Covid-19: Impact of outbreak 'frightening' for many nursing home residents

He said: “It should not be lost upon us that four out of every five nursing home residents who contracted Covid-19 recovered form the virus.

“We knew that Covid-19 disproportionately impacts on older people.

“The planning and focus was almost exclusively on our acute hospitals. Multiple clusters initially emerged in our hospitals.

“But the numbers in nursing homes started to increase.

We were already aware people in our homes would be amongst the most susceptible to the virus and a national strategy and response was required. In the absence of such, the challenges emerged.

Mr Daly added: “Our decision to restrict visitors on Friday March 6 was informed by our Nursing Committee, comprising of clinical experts representing nursing homes across the country.

“It was not taken lightly. Covid-19 was within our communities and the weekend presenting would see thousands of people engage in close contact with residents and staff.

“At the NPHET briefing of 10 March, the decision was taken to publicly challenge the decision to restrict visitors as premature.

“This is despite HIQA, presented as the representative voice for our sector at NPHET, announcing that same day it would suspend visits by its inspectors to hospitals, citing the safety and wellbeing of people using services and staff.”

Sage Advocacy executive director Mervyn Taylor told the committee that the impact of the outbreak has been “frightening” for many residents, and for those with dementia the arrival of people in full PPE was “terrifying”.

“Serious shortages of staff meant that there was little, if any, time to provide support to residents in facilities where many died,” Mr Taylor added.

“For families with relatives who were extremely ill or dying, the inability to visit or to even talk to their loved one by phone was a source of considerable distress and frustration.

“At the core of this issue is the fragmented nature of social care for older people.

“Home support services, such as they are, are not on a statutory basis, are not regulated and have no clear vision, other than the level of home care packages that can be provided in any one year.

“Care in nursing homes is on a statutory basis and is regulated, but it has an overly complex and ultimately dangerous architecture.”

Mr Taylor added: “Over recent decades the State’s approach to residential care of older adults has been one of retreat in favour of private providers, with the remaining public facilities providing care mainly to the more frail with complex care needs, sometimes in famine-era buildings.

“Elements within the HSE, working with NGOs, put forward proposals for a change to a Teaghleach or smaller-scale household model but they were not supported.

The State, having outsourced the service, practised ‘sectoral distancing’ while the public, notwithstanding the excellent service provided by many facilities, has grown increasingly wary of the dark side of private investment in human vulnerability.

“Simply stated, we are talking of vulnerable people in a vulnerable sector.”

Mr Taylor outlined a number of the organisation’s recommendations, including:

• An integrated system of long-term support and care spanning all care situations with a single source of funding.
• Integration of private nursing homes into the wider framework of public health and social care.
• A wider range of service models and ownership models for both homecare and care in congregated settings.
• Incrementally develop a network of world-class community hospitals as teaching facilities.
• Legislation for adult safeguarding and protection of liberty in places of care and legislative recognition for independent advocacy.

Mr Taylor concluded: “The Covid-19 public health emergency has shown some of the great strengths of Irish society. It has also shown weaknesses.

“We have a two-tier healthcare system and a two-tier siloed approach to the long-term support and care of older people which is biased towards congregated settings.

“We owe it to ourselves, and to those who have sacrificed so much, to do better.

“Let’s shed a tier and set about building Slaintecare – a single-tier national health service with an integrated system of social care focused on home and a much wider range of options between home and community hospitals.”