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12th October 2020

Is it time to bring families back into care homes

In my role as a Best Interest Assessor I spend a lot of time talking and listening to the families of people with dementia who are in care homes. It is a very stressful time for everyone. Although relatives generally understand why visiting is restricted, their loved ones do not. I hear things like “Dad thinks he has done something wrong”, “mum can’t understand why I can’t hug her” or “Dad thinks he is in prison!”. Families who can no longer help out with mealtimes or personal care are worried that staff are struggling to keep up with basic care. They are worried that the lack of regular social contact and meaningful activity will cause their loved ones to become depressed. Families are frightened that their loved ones are deteriorating and will quickly forget who they are. One family member told me that he found the time-limited garden visits so distressing for both him and his father that he feels it is not worth continuing and that he has therefore seen his father for the last time. These are genuine worries and there is growing evidence that many people with dementia are deteriorating both physically and cognitively without the contact and stimulation of regular visits from friends and family.

There’s no one size fits all solution for caring for people with dementia. Some residents are doing remarkably well. Some are able to use their visual and auditory skills to engage with video calls and with good preparation and support from care staff this has worked really well and provided comfort for both sides. But video calls don’t always work. The vast majority of us need human contact to thrive. People with dementia have already lost so much and taking away contact with loved ones feels like a prison sentence when no crime has been committed.

There is some remarkable work going on in care homes to try to support and connect families with their loved ones, yet despite their best-efforts people with dementia are still going downhill. It is upsetting for care staff who can’t do anymore, and this awful virus is not going away anytime soon. Is it time to rethink?

Care homes are rightly cautious about visits because of the risk of infection and strict controls and procedures are paramount for the safety of all concerned. In July leading charities including Alzheimer’s Society and Dementia UK wrote to the Health Secretary to demand that relatives are treated as care workers. New guidance from central government sets out steps that councils can take, working in partnership with care homes to enable visits in a safe and meaningful way. There’s no doubt that extreme caution is required and each case needs to be taken on its merit, but we need to find new ways of managing the risks of COVID-19 for people with dementia without robbing them of human contact as it certainly looks like it is here to stay for a while yet.

https://www.alzheimers.org.uk/news/2020-09-23/role-councils-and-better-connecting-families-affected-dementia

https://www.dementiauk.org/care-homes-and-the-coronavirus-outbreak/

 

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Katie Farrar

Occupational Therapist

Katie qualified as an Occupational Therapist in the year 2000. For most of her professional career she has worked in the field of older people’s mental health services within community mental health teams. As part of this she has had extensive involvement with people with dementia and their carers, both in the community and in care home settings. Katie is currently working with the Dementia Pathway Team supporting people with dementia in the care home setting and particularly with advanced care planning for end of life care. She has also recently completed the Mental Health Act Best Interest Assessor Course at Leeds Beckett University. Katie has developed and delivered training to care homes on dementia awareness, managing delirium and managing challenging behaviour. As well, she has supported carers to offer meaningful activities and experiences and provided guidance to care homes on improving environments to become dementia friendly. Read more

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