Nursing homes: ‘Upset suffered cannot be overstated’

Ann Fitzpatrick remembers watching the Covid-19 pandemic spread across the world, and wreak havoc in nursing homes, throughout January and February. "I couldn't but think at that point, that this too will happen in Ireland. "

She moved quickly, trying to get gowns, gloves, masks and sanitisers for her home, St Theresa's Nursing Home in Thurles, Co Tipperary. However, she found herself frustrated, with supplies bought up by the HSE, itself worried about the impact on the acute hospital sector.

It was like, she says, “we were all going out to battle and some of us had greater armour than others”.

When three suspected Covid cases emerged in her nursing home, where 30 people live and 32 people work, she was caught up in testing backlogs, waiting “eight or nine days” to get results. And when extra funds were made available to the sector, she says they came with the condition that her nursing home accept people being discharged from hospitals. She refused the funds, due to concerns over the risk of infection among workers and residents.

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To date, she has had no Covid in her home, but nursing home stakeholders who volunteered their experiences for a 200-page expert report on the nursing home sector and Covid-19, published on Wednesday, were not so lucky. The report details the emotional and psychological impact of the pandemic for families, employees and operators.

‘Significant strain’

The authors of the panel engaged with homes that experienced significant numbers of deaths – one home experienced six deaths in a 36-hour period. The report notes that in addition to fatalities, many residents and workers contracted Covid “which placed a significant strain” on basic staffing levels.

The report details that in some instances, residents did not have direct GP support as doctors themselves were cocooning. This was at its worst early in the pandemic, and later improved.

“The overall level of upset suffered by residents, relatives and staff connected with these nursing homes cannot be overstated. Many will require ongoing support and understanding in the coming months.”

The panel found that once Covid came into a facility, “it seemed to spread with undue haste”; while it praised HSE Covid response teams, it found that “speedy access to PPE varied, especially in the early weeks of the pandemic”. The authors found that “staffing levels were overstretched due to illness, the need to isolate – something that still causes many of the staff concerned ongoing distress and guilt”.

Meanwhile, many in nursing homes said that while they understood the rationale for visiting restrictions, they “were still thought to have been cruel, especially for residents who were close to death and also for residents with dementia whose diminished insight as to what was going on was compounded by not seeing their relatives”.

Family members expressed their “utter frustration bordering on anger” at the policy, particularly when a family member was close to death “and no family member [was] allowed in to say goodbye”.