News | Monday, 15th June 2020
Coronavirus: How can we stop social isolation in care homes?
Drive-through and garden-based visits can help care home residents feel connected, says Dr Sarah Campbell
By Dr Sarah Campbell, Lecturer, Faculty of Health, Psychology and Social Care
The Coronavirus (COVID-19) has touched all parts of people’s lives and none more so than for those in residential care facilities, such as care homes and nursing homes.
The pandemic crisis has led to these residential facilities having to make challenging decisions to protect residents and staff from the spread of the virus. We have tragically seen the high numbers of deaths in care and nursing homes, which has been gravely concerning and it is a truly unprecedented time within this sector.
However, of equally grave concern is the social isolation and loneliness being faced by care home residents in this latter stage of their life.
Families and friends have been unable to see their loved ones living in residential care facilities as care and nursing homes have restricted numbers entering and leaving in an attempt to stem the spread of COVID-19. This has led to the closure of their doors to visitors and has also led to smaller staffing teams.
As well as this there have not been the usual engagement activities with creative professionals, chaplains, or other staff such as allied health professionals and care-based hairdressers entering the care environment. It has led to care facilities making decisions about what is ‘essential’ care to the neglect of other aspects of care and wellbeing.
Staff shortages
Care facilities have been under incredible pressure operating with a shortage of staff, and often having to do more than usual because they may have unwell residents to attend to, they may need to undertake tasks usually done by allied health professionals, care-based hairdressers, and activity providers; all of which impacts on the emotional wellbeing of residents.
Residents are not only not seeing people from outside of the care facility, they are often not seeing many people from within the homes, as gatherings are limited or non-existent between residents. And when residents see staff it is often under masks and visors, essential protective equipment for preventing the spread of COVID-19.
Media reports have described how residents are spending extended periods within their bedrooms and in some residential care facilities having all their meals within their rooms. The numbers of those living with dementia in care homes are also high, around 70% of all those living in residential care facilities have some form of cognitive impairment.
It may well be even more difficult for those living with dementia to understand why they are being restricted to their rooms, or to understand why their families and friends have not visited and they may feel abandoned. Lack of activities and interactions for those living in care can lead to feelings of uncertainty. It is essential to support relationships and connectivity in order for restorative atmospheres to emerge in care environments. Social connection is important for residents to feel a sense of community or belonging.
As the experience of depression within residential care facilities is also extremely high these kinds of limitations on social engagement increase the likelihood of experiencing a depressive period. This can lead to lethargy and feelings of demotivation even for basic daily routines, such as bathing and eating.
For older people not moving around can also be hugely detrimental for both physical and mental health, and there is the risk that sedentary behaviour itself leads to a shorter life span.
As people outside of care facilities become able to move around with more freedoms from the lockdown period and they regain contact with friends and family albeit with social distancing measures. We risk further leaving behind those in care facilities who have no idea when there will be a relaxation of measures in their homes.
Drive-through visits
There are care facilities which have been incredibly creative and resourceful and who are taking innovative measures to enable residents to meet with family members using ‘drive-thru’ visits or social distanced garden visits. However, finding solutions requires care facilities to feel supported and reassured.
At a time where guidance is most needed it has not been nuanced enough for the sector and currently all care home inspections have also ceased. The Care Quality Commission could be utilised in order to ensure care homes are undertaking the best practice measures to both manage COVID-19 and importantly to also support residents to enjoy the quality and dignity of life that they are entitled to.
Prior to COVID-19 care facilities often described staff shortages, and the physical and mental pressure of their work. It could not be a more challenging time to work in this sector dealing with high levels of risk, and trauma. Yet the risk of residents facing the latter part of their life locked down, without exercise, the opportunity to be outside, to socialise and to receive other vital input into their everyday lives is also something that needs to be balanced against these stark choices regarding such a virulent disease.
Involve relatives and residents
Relatives and residents need to be involved and included in decision making. There are organisations that highlight good practice, and provide advice to care facilities, such as ‘My Home Life’ and the Relatives and Residents Association. But there must be a co-ordinated response that enables all residential care facilities to access advice, support, guidance and examples of good practice and to ensure participation and involvement of all stakeholders.
In the UK we have just seen mental health awareness week – 18 to 24 May 2020 – and it is vital that we extend our awareness to all areas of society, and we must not neglect those living in residential facilities where the risk of mental distress is extremely high and surely worsened by the challenging times we are living through.
It would also be hugely valuable to ensure that research is funded which can explore the impact of this crisis within the residential care sector to explore approaches and innovations to care that create and support social connections whilst ensuring the safety of residents and staff.
Organisations that can help:
