Sweeping bans on visiting at thousands of care homes risk residents dying prematurely this winter as they give up hope in the absence of loved ones, experts in elderly care have warned.
More than 2,700 care homes in England are either already shut or will be told to do so imminently by local public health officials, according to a Guardian analysis of new government rules announced to protect the most vulnerable from Covid-19.
Care groups are calling for the government to make limited visiting possible, including by designating selected family members as key workers.
Since Friday any care homes in local authority areas named by Public Health England for wider anti-Covid interventions must immediately move to stop visiting, except in exceptional circumstances such as end of life. It also halts visits to windows and gardens and follows seven months of restrictions in many care homes that closed their doors to routine visits in March.
The blanket bans will result in the “raw reality of residents going downhill fast, giving up hope and ultimately dying sooner than would otherwise be the case”, warned the charity Age UK and the National Care Forum (NCF), which represents charitable care providers.
The organisations estimate 300,000 residents and family members are already affected by the policy – similar to the population of Brighton. However, care home outbreaks are rising sharply. In England, confirmed outbreaks of acute respiratory infections in care homes involving Covid rose from 35 on 6 September to 228 a week later. The UK’s largest care home operator, HC-One, has already closed 147 of its homes across the UK, close to half of all its facilities. It has recorded Covid outbreaks at 30 homes.
Visiting bans currently apply to homes mostly in the north of England and the Midlands, in 44 areas stretching from Newcastle upon Tyne to Solihull. Birmingham, which has the highest population of any area of intervention, has 296 residential, nursing homes and supported living facilities and the city council has told them to halt non-essential visits with exemptions for end-of-life visiting. The next largest affected areas are Sefton in Merseyside and County Durham. More areas are expected to be added to the lockdown list as infections continue to rise.
The Alzheimer’s Society also warned that removing family visitors who know how to help feed people with dementia who otherwise struggle to eat could trigger more deaths. It has received calls to its helpline reporting that without visits loved ones have stopped eating and “lost the will to live to the point of dying”.
“We are not aware of any evidence showing that visits, if carefully managed, have been a significant risk in spreading the infection so far,” said Caroline Abrahams, the charity director of Age UK, and Vic Rayner, the executive director of the NCF, in a joint blog published on Tuesday. “On the contrary, our understanding is that the evidence points more towards people who come in and out of a care home inevitably being rather more of an ongoing risk, whether they are staff or visiting GPs and district nurses, or indeed CQC inspectors.”
They added: “It is not unusual, for example, for the partner of a resident with dementia to spend many hours with them, helping them very slowly to eat and drink sufficiently.”
The Alzheimer’s Society is calling for designated family members to be allowed to continue visits, by including them in weekly staff testing and supplying them with PPE, saying they are “an integral part of the care system” and that locking them out may have already contributed to deaths.
“We want assurances that family carers are placed on an equal footing with key workers,” said Gavin Terry, the head of policy at the charity. “We need to recognise the individual needs of people in care homes.”
The Department of Health and Social Care’s (DHSC) winter action plan for care homes asks care home operators not in areas of intervention to develop a policy for limited visits “based on dynamic risk assessments which consider the vulnerability of residents. This should include both whether their residents’ needs make them particularly clinically vulnerable to Covid-19 and whether their residents’ needs make visits particularly important.”
A spokesperson for the DHSC said the government’s first priority was to prevent infections in care homes and protect staff and residents.
“The adult social care winter plan sets out tightened infection prevention and control measures to enable visits to continue safely where possible,” they said. “We expect any area listed as an ‘area of intervention’ to immediately restrict visiting to exceptional circumstances only – such as for the end of someone’s life.”