Challenges facing care homes during lockdown

Working in a care home during the Covid-19 outbreak presents a lot of challenges, especially when caring for residents with dementia. Keeping our residents safe during the pandemic has been our overriding concern, and thanks to an outstanding commitment from our staff, we have remained virus free.

However, the wearing of PPE and prohibition of visitors has brought about new problems. Our elderly residents all have dementia, and many have sight and hearing impairments. Those who rely on lip reading or facial expressions, to gain clarity in a conversation, are frustrated by the face masks that we wear. Wearing face masks also means our voices are muffled, making it difficult for those who are hard of hearing. To combat this, we are using face shields when possible.

Another major problem is that our residents can’t understand why their families are not visiting them. They feel abandoned and unloved. We have tried video calls, but our residents are not of the technological age, nor are some of their relatives. We have also done some window visits, but it often confuses the patients with more advanced dementia, as they wonder why they are not coming inside. We have been doing a lot of letter writing, but it is not the same as a visit.

Care staff are seeing an increase in feelings of anxiety and depression amongst residents. Social distancing rules make this difficult to deal with, because staff are not able to give the hugs that they are used to giving the residents. In other care homes, where staff have gone off ill or are self-isolating, residents also have to deal with unknown carers, creating more confusion.

As part of my Churchill Fellowship, I travelled to Australia, Canada and the USA to investigate the application of Montessori methodology in dementia care. Montessori is well known in early years education, but it has proven benefits when caring for people with dementia too. Using this approach has shown to improve the wellbeing of those with dementia, and allows them to retain some independence. I have been using the philosophy to engage our residents in making cards for family, rainbows for our intergenerational children’s groups (who can’t visit us) and pages in their memory books. Keeping them extra busy has been a struggle, as no amount of distraction can take away the fact that they are no longer able to see friends and family.

The official guidelines issued to care homes have got progressively got more intense over the past few weeks, as many homes report more cases of Covid-19. However, more consideration should be given to those who suffer from dementia or other cognitive impairments. It would be helpful for manufacturers to develop a clear, inexpensive face mask to enable lip reading, as this would allow care-givers to maintain communication with residents.

For me, I will continue to support my elderly dementia residents safely through this, and look forward to reuniting them with their family.