Family Visits in Health and Social Care Settings: Covid-19

Part of the debate – in Westminster Hall at 3:21 pm on 11th November 2020.

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Photo of Patricia Gibson Patricia Gibson Shadow SNP Spokesperson (Consumer Affairs) 3:21 pm, 11th November 2020

I am very glad to participate in this debate. I thank Joy Morrissey, who set out the importance of social and family contact for older and vulnerable adults. She made specific reference, in disturbing detail, to her own constituent in a way that sums up the difficulties that we face.

I have found this debate difficult. The issue before us, and certainly before the Minister, is very fraught—every choice in this situation brings its own serious challenges. I am conscious that these matters are devolved to the Scottish Parliament, but I speak in the spirit of common areas of concern about the issue. Specifically, how do we support the emotional and social needs of our older people while taking due cognisance of our need also to keep them safe? We have shared that goal today across the Chamber. I put on the record that those working in our care sector, I think we can all agree, do sterling work and deserve our thanks and recognition. I declare an interest: my sister Kathleen and my niece Chloe both work in the care sector.

Keeping older people safe and allowing them access to loved ones is something that every participant has highlighted. The balance is very difficult to strike, I think; we have heard about the tensions as we try to work through how we strike that balance correctly. I speak as one with some personal insight into the issue: my mother-in-law is in a care home in Saltcoats. She has dementia and lockdown has caused a dramatic and shocking decline in her condition. She has simply stopped eating. Her decline has been so great that I do not, in all honesty, believe that it can be reversed, or perhaps even halted, in her case; I accept that that may not apply to many people in her position, of whom I know there are many.

I have also heard from staff in several care homes that older people are suffering very badly from their lack of social interaction with other residents, their lack of contact with family and their missing out on the kinds of exchanges and conversations that could once have been taken for granted as a normal part of their day.

The lack of stimulation for many older people—it is horrible to say it—is akin to a slow death and is very upsetting. It is upsetting for the families of those who live in care homes and for the staff who work in them, who, throughout the pandemic, have coped with enormous challenges in a way that I hope they know we are very grateful for and of which they can be proud. Care home residents with dementia do not really know or understand why they cannot see their loved ones, which only adds to their distress and that of their relatives, as Dan Carden illustrated for us.

Conversely, many people who have elderly parents in care homes are very keen and anxious that their elderly relatives should be kept as safe as is possible at this time, until there is a vaccine for the virus or it subsides. We need to be mindful that the average age of those dying from covid is 83 years old. That stark statistic reminds us of the kinds of choices that we are trying to balance.

We are now in a position whereby visits to care homes to see elderly relatives can resume—obviously, with strict measures in place to ensure that they are as safe as they can be. Residential care homes have made use of screens and windows, and outdoor and virtual visits. However, there is some concern among care home owners —we have heard a bit about this today—that they will face litigation over covid deaths as their insurance premiums soar in the midst of this pandemic. I think that, just as the NHS has some protection in that regard, so too must care homes.

We have all heard of the distress and loneliness, the destructive sense of isolation, that older people have felt, particularly but not exclusively in care homes, as they miss that very important contact with loved ones. A phone call or a Zoom connection is a substitute, but it is much less satisfactory in terms of emotional connection. There is no substitute for an isolated older person having a cup of tea while sitting in their favourite chair just across from a loved one, having a hug and seeing the smiling faces of their grandchildren. A virtual substitute can never replace that.

As our older people wait in a limbo of loneliness, missing loved ones, they do not know—we do not know —how long this limbo will last. That uncertainty is very distressing, because if someone is at the very advanced stages of life, their fear is that they will never again have close contact with their family. That awful prospect must leave people despairing.

In all this, we must not forget the staff in care homes. They dedicate their days to looking after our elderly relatives. They see every day how some of our older people are simply not coping with the restrictions, and it is very distressing for them; I am sure that it takes an emotional toll on them as well. They feel very keenly their duty to keep their charges safe and they, too, often feel torn and helpless, as so many of us feel in the face of this cruel pandemic.

The biggest fear as the pandemic rumbles on—turning our lives, as we knew them, upside down—is that we save our older people from covid only to lose them to despair. Most residents in care homes have dementia, and I fear that they are utterly bewildered and confused by the current situation. They cannot understand why they cannot mix freely with others, as they used to.

Expanding testing to include designated visitors to care homes—we have heard a bit about this today—as soon as capacity allows will, of course, be part of the solution as we try to make inroads into this difficult situation. We also have the prospect of a vaccine, which we all hope will be available before too much longer. However, we need to continue to look for creative ways, such as that pointed out to us by Andy Carter, to navigate the road ahead. For as long as restrictions are in place, we need to find ways to combat the despair, distress and isolation of our older people, who feel very keenly this separation from loved ones.

Last week, Scotland’s Cabinet Secretary for Health and Sport met again with families of people in care homes. Like all of us, she is acutely aware of the importance of visits for the health and wellbeing of care home residents and their families. Indeed, leaders of all parts of the UK are grappling with these very human issues in which lives are at stake and every choice they make needs to be very finely balanced and is fraught with potential danger. I am sure that these matters give those leaders and the Minister sleepless nights. I do not envy them their task. During these terrible times, a stark and difficult set of choices and decisions have to be made which could literally mean the difference between life and death. Across the UK, guidance for social care settings continues to be under review so all that can be done, will be done, to support safe visiting.

I look forward to hearing the Minister’s views on these important matters and how she thinks we can better support our older people in care homes. Theirs is a generation whose lives were blighted by war in their youth and are now blighted by this cruel virus in their old age. Of course, we need to protect them and look after them, but for many the cost of isolation from loved ones and of restrictions on stimulation, is very high, as they lose their sense of who they are and their dementia takes greater hold of their lives.