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Who Cares? We do

Every month we look at an issue that is important to older people at Leeds. This time we focus on care homes. There are over a hundred care homes in Leeds. How have older people and their carers coped with Covid and the grief and isolation it has brought?

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May 2021

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At care homes across Leeds, families are finally uniting. On March 8th 2021, Covid restrictions eased and residents of care homes could nominate one person to visit them. Their visitor must test negative for the virus, wear personal protective equipment (PPE), and try not to have too much physical contact. And the care home must allow it. Even so, this is a huge step. Husbands and wives; parents and children; friends – people are finally able to see loved ones. The Yorkshire Post has been featuring some of these good news stories, most notably that of Francis Heaton, who was able to celebrate her 100th birthday with family at the end of March.
 
More good news: infections amongst residents of care homes are falling. Research has shown that residents who have been vaccinated against Covid have a much lower risk of infection. Even after just one dose, they were 62% less likely to have the infection after 5 weeks. This research by University College London recently shows a simple fact: the vaccine is working!

Even with hope on the horizon, it’s important we address what a difficult year it’s been for home residents and their families. Lives have been lost and lives have been damaged. People have been isolated and frustrated. Everyone’s lives have changed, but perhaps none more so than those of older people who live in care homes. Sometimes it’s the simple things that are missed. Graham, one of the Shine writing team, had started helping out in a care home just before the pandemic. He recounts one of his first visits here:

“I have experience as a volunteer in a residential home in Horsforth which, sadly, was a short one. I was there as a befriender, my remit being to interact with the few male residents. They tended not to take part in any of the numerous activities. I knew it wouldn’t be easy when I introduced myself to Bill and he just said, ‘What was the point?’ He had nothing he wanted to say! This seemed to be the shared reaction of the male residents, until I called on Ray, a guy who loved his music and enjoyed playing snooker in his day. I like a game myself, so he suggested we go to the local club. He met me in reception on a mobility scooter. On seeing how quickly he sped off, I had new name for him: Rocket Man Ray. He was half-way down Town Street before I caught up with him. That’s when I found out I could no longer sprint. He went straight past the club and I found him in the bookies. Must be a third love of his. He beat me at snooker, but I enjoyed his company, and we did it every week until last year’s lockdown. That was the last I saw of him. I’m not allowed to visit the home due to restrictions. A nurse who works there tells me Ray is not the same man due to losing his wanderings. What in impact this pandemic is having!”

Suddenly we were in
lockdown, not allowed to mix with
relations or friends.
All activities suspended
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It seems so insignificant, going to the local snooker club and popping into the betting shop on the way. But such small pleasures are what can make life meaningful, especially if you are in poor health. So many older people across the city have had their lives dramatically altered. What does it feel like, to be an older person in
a similar situation? Betty, another Shine writer, recounts her experiences below. Betty lives with her husband in “sheltered housing accommodation”, which means she lives independently in a self-contained flat but with communal facilities and support. Many of our readers live in similar situations; often there are wardens who help with the running of the complex and social activities. Over to Betty:

“Two years ago, we moved into our apartment, and because we had a restaurant open for lunch every day and a staff member to clean once a week, I became a lady of leisure. We became friends with most of the residents through the varied social activities. We could choose from an exercise class, art class, writing group, a quiz night or of course a Bingo night. There were often concerts by choirs, and special events nights to be enjoyed by all.”

Sounds pretty good, doesn’t it! What happened when the pandemic hit?

“Suddenly we were in lockdown, not allowed to mix with relations or friends. All activities suspended, restaurant closed, cleaners left. We had to wear a face mask whenever we went outside our front door, hardly recognising one another, not able to stand and chat with each other. Not knowing who was ill or well. Our usual gossip area was the Laundry, but only one person at a time could use the facilities at a time. No gossip! The first couple of weeks went by, the virus spread even further. All of a sudden, I found it hard to be my usual cheerful self. Depression set in, I found it hard having to do my own housework and I was not getting any younger. Having to order, prepare and cook meals, especially after being spoiled since living here with all its amenities, became harder. It was a real culture shock. My depression became worse. My husband and I kept falling out over the silliest of things. We would make-up and then two days later would fall out again. It is now over a year since the first lockdown. A year of being kept in the apartment. Virtually the whole time just the two of us - no visits from my daughters to relieve the strain. The seemingly never- ending round of cooking, cleaning, disinfecting everywhere to keep us safe. Most of all it is not seeing family and friends that is so distressing.”

Family and friends of older people who live in care homes are particularly concerned for their loved ones and their emotional well-being. There are some people who are trying to shed light on these issues. Healthwatch Leeds was set up in 2013 to bring the voices and opinions of local people to influence health and care decisions. Healthwatch has been talking to relatives of older people about the impact of the Covid restrictions and they’ve put together a report to share the findings. They have allowed us to share some quotes from that report. One relative put it well: “we are essential to the wellbeing of our families’ lives”. It’s hard to argue with that.
The restrictions are hard for everybody, but particularly for older people who are living with Alzheimer’s or dementia. “My mum cries every day,” said one relative. “Her paranoia has increased, and her Alzheimer’s has deteriorated. She has forgotten people now and is forgetting conversations and little things that she knew how to do before. In four years, we have seen or talked to each other every day, so it has affected both of us.” Heartbreaking. Some older people rely hugely on the daily visits of family and carers, even for basic tasks such as eating. Many have seen their condition get worse. “I cannot help feeling that isolation has played a big part in my mum's deterioration,” said another family member. “She has Alzheimer's, she misses my regular visits. She still knows me, and I used to visit every other day. We are very close.”
 
This is an area where digital technology can help – but it’s not always the panacea it’s made out to be. Many older people have benefitted hugely from being able to use iPads or smart phones to make video calls to grandchildren and other friends and family. But for others, especially people with limited speech and understanding, there’s nothing that beats face-to-face contact. For lots of people, touch is the most important sense. Sometimes it’s hard for families to know how their loved ones are doing. “It’s hard to tell over the phone or Skype as it’s such a short period of time,” said one relative. “We get to know more from the care team, who we trust.”

It can be difficult to find yourself in a care home. It’s a huge wrench for families and loved ones too. Mally and Maureen both have had friends in care homes, and they share their thoughts below. Mally first. Jim developed dementia (an “unwelcome intruder” according to Mally) and his wife Pat had to face the prospect of living separately from him.
 
“Pat was a daily visitor. She knows that her frequent visits ensured the best possible care for Jim for she was able to not only make good relationships with the staff but was also able to pick up on any issues that arose and affected Jim’s well-being. At one point his behaviour changed, and Pat discovered that the Aricept he was prescribed was deemed too expensive and stopped. The medication was reinstated at Pat’s insistence. She realised he was more comfortable going to the toilet rather than using a bed pan and the reason he was refusing his porridge was because it was being served without syrup. These small issues ensured Jim’s comfort and well-being; Pat is sure these issues wouldn’t have been addressed if she had not been such a presence in the home. Pat knows she did the best for this man with whom she had shared so many good years but wonders how he would have been cared for if she hadn’t been his advocate.”

Mally’s friend Pat was an integral part of Jim’s care “team”. There are so many families doing similar amazing work across the city – and to exclude them by denying visitors has been very difficult. Maureen’s friend Val had to go and live in a care home last year. The friends met in 1962 as part of The Shadows Fan Club! Since then, they’ve always shared he ups-and-downs of life. Maureen takes up the story:

“Twelve years ago, Val suffered a brain aneurysm and was not expected to live - but live she did, making a good recovery, until a stroke then left her with slurred speech and limited mobility. Anxiety and depression followed, and Val lost interest in everything, speaking only of her ailments. Unable to perform the simplest tasks resulted in daily visits by carers. Accepting of the situation, Val’s daughter found a lovely care home, providing all the 24-hour care needed.

Unfortunately, the move coincided with lockdown last March so daily visits were replaced by FaceTime via phone. Initially speaking to the staff more than residents, my pen-friend gradually settled in. No longer mentioning her ailments, she spoke instead of the fun and laughter, enjoyed through activities held almost daily. Val’s mental health improved significantly. On sunny days games and themed events with delicious meals were held on the lawn. Through the care home’s Facebook page, I can follow weekly updates, with photos of happy times being enjoyed by all.
 
As lockdown restrictions tightened, appointments had to be made to see a loved one at the front door, with visitors wearing a mask, apron and gloves. Val was allowed to visit the hairdresser with her daughter, followed by precautionary quarantine in her room for seven days. At Christmas, each resident was allowed one visitor on presentation of a negative Covid test.

The residents now meet up with their chosen family member, following safety guidelines, in the garden. A specially designed see-through dome with comfortable seating and table for two has been welcomed by all. All having had their second vaccine now, Val and her new friends look forward to the day when they can escape to the country or coast for an outing – just like the rest of us!”


Part of Maureen’s story bears repeating: “A specially designed see-through dome with comfortable seating and table for two”! What an incredible solution to Covid restrictions! And there are other ways that care homes are adapting to provide the best experience under very trying circumstances. As we know, many activities have stopped. So, one activities co-ordinator had a bright idea: “We have prepared an activity bag which consist of things like coloured pencils, paper crosswords and residents’ favourite magazines. We know it was safe to leave those in residents’ rooms to keep them occupied. The bags have been topped up all the time. They have proven to be a great way of maintaining residents’ wellbeing.”

There are hundreds of these inventive ideas, to bring joy to the lives of older people. Last summer Arts Together paid musicians, poets, opera singers and other artists to perform in the grounds of care homes. One of the performers was Tessa Smith: “It is a real joy to go and sing for the residents, and see how much they enjoy listening, singing and dancing along to the music. I feel very lucky to be able to provide this entertainment in these settings; it raises my spirits as much as it does theirs!” Jo Bailey, Wellness Co- ordinator at one of the care homes involved, agrees. “Having Tessa really brightened up everyone’s day and brought them together,” said Jo. “It made such a difference being a live performance, and everyone appreciated being given the chance to enjoy a musical interlude from such a talented singer.”
 
Some care homes have gone the extra mile to keep residents safe and well. Staff at Meadow Court Residential Home near Huddersfield all agreed to “move in” on site! Staff members and directors lived in a series of motorhomes, away from their families for several weeks. All to make sure they didn’t pass on the virus to vulnerable residents.

What next for older people living in care homes? As restrictions ease, it’s hopeful that life will improve.
As it does, we must keep in our mind the pain and suffering of the last year or so. The easing of restrictions comes too late for many. We must keep supporting friends, family and staff to come up with ideas to care for older people creatively and kindly. Healthwatch has a series of recommendations, chiefly that when it comes to visits, that lawmakers “weigh up potential benefits to an individual’s wellbeing and quality of life against the potential risks to residents, staff and other visitors”. Whatever happens in the future, it’s vital that older people living in care homes in Leeds know that they are not forgotten. If you’re in this situation, you need to know that all of us are thinking of you. That as a city, we will support you. That we won’t forget you. We care.
 
Do you live in residential care? Or does one of your family members? Please get in touch with Shine if you have a story you’d like to share. We may print it in a future issue! If you have any concerns or worries about seeing a loved one in their care home, or if you just need help understanding what is currently allowed, you can call Carers Leeds on 0113 380 4300 or Healthwatch Leeds on 0113 8980035.

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