Care home visiting restrictions caused ‘immense emotional harm’ – report

Ella Pickover and Áine Fox, Press Association

“Unprecedented” visiting restrictions imposed on care homes during the Covid-19 pandemic caused “incalculable harm to residents”, the pandemic probe has found.

Residents likened their experience of the pandemic to being in “prison” while others reported feeling “abandoned” and “isolated”.

The strictness and length of restrictions caused “immense emotional harm” to care home residents and their loved ones, “often resulting in significant decline in the health and wellbeing of residents”, the UK Covid-19 Public Inquiry said.

Inquiry chairwoman Baroness Heather Hallett highlighted how some people were not allowed to be with their dying loved ones, adding: “Many remain wracked by guilt that they do not deserve to carry.”

The inquiry’s latest report, which examines the impact on the care sector during the crisis, also found that visiting restrictions “at times” led to limited access to medical care for residents.

But the report acknowledges that in absence of tests for the virus, treatment, vaccines and limited personal protective equipment meant that visiting restrictions were one way to try and mitigate the spread of Covid-19.

The introduction of the nationwide lockdown in March 2020 was coupled with restrictions on visiting in care homes to “essential visits only” and by the end of April 2020 guidance was in place which recommended strict restrictions.

“In practice, this amounted to care homes being ‘locked down’,” the report adds.

The inquiry said the initial decision to restrict visits were “broadly appropriate in principle”.

Changes to visiting restrictions were introduced in the summer of 2020 but the report highlights how by the end of 2020 visiting “still remained restricted in many care homes”.

The report highlights how variations in these restrictions “caused much distress, particularly for end-of-life visits”.

“Alternative visiting”, set up during the pandemic to enable people to still see loved ones such as seeing a person through a window, presented “challenges”.

Video calls were “sometimes difficult or impossible” and loved ones described watching a relative decline via a screen as “deeply distressing”.

The document states: “These restrictions brought into sharp focus the difficult choices that governments and ministers were required to make.

“To allow visitors into care homes ran the risk of introducing a deadly virus to an already vulnerable population.

“However, preventing visits caused incalculable harm to residents and their loved ones, and often resulted in a significant decline in the health and wellbeing of residents, especially those with complex cognitive conditions such as dementia.”

It adds: “Visiting restrictions had immediate and, in some cases, devastating effects on residents, their families and those providing care.

“The impact of visiting restrictions for weeks and months on residents was profound, causing considerable trauma and long-term ramifications.

“For many, the absence of visits from relatives meant that the care home no longer felt like their home.

“Residents and relatives alike talked about care homes becoming prisons.

“A profound sense of isolation developed, with some residents reporting that they felt abandoned.”

The report highlights how restrictions were also linked to deterioration in physical health and mental capacity of residents.

Some relatives described how they were “shocked at the extent of the deterioration in their loved ones” when they were allowed to visit again.

The authors also touch on the impact of visiting restrictions on relatives of those in homes.

The document states that while visits to people at the end of their lives should have been permitted “this did not always happen”.

“This resulted in many people dying alone without the comfort of their loved ones by their side,” the report states.

“For many bereaved, this has led to prolonged grief, feelings of guilt and anger.”

The inquiry said the concept of visiting restrictions is “not new” and had been used briefly to combat outbreaks of flu and stomach bugs, but the prolonged visiting restrictions during the pandemic “were unprecedented”.

Lady Hallett said: “The profound isolation and sense of abandonment felt by residents as a result of the visiting restrictions resulted in immense emotional harm.

“Most distressingly, some people were not permitted to be with their dying loved ones. Many remain wracked by a guilt that they do not deserve to carry.”

The report says UK governments should create guidance on visiting restrictions in the event of a future pandemic.

These measures should be “the least restrictive possible” and residents should have the right to see visitors “except in the most grave or exceptional circumstances”, the report suggests.

Jane Wier-Wierzbowska, from Covid-19 Bereaved Families for Justice UK, told the inquiry: “I asked to be able to see my mum, but they refused.

“It had been 10 months since I last had physical contact and, now, she was gravely ill.

“In the last few days of her life, I was allowed to be outside the patio door to her room and the staff wheeled her bed closer to me.

“I stayed there for hours each day in the freezing cold, rain and snow.

“This is an open-ended trauma, a wound that won’t close.”

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