Nursing homes urge caution in easing restrictions in wake of Nphet concerns

The vast majority of private nursing homes are "working towards" easing visiting restrictions, though some will require a lead-in period before making changes, according to Nursing Homes Ireland (NHI).

There may be individual nursing homes with more severe visiting restrictions, and all providers have a responsibility to protect residents and staff during the pandemic, NHI chief executive Tadhg Daly said.

“Sometimes they may have to make a judgment call [on limiting visiting] due, for instance, to high rates of community transmission or staffing issues.”

Mr Daly was responding to concerns expressed by members of the National Public Health Emergency Team that some healthcare facilities are continuing to apply “onerous restrictions” on visiting, in excess of national guidelines “and of any reasonable requirements at this stage”.

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This, according to chief medical officer Dr Tony Holohan, is "impacting negatively on the wellbeing and the rights of patients and residents to share in the resumption of normal social and family life that the wider society is benefiting from".

Mr Daly said easing restrictions was about “balancing risk” and “a degree of caution is needed”. Communication with residents and families was key to resolving visiting issues.

The number of outbreaks in nursing homes is “lessening all the time”, he acknowledged, and the resulting burden of illness is also reduced.

HSE guidelines

Changes to HSE guidelines for visitors to residential care facilities implemented last week removed the requirement for visitors to have a vaccination certificate, and stated there is no ceiling on levels of access.

Further changes on Monday further reduced the emphasis on physical distance between residents and visitors, and removed the requirement for residents to stay within their own “pods”.

Dr Holohan, in a letter to Government last week, said there was a clear need to make rapid progress on resuming social activity within residential centres and in relation to outings for residents.

He also emphasised the need for “reasonable access” for family and friends in all healthcare settings, including hospitals.

“Nursing homes and residential care facilities should move as quickly as possible to restore the activities and social life that provide a stimulating environment within the home for residents.”

In hospitals, nursing homes and residential care facilities, visiting restrictions that are more restrictive than those specified in national guidelines are “not indicated”, he said. The exception was where there is written advice from a public health doctor that additional restrictions are required “in a specific context for a defined period of time” and based on a risk assessment that is reviewed regularly and is publicly available.