Care homes crisis: ‘There will be people who crumble after this is over’

Every afternoon, Anne Cadwallader stands on a box and talks to her husband through the two-inch gap in his care home window.

“It’s absolutely awful. I can’t reach him, I can’t hold him, I can’t comfort him, I can’t reassure him.”

On Easter Sunday, she found she was one of many. “Every single window on the ground floor had children and sons and daughters with their noses pressed up against the window shouting and trying to be understood,” she says.

“It was a terribly, awfully sad sight to see all those people desperately trying to communicate and reassure their loved ones inside. I’d never seen anything like it in my life.”

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Cadwallader's husband, Gerry O'Hare (79), is a resident in Fruithill Nursing Home in west Belfast. He was diagnosed with Parkinson's disease 15 years ago, and moved there when she could no longer look after him at home. Like all care homes, it has been closed to visitors for the past month as a result of the coronavirus pandemic.

“I’m living from minute to minute. Every time the phone goes, I’m expecting to hear that Gerry’s got it, because you read about it going through nursing homes like wildfire,” says Cadwallader.

“He’s very weak. He had pneumonia last June, and I’d be terrified if he gets it, he won’t survive it.”

There are 483 care homes in Northern Ireland, caring for a maximum of about 16,000 residents. As of Sunday, outbreaks of coronavirus have been identified in 53 of them; in some there have been a number of deaths.

"Some people seem to take the attitude, Oh well, you've had your life, you're expendable, it's time for you to shuffle off"

It is not clear exactly how many residents have died from the virus. The numbers released daily by the Public Health Agency record only those who have tested positive for the virus, and who have died in hospital; according to the Northern Ireland Statistics and Research Agency, as of April 10th there were at least 39 suspected coronavirus-related deaths, the majority in care homes or hospices, that were not included in the PHA figures.

"It's very important for the people who have passed away in care homes that their passing is recognised as much as anyone else in society, wherever they live," the North's Commissioner for Older People, Eddie Lynch, told BBC Radio Ulster.

Cadwallader agrees. “Some people seem to take the attitude, Oh well, you’ve had your life, you’re expendable, it’s time for you to shuffle off, and that’s very annoying and extremely patronising, and a callous way to treat and think about people.”

IRA member

O'Hare is well known. He is a former member of the IRA, who was interned and was imprisoned in Mountjoy prison for a time before going on to become a journalist and deputy news editor of the Irish Press. When it went bust he founded the travel newspaper Travel Extra, which is still running 25 years later.

In Fruithill two residents with coronavirus have died in hospital; others have been diagnosed with the virus.

“I was disappointed when I heard the [daily] figures weren’t reflecting all deaths,” says Seon MacStiofain, the nurse manager at Fruithill Nursing Home.

"It's sort of like when the health secretary in England [Matt Hancock] said four medics had died but then he couldn't say how many nurses had died or how many care workers.

“To them it’s nothing, but to us it’s everything.”

Life has changed at the home since the lockdown. Additional infection control procedures mean residents are self-isolated in their bedrooms; if someone displays symptoms of coronavirus, the infection is managed in their room, and extra personal protective equipment [PPE] is made available for staff. There has been testing “since the start”, says MacStiofain.

"There's always this underlying [assumption] that people in care homes have died of neglect, and that's unfair"

According to the North's Department of Health, all care home residents and staff who display symptoms are now being tested. Trade union Unison has said there must be an immediate programme of testing for all care home residents and staff.

Pauline Shepherd, chief executive of the representative organisation the Independent Health and Care Providers, says that although supplies of PPE have now been distributed, testing is being unevenly applied. She urges a deeper consideration of the statistics, including on "those people in care homes who do recover".

“There’s always this underlying [assumption] that people in care homes have died of neglect, and that’s unfair,” she says.

Emotional strain

MacStiofain has seen first hand the practical effort and also the emotional strain among healthcare workers.

“There are going to be a lot of people who crumble after this is over and there needs to be support and help for them.

“The government and society also needs to step back and look at how we are going to fund healthcare, and that’s inclusive of social care.”

"There are family members who live locally who use their daily time for walking to come up outside the home and clap"

Yet there are also positives. In 30 years as a nurse, MacStiofain says, “I have never experienced this level of support.

“There are family members who live locally who use their daily time for walking to come up outside the home and clap.

“We’re very proud of them for allowing us to take care of their loved ones.”

Cadwallader shows her appreciation too. “On Thursday night I stood outside and I banged a pot with my wooden spoon along with all my neighbours up and down the street, hoping that the staff in there know that we all appreciate what they’re doing.

“There’s nothing else we can do except hope and pray.”