Care home admissions during Covid-19

Care homes have continued since the Coronavirus outbreak to both receive back individual residents from acute settings and to continue to have admissions from both the community and hospital  settings. This is a critical role for care homes and is in part to make sure that there is no greater pressure on the acute sector than it needs to be. But it should be understood that care homes always have admissions from hospitals. If care homes stop doing this then individuals will be stuck in hospital which would effectively put them at a much greater risk. Staying in hospital longer than you need to is something which we know carries real danger for patients. It is also something which can be immensely distressing for individuals who might be living with dementia.

The difference with COVID-19  is how these admissions are handled. When being discharged from hospital it is often routine for the person to be tested if they have been Covid positive to make sure they no longer have the disease. However, testing will only show whether the person has Covid on that day. It will not show if they had it before or if they will get it. There are also dangers from  false-negative tests. What there is are strict clinical assessment protocols which are in place before discharge.

Once someone arrives at the care home they will be isolated and will be barrier nursed as if they have Covid – even if it is recognised they do not – this is a belt and braces approach and lasts for between 7-14 days dependent on the risk assessment of the individual. We have made it very clear that no care home should receive any new admission or returning resident unless staff are clear that they have sufficient PPE to allow this to happen. Some care homes have isolated individuals in separate units with separate nursing teams to reduce the risk of cross-infection.

I would ask those who do not want admissions to happen and returns to happen what they would do with these individuals. They are not objects or commodities, they are human beings, often frightened in an alien environment and wanting either to go home or to get some stability. What would you say to someone who is simply trying to get back to their own home including those who have come through the battle with Covid?  Hospital can be a confusing and distressing place for someone with dementia – they want back to what is familiar and safe. And I would ask what would you say to someone stuck in hospital, often with conditions other than Covid, in the knowledge that they are at greater risk of infection and deterioration the longer they stay there?

We need the least restrictive and safest option for the most vulnerable.

Some of the commentary over the last weekend has been inaccurate, alarmist and insensitive. In all the emotion of the moment, we all of us need to remain respectful, to use language which affirms individual worth, and always to seek the best interests of the most vulnerable.

 

Dr Donald Macaskill, CEO

Grieving in the time of a pandemic

Grieving in the time of a pandemic

Professionally I have been involved in the work of death, dying and bereavement for most of my adult life, both teaching and writing about the subject. In some senses then I am at ease talking about death and dying, about the pain of loss and the emptiness which the absence of another leaves.

At a personal level, like so many, I have had times when I have lost those very close to me. In those moments I have been forced to do the hard work of grief. In all honesty it has been in those personal times despite my so called ‘head knowledge’ that I have struggled to find a path through and a sense of balance when the waves of emotion overwhelm.

Bereavement is the sense of feeling robbed and bereft. For no matter how expected or anticipated a death or loss is, its ache is still sore, its pain still raw, its touch a cold beyond description. The pain of grief is like no other. It is a total emptiness, feeling abandoned and bereft and a searching which never seems to end.

This sense of lost-ness is beautifully conveyed in the original word for ‘bereavement’ from the Old English- ‘bereafian’ which denotes a sense of deprivation, of being robbed by someone, of being seized or grabbed out of living and life.

It is this feeling of being robbed that has been described to me in the last few days in my conversations with people who have had to endure the death of a loved one, someone they knew or who they cared for to Coronavirus.

This pandemic robs you. It robs you of time. It robs you of the moments when you would have been with another to say goodbye. It robs you of the touch, of the assuring smile, of the ability simply to wipe away a tear, of the chance just to be there. For to be with another at such times is to be still, to be in a touching place between life and death, between presence and absence.

This pandemic has robbed us of our traditions of saying goodbye. This is true of those who have died whether of Covid or for any other reason. It has robbed us of those moments when we find ourselves comforted by others; family have literally to be two metres apart unable to hug and console. It has robbed us of times when a song, a piece of music or hymn has sparked a memory and given familiar reassurance. It has robbed us of the rituals and rhythms of funeral and wake, of tradition and association. It has robbed us of the conversations which have sparked laughter even from the depths of sadness. It has robbed us of our ability to be with others, to reminiscence and remember.

This is in no way to deny or forget that undertakers and funeral directors, clergy and officiants are doing amazing jobs to keep things as ‘normal’ as possible not least through ‘Zoom funerals’ and video links. But strangely that very ‘connection’ has for many of us felt artificial serving only to confirm the sense of bereftness.

But out of such a sense of futility there are those who have been working hard to ensure that we can grieve despite the pandemic.

I wrote last week bout how important it was that we all made efforts to ensure that even if far from perfect there is a chance for people to say goodbye. I was therefore very pleased that a few days ago the Academy of Medical Royal Colleges along with Marie Curie and Scottish Care was able to publish some guidance to help this process. Huge thanks to Professor Andrew Elder for championing this and getting this done. 

Then on Wednesday we saw the publication the first Bereavement Charter for Children and Adults in Scotland. Over the last eighteen months I have been honoured to chair the working group of practitioners from across a whole range of organisations who have come together because they believed that Scotland needed to get better at dealing with death and dying. They devised the Charter as part of a national movement to get us all reflecting more about the role that grieving and supporting those who grieve should play in our lives and in our communities. 

No one could have imagined that the Bereavement Charter would be launched in such strange and disturbing times. Its messages have never been more important or necessary.

The next few weeks we will be all of us be rightly focussed on beating this virus. We will also be concerned about those most impacted in families and as professionals in the NHS and in care homes and home care. But after we get through to the end even if it is just the beginning of the end we will still be robbed of so many who have died, still needing to do the work of grieving.

We will need to do a lot to support those who are formal carers especially those who have faced grief at its most acute. For no matter how skilled and experienced you are we all need to be supported and upheld through our grieving, we all need to find a solace that comforts us in our weakness. When we have a sense of futility and despair, both personally and professionally, we need there to be space to open up and pour out our feelings; we need there to be people who have time and capacity simply to be present and there for us.

That will necessitate real change. There will be few of us who will be left untouched by this pandemic. Few of us will not know someone, however distant, who has been lost to the virus. We will all of us need to grieve both as a nation and as individuals. We need to be given space and time for that to happen.

We will, I hope, have a National Day of Mourning. I hope we will also as individuals and families have space for formal memorial services and events to recognise those who have died. But I also hope we will start to change the way we think about death and dying, the ways we need to begin again to restore the lives of those who are grieving and give solace to their hurt. Perhaps as a society in recent decades we have lost the capacity to share the grief of others and have individualised death, dying and loss. This surely has to change. We owe it to those who have died that their loss should mould us into a new tomorrow.

If Coronavirus leaves us with anything I hope it will be a determination not only to live better but also to be more comfortable and open in the face of dying as individuals and as a nation, for it is in that light, I am convinced, that we end up living our lives to the full.

Donald Macaskill

PPE

Mandi and her company National Property Auctions has retooled to help those in need during the Coronavirus crisis. She is currently able to supply large volumes of PPE to the NHS which has already been checked and approved through the lab at Gartnavel Hospital. She has two flights coming in from China next week with over 5 million pieces of PPE kit onboard including gowns, masks, plastic visors and suits.  Mandi can source anything please call her today. In addition, she now has a team who have offered to deliver to any care home or establishment once the PPE comes into the UK, so an added benefit to you! Call her today!

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Call my mobile today 07958313872

Email – [email protected]

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Grey Matter Learning

Grey Matter Learning’s response to COVID-19…

We’re working to support our community during this COVID-19 crisis. We are humbled by the positive response that we received on our free Coronavirus e-learning course. Since 2006, our mission has been to Improve Lives Through Learning and to help the community further during this outbreak, we’re now offering:

 

We hope you and your families stay safe and well.  If there’s anything else we can do to support you in the meantime, then do let us know.

SMC

We are a UK based medical protective clothing and test equipment supply and distribution company for health care professionals and private citizens. SMC Medical is a new division of SMC Corporation Ltd, who specialise in inventing, developing and bringing to market, unique tools for the professional and consumer.

SMC Medical source and distribute only high quality products from reputable and quality manufacturers, we want our customers to feel confident that they are in safe hands when choosing us.

Amid the ongoing worldwide COVID-19 pandemic, SMC Medical has been working with its worldwide network of engineering and manufacturing partners to offer some of the most critical products, which are in short supply.

Contact Details

Telephone: 01664 503154

Mobile: 07860 308447

Additional Email : [email protected]

Website www.smcmedical.co.uk

GDS Solutions

GDS Solutions are a Business Solutions company providing many different services to the care sector, including Utilities, Digital Signage, CCTV, Two-Way Radios & Shredding Services. In the current climate, we have adapted and expanded our business to provide vital PPE to the care sector, as we already provide for the NHS as we are part of NHS Procurement and have been for many years.

Contact Details:

Andrew Smith

Email: [email protected] or [email protected]

Telephone Number: 07494 262 591 (as working from home), Office Number for future reference 01505 850042

Website: www.gds-solutions.co.uk

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Karen Napier Charity

The Karen Napier Charity is working with the Invergordon Distillery and Pearson cosmetics to provide free of charge hand sanitisers who provide care in the community in the Inverness area.  

Should you require a delivery of such hand sanitisers in this area, please contact:

Kyrie James

[email protected]

01381 622364

GMeds

Need PPE? All you have to do to register with GMeds is simply go to our website and complete the expression of interest form. A GMeds rep will then contact you to open an account and allow you to place an order. It really is that simple! Register here at

www.GMeds.co.uk

GMeds is a subsidiary of Global Packaging a 40 yr old importer and distributor of packaging materials, who already supply the NHS with items such as clinical waste bags etc. We have used our far east manufacturing capability and contacts to source PPE and our established logistics capability to import, store and distribute PPE items. However, rather than supplying national organisations and wholesalers as we normally do, in this instance, we have created a supply route directly to the end-user; the front line care providers. That’s YOU! So individual care providers can now open an account and access PPE supplies direct from the importer; thus keeping the effect of the huge price increases to a minimum. 

Midmen Ltd.

Looking for a broad range of PPE? Midmen have what you are looking for! Working with a supplier that is able to ship directly from Europe with a lead time of approx 72 hours.  Check out our products and pricing – in stock items that are in constant production in 5 factories in Europe.  For more information or to order email [email protected]  directly.

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