Up to 250 people with dementia may have died in care homes during Covid-19

Up to 250 people with dementia may have died in residential care homes during the Covid-19 pandemic, according to a new study which calls for a review of current visiting restrictions.

However, this may be a low estimate and the number could be more than double this figure if the death rate matches the prevalence of dementia in residential care settings, the study suggests.

There has been little emphasis in Ireland on the needs of people with dementia during the pandemic, it says.

Up to May 12th, there was no mention of the condition, or of Alzheimer’s, in the minutes of the National Public Health Emergency Team (NPHET) or their letters to the Minister for Health.

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"For some this may not appear that untoward, but given that in Ireland close to three-quarters of all residents in nursing homes are likely to have dementia, the omission is noteworthy," say study authors Niamh Hennelly of NUI Galway and Suzanne Cahill of Trinity College Dublin.

The Irish model of accommodating people who can no longer live at home in “large-scale generic nursing homes” differs from the small-scale options, including assisted living, available in other EU states, they point out.

This is “not conducive” to quality of care during normal times and will “undoubtedly have a deleterious impact” on people with dementia during a pandemic.

Given the unique and complex needs of people living with dementia, measures to ease the current restrictions on close family members’ visits to nursing homes and care homes should now be reviewed, the authors recommend.

Social connection

As Covid-19 is likely to be around for the foreseeable future, policy and practice needs to focus on optimally supporting people with dementia and their carers by providing more innovative ways to keep people socially connected, the study advises.

Staff need to be trained in delivering personal care tasks to people with dementia and there is a need for the careful use of assistive technologies to support the psychosocial wellbeing of people living with dementia, while maintaining physical distancing.

The authors say it is impossible to know how exactly the pandemic has affected the day-to-day lives of older people with dementia, for whom social contact, connectivity and pleasurable activities are so important.

“Given the Government’s cocooning guidelines for those over 70, we can only speculate that the latter will have a profound impact on quality of life. This, coupled with the cessation of group recreational activities in nursing homes, group outings from nursing homes to familiar places, and the absence of regular visits from family members and exposure to familiar faces of close relatives will all also adversely affect wellbeing.”

Although not a risk factor in itself, dementia places a person at “heightened risk” of developing Covid-19 due to increased age.

The condition also exposes a person to risky behaviour during the pandemic as it is more difficult for people with dementia to comply with public health guidelines and to cocoon.

An estimated 20,000-36,000 people in Ireland live with dementia in the community.