CARE homes were treated as if they were hospitals and the pandemic heightened prejudice against “poorly paid but knowledgeable” staff who should not be blamed for death rates and system failures, an elderly care expert has said.
Professor June Andrews, who is a Fellow of the Royal College of Nursing, said there should have been greater government consultation with the care sector before key decisions were made such as the UK-wide transfer of elderly patients from hospitals, seen as partly responsible for soaring death rates.
She said much of the guidance for care homes had been issued by people “who have never worked in a care home”, saying a directive to remove possessions, was more akin to “an isolation room in a hospital” and increased the trauma faced by residents separated from relatives.
The First Minister said yesterday that she had “huge sympathy” for relatives unable to see loved ones in care homes as campaigners gathered outside Holyrood, renewing calls for visiting restrictions to be eased.
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Relatives are also demanding the same access to testing as key workers to enable increased and safer visits to care homes.
Chief Nursing officer Fiona McQueen said the Government is “actively considering” how to increase access for families.
Ms Andrews, who is also a Professor Emeritus in Dementia Studies, said elderly patients could have been kept in hospital for longer but fears of emergency rooms being deluged by cases were motivated by shocking images of patients on trolleys in hospital corridors in Italy and Spain at the start of the pandemic.
She said the pandemic had also heightened a “pre-conceived prejudice” against care home workers.
“Some of the Government advice that was given, it was almost as if it was being given by someone who doesn’t understand what a care home is for, “ said Ms Andrews.
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“It is not a hospital, so some of the advice such as removing unnecessary things... that is what you do for infection control in an isolation room in a hospital.
“You cannot do that in a care home, one because it’s not practical and two, you don’t have anything to replace it and 90 per cent of the people in care homes have dementia and they need their stuff around them otherwise they get confused.
“There was a mistaken view across the UK that very many hospital beds would be urgently needed by acutely ill younger people with Covid.
“But discharging these older patients without enough time to prepare was a recipe for disaster that could have been predicted by care home operators because they know and understand care homes and how to care for older, frail people.
A lot of them (residents) could have been kept in hospital a bit longer.”
Figures show there were almost 1,900 deaths in care homes where Covid-19 is on the death certificate and an investigation found at least 37 patients were transferred after testing positive for coronavirus.
Official figures previously revealed 1,431 untested patients were moved between 1 March and 21 April, before pre-discharge testing became mandatory.
The Scottish Government said discharge decisions were taken by clinicians based on people’s needs.
Ms Andrews added: “The people who made those decisions, they did that on the basis of seeing images from Italy and Spain or people lying in hospital corridors.
"I’m not saying it didn’t happen but it was a framing of what was happening. We never got anywhere close to that in this country.
“The people who were starved of contact with the families, a lot of these people just got sick and died.
“It wasn’t the care homes’ fault but we’ve got this system that doesn’t work very well when you start messing about with the rules.”
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Ms Andrews will be among a panel of international elderly care experts taking part in a online event later this month which aims to highlight lessons learned from the experience of the pandemic, the findings of which they say must be integrated into the response to a possible second wave of the virus.
A Scottish Government spokesman said: “We want care homes to be first and foremost people’s homes and not just to be safe, but enjoyable places to live.
“Since the start of this pandemic our priority has been to save people’s lives, wherever they live and we have taken firm action to protect care home staff and residents as far as is possible.
“The Scottish Government is not involved in taking decisions about individuals’ care or the settings in which care is provided.
"However a framework of legislation protects the rights of individuals receiving care and throughout this pandemic we have worked closely with our colleagues in the NHS, local government and the voluntary and independent sectors to do all we can to ensure the needs and rights of residents in care homes continue to be met.
“We are acutely conscious of the impact restrictions can have on residents and their families and we are actively considering how we can secure a better balance between safety and improved quality of life for everyone living in a care home.”
The Herald's Think Dementia campaign aims to improve care standards for people affected by dementia and their families. Visit our dementia hub at www.heraldscotland.com
Care Homes: The One Step Guide by June Andrews is available now.
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