it to happen, I think lives could have been saved through this second wave.

You can think what you like but it’s wrong. You’re suggesting that we schlep older, frail and vulnerable people out their homes to another place where it might not be safe. It might not even be what they want. People who live in care homes are still allowed their views.

[quote WinnieHarlow]@cologne4711 I explained earlier that I was caring for an elderly relative following an operation for rectal cancer. I found caring for her no more demanding than caring for a newborn was my analogy She herself wanted to go into a care home after the procedure.[/quote]
But caring for a relative that doesn't need to be in a care home. You've admitted she just saw that as an option after her surgery!

I've got a 5 year old they can't be left alone, so is that the same as caring for a dependent older person? Ridiculous.

I think you possibly need to listen to some of these people who actually have experience of care homes.

@shuyler can you provide evidence of this before you accuse me of being naive?

It's an intractable issue. I think I'm right in saying that the vast majority of the elderly would far rather not go into care homes, and most families would rather not too. However, they go into care homes because they have such complex needs that it is the only realistic option (other than full time professional live in care in their own home, which is of course eye wateringly expensive). In an ideal world, people would be both financially and emotionally supported to care for their elderly but I imagine that many would actually struggle when numerous illnesses - and dementia - reach that level of interrelated complexity.

My GM lives in sheltered housing. Which is pays for monthly, her bills plus food and cleansing Etc. in normal times she would also get a social life and Trips out and visitors and entertainers plus hairdressers and foot care etc.

How would she afford to live else where as she’d still have to pay out each month.

@Haenow yes people in care homes are allowed their views, and many desperately don’t want to be there - and would be safer cared for by family as stated in the article I linked.

[quote WinnieHarlow]@shuyler can you provide evidence of this before you accuse me of being naive?[/quote]
Evidence of what, daily social work practice? No, that’s confidential. I’m never going to give even vague examples, let alone to someone who clearly doesn’t have the welfare and wellbeing of society’s most vulnerable in their best interests.

You’re more than welcome to read info on the court of protection and 32 Essex street. We continue to follow the law (MCA 2005) and where we haven’t, it’ll be on there. There’s tonnes of case law and transcripts.

Do I think we - as society - have done everything to protect our vulnerable? No! We never do though and people don’t usually care. This has just been more publicised. Those of us in the care sector know we’ve been letting people down and do our best within the constraints. Clap for carers indeed.......

My Ddad spent his last months of life in hospital and then a care home. We first tried to manage care in his own home with carers coming 4 times a day. He wasnt a large man (probably 5'6, and weighed 9.5 -10st) but neither myself or my siblings could lift him when he fell. He couldnt wash or bath himself, he couldnt go to the toilet and we couldnt change him if he soiled himself. I dont feel at all guilty that we chose a care home for him as he got 24 hour care from people whose sole job was to care for him. Even if I had given up work to look after him I couldnt have been indoors 24 hours a day to attend to him. What if I had gone out shopping or taken my DC somewhere and he had fallen out of a chair or needed his pad changing?

I would have thought most people, if they only needed help with cooking or cleaning would potentially choose an assisted living flat , retirement village or having a cleaner or meals delivered, over going into a care home.