“Emptiness I have never felt.” – the trauma of caring in the pandemic.

We are now eight weeks into the Covid19 pandemic in Scotland’s care homes and the extent of distress and trauma being felt by many residents, staff and families is really hard to bear.

I was going to write something positive this week about the way in which infections are declining, about the amazing  work that frontline staff, managers and owners are doing to keep spirits up and positivity going, and about the news that in one Health Board there are hardly any Covid positive cases in the care homes in the area. So yes, there is at last a sense in which we are turning a long slow corner … hope is on the horizon.

But on Thursday I received a letter of such honesty and beauty that I need to share  some of its content with you in this blog.

Mary is a nurse in a care home run by a family who have owned the home for many decades. It is a good home with plenty of individuals wanting to come in as residents and with very good and consistent Care Inspectorate grades. The staff are skilled, empathic, kind and committed. There really is, in Mary’s words, a home from home feel about the place. From her description this is a care home which is doing precisely what all good care homes do, providing life and energy and safety for those who need additional support due to frailty or age. Sometimes in all the debate and necessary focus on infection control of the last few weeks people have forgotten that a care home is not a ward, a unit or an institution but someone’s home. Places where people are encouraged to bring in possessions and furniture to make the loss of their own homes and spaces less acute and hard. Places where you are encouraged to wander and chat, to settle and be still, to dance and play, be active and alive.

Mary has worked in the home for nearly 13 years and she has nursed individuals through the rhythms of pain and parting, has given solace at times of sickness and celebrated when people have recovered and been restored to health. This is the nature of care home life, a life in tune with the seasons of humanity, comfortable with living through older age and enabling not existence but life to the fullest in the face of mortality.

Then the virus struck in Mary’s care home. Like the thousands of other nurses and care staff in Scotland’s care home sector Mary is skilled and experienced in dealing with viral outbreaks not least norovirus and seasonal flu. But Coronavirus is unlike any other. Its silence creeps and kills, it’s invisibility touches and destroys. Despite very stringent efforts, with adequate PPE and a well-trained staff the virus got into the care home. No-one knows how but it did. Mary writes:

“We have been living with this virus eating away at the heart of our home. In a matter of days, we have lost so many people it is just too hard. We have lost real characters  – people who made the place what it is with their laughter and jokes. We have lost folks who have been here for so long. And when I say lost that doesn’t even tell it as it is. The deaths were really hard. They were sudden and horrible. People need to know about this. No-one is talking about the horribleness of this disease… No one wants to know the real fear we feel as we sit there holding the hands of people as they pass… It is all just numbers out there read out every day. It is all about getting back to normal. I can never get back to normal… But it is our friends, people we know like a family.. I have lost so many… I cannot sleep at night because of the sadness I have… it is an emptiness I have never felt. I can’t even say goodbye to them.”

Mary is not alone. Others have written to me or reached out through social media to say the same thing that we are not telling the full story of the deep sadness that is being caused by this virus. That as a society we have become inured to the statistics turning them into data analysis, projections and comparisons.

All of us who have known and lost someone to the virus will live with that memory for ever. We have not had the chance to grieve. We have not had the moments of hearing the story of a life lived because there is no one to tell it to us. But those who have had to be present at the bedsides of residents and friends, those who have experienced multiple deaths in such a short period of time, their trauma is acute and aching.

It is each of our responsibility over months and years to uphold and support these people. We will need to be very alive to the reality that what some will suffer will be post-traumatic stress. We will as a whole society, from Government to provider, from neighbour to family, require to be present to listen, console, support and cradle their grief.

But it is not just for care staff. Our cradling and solace-giving needs to be for the families and friends unable to be present, for fellow residents who have lost friends, and indeed for ourselves.

I hope that in the coming days and weeks the increasing words of harsh criticism, of finger-pointing and blaming, will be quickly worked through. I accept that they are often a understandable response to grief and trauma and that they are sometimes necessary to assure and to hold accountable all of us for what we have done and not done. But they ill-serve us if we want to move forward as a nation, as a community and as individuals. We need to learn again how to be kind.

I really do hope that we are all able to be increasingly present for those who feel like Mary, emptied of hope and life. I hope we will remember that true community is when we work, act, sit and rest in a spirit of open honesty and togetherness.  

There are hundreds of stories which have been left untold. As we come out of this cruel time it is up to each of us to give space for their hearing, soothing for the sorrow felt, and comfort in the emptiness. Mary and others in our care sector deserve no less.