Care Home Nursing During Covid-19 - Clare's Story

I am a Care Home Research Facilitator for ENRICH (Enabling Research in Care Homes) for 15 hours a week and for the rest of the  week, I work as a nurse in my local nursing home.  As coronavirus spread and our lifestyles became more limited, deployment from ENRICH became a looming inevitability.  I was concerned that I would be deployed to a high risk area and transfer the virus to the residents at the nursing home, but instead I was deployed to actually work in the nursing home full-time.  This was much needed, as our team of six nurses had been halved, two nurses had to shield for 12 weeks and one was self-isolating.

The first major change for the residents was closing the home to visitors.  The last visiting day was Mothering Sunday, which was a particularly bittersweet day to work with relatives saying and singing goodbye to their loved ones not knowing when or if they would see them alive again.  Some of our residents are over 100 years old and have children in their 80’s.

After a few days of not having any visitors the residents seemed to become subtly aware that something was not normal.  In my nursing home of 26 residents, all but one resident has some form of dementia, ranging from mild to severe.  Residents who usually would not remember by the afternoon that they had had a visitor in the morning, had an awareness that no-one had been to see them for days. One lady has her dog visit most days and now hasn’t seen him for weeks. We explain why, but that becomes forgotten and there is an undercurrent that something is not quite right with the world.

The next major change for the residents was staff wearing facemasks.  I would have thought this would absolutely terrify the residents, being woken up by someone whose face was mostly covered, but they generally didn’t seem to mind.  Maybe because of their underlying worry, by seeing us all wearing masks makes them realise that that worry is not personal to them and we are all working together.  One resident says we look better with the face masks on and another breaks into hysterics every time she looks up and sees us.  It did distress one of our ladies initially and made her quite angry towards us, but she seems to finally accept them now (she turned 100 years of age during lockdown and her party had to be cancelled, she did get her card from the Queen though).

One lady talked about the similarities with the strange times of World War II, where as a child she carried her gas mask to school with her every day, practised putting it on and luckily never had to use it.  The first day I wore a mask she struggled to recognise me and said she was identifying us all by our voices, but she recognises my eyes above the mask now and says she doesn’t mind us wearing them and knows it’s a necessity.

Another resident tells us to take them off every time he sees us.  He says we look like zombies.  We explain about the coronavirus and that we are wearing them to protect him. 

But we only have to leave the room for 30 seconds and on returning, he has forgotten the previous conversation and asks us why we are wearing masks, the masks upset him, “take them off”, he shouts.

There are a few residents that want to keep abreast of the news, one resident was up til  6am watching television and would not go to bed,  as she was that fascinated by the reports.  Some residents are interested in how our lives have changed and what it is like to go shopping, and find it hard to believe schools have closed.

At the time of writing, we have not had any known or suspected cases of coronavirus in our care home, however no-one has been tested to know for sure.  The general atmosphere, despite these strange times, is positive and not massively different to normal.

By Clare Bates,  Care Home Research Facilitator and Nurse

April 2020