How care homes have been affected during the coronavirus pandemic

If you have a family member or friend with dementia who lives in a care home, you will probably have concerns about coronavirus (COVID-19). This guidance will help you support them.

Some of these details may be unsettling to read but we hope that it is helpful. When you know about and understand how coronavirus is affecting care homes, you may be able to work with the home so you can all support the person with dementia better.

Why have care homes been so badly affected by the pandemic?

Care homes have been hit extremely badly by coronavirus. The virus has spread quickly through some homes to residents who are at particularly high risk if they develop severe COVID-19. Many have sadly died.

There are several reasons why care homes have been so seriously affected. They include:

  • vulnerable residents – people in care homes, especially nursing homes, are often in their 80s or 90s. They are also often living with dementia, frailty or underlying health conditions, and sometimes all three. These make almost all care home residents especially vulnerable to coronavirus. If they catch the virus they may become very seriously ill. 
  • the home environment – care homes are above all where people live, not like a hospital. Residents and staff are used to socialising and doing activities together. Providing personal care means that staff have to be in close contact with several residents over a day. All of this close interaction means that the virus can spread quickly within the home, even if measures are put in place to help stop this. 

    Some people with dementia frequently walk about and would normally be supported to do this safely as far as possible. This type of behaviour is particularly difficult for everyone because of the challenge in managing both priorities. The individual needs of the person with dementia remain, but so does the risk that they might catch or pass on the virus.
  • features of the virus – coronavirus spreads in small droplets (when someone with the virus coughs, sneezes, talks or breathes out) and by contact with surfaces, such as in shared living areas. 

    The virus can cause symptoms in older people that are different and so easier for care home staff to miss. In some residents and staff, coronavirus infection causes no symptoms at all. 
  • stresses on staff – many homes have had several staff members off sick with coronavirus. Staff are already busy but absences put extra stress on top on protecting and supporting residents. Care homes are familiar with residents dying, but the way in which many residents have died has been particularly difficult for everyone involved in the life of the home (residents, staff and friends/families).
  • lack of support – care homes have reported well-publicised problems getting hold of personal protective equipment (PPE). Many homes have had to buy PPE at inflated prices. Some have passed these extra costs on to residents. 

    Not all homes have been able to test residents and staff for current coronavirus infection in a timely way. The lack of guidance has also made it much harder for care homes to keep their residents, staff and any visitors safe.

    The discharge of people from hospital into care homes without first being tested for coronavirus probably brought the virus into some homes for the first time. This lack of testing in hospital before discharge was happening at the start of the pandemic. It is no longer policy.

What has this meant for people affected by dementia? 

About three-quarters of care home residents have dementia. The impact of coronavirus on them has been huge. Some people have seen their dementia get worse and faced a decline in both their mental and physical health.

The ways in which people with dementia have been affected by coronavirus include:

  • deaths from COVID-19 and a higher number from causes not directly related to coronavirus (for example, dementia and diseases of the heart and blood vessels)
  • grief for other residents (close friends) who have died
  • fear and confusion about their own wellbeing
  • picking up on stress and anxiety in care home staff
  • feeling unsettled because the faces of familiar staff members are hidden by masks
  • struggling to understand or comply with new restrictions within the home
  • impacted by friends and family not being able to visit and not always understanding why.

Of course, you will also be affected by all these issues, as are care home staff who are part of the community of the home. Understanding what the coronavirus means for care homes and what they have to deal with is a step towards addressing the problems.

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