OPINION - Nursing homes were low priority in Covid-19 preparations

“If they don’t die of Covid they are going to die of loneliness. That was a genuine concern,” said Susan Cliffe, deputy chief inspector at HIQA.
This was stated recently as the government and health service looked at the manner in which they could open up nursing home to  visitors.
If ever there was a comment to cause concern for families this was it, but then when one looks back on the last three months nursing homes and their staff seem to be at the bottom of the pile when dealing with Covid-19.
It was only as time went on, which in essence meant the numbers of deaths in nursing homes rose, that clarity began to take shape with those tackling the Covoid-19 pandemic on a national basis  and found that more focus and help was needed in this sector.
As of the end of May 900 nursing home residents have died due to Covid-19 in Ireland. They make up more than half of all deaths attributed to the disease here.
Looking back the first concerns were raised by families in early March when the NHI issued a statement saying "visiting restrictions are now in place in nursing homes nationwide. No non-essential visiting, children, or groups will be allowed".
Almost immediately, the move hit RTÉ's Liveline. Relatives were concerned about the impact on their loved ones, fearing they would feel isolated and lonely.
At the same time, they understood why the decision was being made, acknowledging that the elderly were at high-risk from the virus.
Meanwhile nursing home operators also became concerned about taking in people being transferred from hospitals.
In the normal run of the mill patients who would moved to nursing homes were instead remaining in hospital beds, and on wards.
This was happening as fears grew about our hospitals' ability to handle a looming surge.
On the ground the concern in the health system, was focused mainly on intensive care capacity.
Figures provided by Nursing Homes Ireland indicate around 1,000 people were transferred into nursing homes from acute hospitals during February and March.
And so the situation rumbled on with nursing homes reporting lack of PPE and staff shortages.
For those with parents or family members in nursing homes these have been very tough times.
They may have been allowed a glimpse through a window but that would be the only contact available to them.
I have written in this column before about my mother, her Alzheimer's and how that has affected our family.
To not be able to see, touch or talk to her has been heartbreaking, especially as each month brings a deteroiration.But she is happy in her own world.
And to be honest for once her Alzheimer's has been a benefit - she cannot miss us if she cannot remember us.
This might seem harsh and cynical but is so true.
She doesn't know who I or each of my three older brothers are - we are strangers to her although on very rare occasions a glimpse of recognition seems to come through  - or maybe that is just wishful thinking.
Myself and my brothers can never get these three months back again with her, something no doubt we will deeply regret in times to come.
Imagine then our delight to hear of the lifting of restrictions and the possibility of visiting her.
We put a plan in place so we could see her at every available opportunity open to us.
But sadly these all came to nought.
The nursing home was only allowing visiting between 2-5 from Monday to Friday.
There is only one visitor allowed in the home at any one time, so essentially there can be only six visitors per day.
When entering you have sign in, with your own pen, complete a Covid-19 form, and sterilise hands.

You are then led to a room, which is sterilised after each visit, to sit and wait for the resident.
However there is a glass panel between the two of you  and of course the two metre rule is strictly adhere to.A
ll of this is done to ensure the upmost safety of all.
If the patient has a tendency to get up from her a chair, or generally cannot be left alone, a nurse stays in that side of the room.
This makes visiting an elderly relative very tough. Even the residents in good health are finding it difficult on an emotional and physical level.
For someone like my mother it is impossible. She has very little sight and her hearing is also quite bad -  there is no prospect that she would be able to see or hear the person visiting.
On top of that staff also have to carry out procedures such as sterilising her hands before she can receive anyone.
That mightn't seem a lot but for someone with Alzheimer's it can cause great distress.
Overall the advice to us at the moment is not to visit. It is painful for us but at the core of this is the health of our mother.
Anything out of her routine can cause her distress and to put her through the motions of having a visitor, who she can't see or hear, would be selfish on our part.
By no means it is not that we don't want to see her but we would be doing it for ourselves rather than her.
The dedicated staff at the nursing home in Navan where she resides have done their upmost to ensure that Covid-19 has not taken hold in that premises.
Thankfully that is still the case but it has been achieved only by the staff making sacrifices - not going out, not going to the shops.
It is one of the few homes locally that has succeeded in this regard, with a nearby premises losing 14 patients within a very short period of time.
That is 14 families left grieving for someone who they had not been able to hold or touch for a long time. They never got to say goodbye.
As stated nursing homes seemed to have been low down on the list  last March when plans were being made on a national level to tackle Covid-19.
It is understandable that the main focus was on getting hospitals prepared and having ventilators in place ready for the peak in cases.
But that does not excuse the near total disregard of nursing homes and their patients.
The elderly were known to be the most vulnerable group and yet staff were finding it difficult to source even PPE.
And of course, there are confirmed stories that patients were moved into homes directly from hospital settings without being tested - indeed the same is meant to have applied to hospices.
We are all being warned of the possibility of  a second wave - that we must abide by the strict guidelines in order to prevent this.
Now is the time that the government and health service's focus should be directed to nursing homes.
We know now that here is where the most vulnerable cases are, we know that once it takes hold it can have devastating consequences.
As regards the future visiting of  by my family to our mother - well we don't  see how this will change any time soon.
The threat is still there  and even staff seem to be bewildered as to how visiting can return to any type of normality.
In the meantime, all I and my family can do is stand in a car park and look through the window.
It mightn't seem a lot but to us it is priceless.