Psychological help needed over nursing home deaths, regulator says

Nursing-home staff, surviving residents and relatives of residents who died from Covid-19 will require psychological help after the trauma of the pandemic, a care regulator has said.

Susan Cliffe, deputy chief inspector of the Health Information and Quality Authority (Hiqa), said that, coming out of the third wave of infections, the effect of the pandemic on nursing homes and their staff who cared for residents for years, as well as relatives of the deceased, had been traumatising.

There would be a need for different “psychosocial” supports in the aftermath to help staff, residents and family members of lost residents deal with post-traumatic stress disorder occurring from the loss and experiences of the pandemic, she said.

“Some families are traumatised by the knowledge that their family member passed away possibly with nobody there beside them, or maybe with people looking in windows, or maybe with just one person allowed to go in and sit with them,” she told The Irish Times.

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“Staff are traumatised by what they went through because of the nature of this illness. You could be talking to somebody at lunchtime and they seem to be fine, at 10 days post-Covid, and then suddenly they pass away that evening. It can be that sudden, that acute deterioration when you think they have turned the corner. Staff are definitely traumatised by it.”

Nursing-home staff and surviving residents who had shared living space for years with many long-term residents who died from Covid-19 would have to deal with this loss.

“There are some very sad stories out there and it’s not the way any one of us would want to go or have a family member go,” said Ms Cliffe. “That is one of the dreadful consequences of this pandemic.”

Third-wave surge

The third wave since Christmas led to a surge in infections and deaths, with the nursing-home and long-term residential care sector again among the worst affected. Health Service Executive figures published this week put the number of deaths linked to nursing-home outbreaks during the third wave at 816.

“We thought we had seen the worst last year but we actually had not,” said Ms Cliffe, referring to the first wave that disproportionately affected nursing homes and care facilities.

“The speed with which it spread to nursing homes from mid-December to mid-February was not like anything we saw before.”

The rollout of the vaccine to nursing-home residents and staff over the past two months has led to a drop in infections and deaths across the care sector.

Mary Dunnion, chief inspector at Hiqa, the State's health service watchdog, said that, in a sign of the benefits of vaccinations, the regulator has not had to "escalate" concerns or risks to the HSE about care facilities battling infections for the last two weeks.

“And where there is a Covid outbreak, the residents are not as adversely affected as they would have been before. That is all really, really positive. Our biggest barometer is that we haven’t had to escalate,” she said.

At the peak of the third wave, Hiqa had to escalate issues at up to six nursing homes a day with the HSE’s crisis-response team about risks in managing a Covid-19 outbreak.

‘Remarkable change’

Ms Dunnion said there had been “a remarkable change” from the first wave with the HSE having improved structures responding more quickly to escalated concerns about care homes to help provide staff cover for hundreds of care-home workers out sick.

“It enabled us to communicate and escalate much more quickly,” she said.

Ms Cliffe said the fact that the hospitals were as badly affected as nursing homes in the third wave meant there was a greater sense of “social cohesion” at battling the pandemic across the health sector and removed earlier questions around nursing homes during the first wave.

“There was not so much of that blame culture that evolved a bit during the first wave about what were the nursing homes doing that was so wrong,” she said.

“There was a cohesion to the support that was available; it was more of ‘we’re all in this together’.”