Tuesday, June 23, 2020

To Visit or not to Visit.... that is the question..

First things first, the virtual tour with our MP two weeks ago went well.  I am delighted to report that he was able to spend over 1.5 hours with me (via video call), meeting staff and residents and seeing around our home.   I think I can say with certainty that he understood more of the challenges after the meeting than he did before the meeting.  We discussed;
  • The admission of untested residents from hospitals at the start of the pandemic (although we took in no admissions we were asked to do so).
  • The challenges of PPE and social distancing and how "one size" does not fit all when it comes to guidelines for care homes.
  • The challenges specific to those living with dementia through the pandemic.
  • PPE issues - some PPE which is not fit for purpose.
  • End of Life visits
  • The future of small privately run care homes
Many of the issues we discussed do not have easy solutions, there is no magic wand but I really wanted to give him an understanding that a one size fits all approach can not work.

It was not all gloom and despondency.  He said at one point he was surprised just how "homely" our home was.  Music to my ears!  We told him about the activities, how we have communicated with families...  I even sent him a link to this blog.  I hope that going forward he will be able to fight the corner for the residents of care homes...

Over the past few weeks the subject of family visits has been one that plays on my mind.  As lockdown restrictions are lifted I know many family and residents themselves look forward to the time they can see their loved ones.

Today further lockdown restrictions were lifted.  Two hours after Boris made his announcement we were sent guidelines which state "Family and Friends should not visit care homes apart from next of kin in exceptional circumstances". But that ultimately it was for the care home to make the decision on whether it is safe to visit or not.

When we allow visits they will be in the garden (although I am hoping to build a visitor pod in the not too distant future), socially distanced and limited to one visitor.  Every single resident, every single family member has their own set of circumstances.  
Will the resident benefit from the visit?
Will the resident and family member be able to socially distance - imagine you visit your Mum, she dissolves in tears at the sight of you after 14 weeks, how hard will it be not to hug, not to hold hands.... even more so if your Mum has dementia?
Is the resident part of the very vulnerable shielding group?
Has the visitor been socially distancing / do they work in a higher risk environment?
Do I temperature check on arrival? what PPE to provide? How to we clean the seats between visitors?

And then the most serious of all..... if we make the wrong decision and a visitor is asymptomatic and passes Covid-19 to their loved one, who pass it on to the other residents...... and staff......It keeps me up at night.

At the moment I feel that garden visits will be right thing to do for some residents.  Those residents who we know will benefit from a visit.  I know how hard this is for families having to wait to see their loved ones in person. 

In the meantime I will ensure we keep our wonderful residents, safe, loved, busy and happy.  I will send images, I will send videos, I will over communicate to all our residents families.... and my dogs.... they will also keep watch on them.

Wednesday, June 10, 2020

How to communicate?

I have not updated this blog for a little over a week, it feels longer!

All our residents are fit, well, happy, loved and well cared for.  We remain in lock-down and our residents have not seen their family and loved ones for more than three months,

I know that I speak for all carers, all over the country and probably world, when I say that although bonds between residents and carers were strong before the Covid-19 pandemic, but since lockdown our bonds have become even stronger, we have been cocooned with our residents, seeing them rather than our own parents and other family members and our residents have become part of our family.  I think of them before I got to sleep, when I wake in the night, and first thing in the morning (whilst also thinking about my husband and children).

We continue to keep our residents busy with a variety of different activities.  I am honest with them all, telling them everything I am doing to keep them safe
and keeping them updated as guidelines continue to change.

Communication is critical, and with our facemasks being worn at all times, this is tricky, particularly for those living with dementia who are unable to verbally communicate (and read).  I have raised these concerns to every single regulatory body and advisory group.  The feedback remains that the risk of asymptomatic transmission trumps the need to communicate.

These "expert" advisory bodies recognise the challenges and suggests;
- Put a mask on the residents so they don't get scared and feel the same as you (this does not even warrant a response from me).
- Give them a teddy or doll with a mask on (our residents are not children).
- Use an iPad to wipe board to communicate (many of our residents are not able to read or communicate in anyway, and for those who can, imagine if every single conversation you had with your loved one was on a wipe board)
- Wear stickers with your face and name on your tabard so residents know who is behind the mask (I got these made up, with the help of a company in Dubai..... and then we were advised that PPE changes meant they are no longer able to be worn).

PPE guidelines change weekly - now we are allowed no lanyards, no bright badges, no "Hello my name is..." badges, hair has to be in a bun (not plaited), headbands must be worn at all times.

So our residents now see us in masks, plain uniforms, no name badges, no smiley pin on watches.  I continue to advise the staff of these changes, and every time my heart sinks as I know we are ever so slightly chipping away at our ability to communicate.

I have done my own risk assessments, with family members and staff and for one resident who cried everytime we were with her, some staff do remove their facemasks,  she instantly brightens and relaxes.  I believe the negative impact on their wellbeing can not be under-estimated.  When I am doing activities with our residents and can ensure I am a good distance from them I do remove my mask.  When we go outside I take my mask off and keep as far as possible from them.  As the picture shows, some of our residents find other ways to communicate safely with those they meet on a walk.

I am not saying we should not wear masks, but the whole issue needs to be understood and the impact on quality of life considered with consultation with residents, and their families.

Which brings me onto this....  Tomorrow I am meeting (virtually) our MP to give him a video tour of our home, introduce him to some residents and carers and talk to him about the reality of life in a care home.

Today I am planning how to structure the conversation....

What would you want your MP to know if you were me???

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