As the number of confirmed coronavirus cases increases in care homes and nursing homes across Belfast, there have been appeals for workers and residents in the care home sector to be treated on a par with hospital staff and patients.
"There is heroism in our care homes today as dedicated staff look after residents who they love as much as they love their own families, but there is also fear," said the manager at one West Belfast home.
"My plea would be for the government and the community to treat care homes with the same respect and resources as is now given to hospitals. We are facing into the unknown. There is hardly a care home or nursing home left in Belfast which doesn't have coronavirus among its residents and very difficult and heart wrenching decisions are now being made on a daily basis."
Staff at one West Belfast care home have been dealing with a suspected Covid-19 cluster for the past week while in other institutions, according to reports, the rate of contraction is on the rise.
"If you have a resident diagnosed with coronavirus who has dementia, what can you do?" said one care home worker. "You can't explain the situation to the resident and it isn't possible to imprison an able-bodied person. The result is that the infected patient is mixing with other residents and the disease is spreading. I know of one home where there was one case last week, now there is four, and by next week there will most likely be 15. That's not a case of not having PPE or not being in lockdown. That's just a situation where, despite everything that can be done being done, coronavirus cannot be stopped from getting through the doors. There are no simple solutions: some say empty out the care homes but where would our residents go? Sadly, in the fortnight ahead, things are only going to get worse."
For almost a month now, visitors have been discouraged or banned from most care homes across Ireland, placing enormous emotional strain on families. The Public Health Agency has advised against any family member being with a dying relative who has coronavirus while some health trusts are limiting access at the time of death to just one person. "In West Belfast, we are sometimes dealing with parents who have ten children so you can imagine the unbearable heartache and pain families are experiencing," said the care home manager. "The only thing I would say is that this is absolutely shattering our staff as well. I have seen some of our staff breaking down three or four times a day at the suffering of residents who they love dearly. So I would beg families who are distressed at not being able to be with their loved ones to understand our pain too."
It is believed some care home and nursing homes in Belfast is no longer taking admissions. However, others are still accepting new admissions to help with hospital discharges.
Hospitals are still admitting seriously ill residents with coronavirus from care home settings. However, one nursing home owner said that if the Mater and City intensive care beds are taken during an expected surge over the next 14 days, then he believed residents of care homes who are over 75 will not be admitted to hospital.
Some of the care homes are beginning to report drops in staff numbers - "through self-isolation, general ill-health, fear and staff burn-out," according to one person familiar with the situation across the North. Trust staff in social care roles may be called on to physically support care homes if the situation deteriorates.
A change in government regulations around furlough which allows workers who have been made temporarily redundant to work in care homes — and other occupations — and keep the extra cash earned could relieve the situation and bring a new stream of staff into the homes.
The situation around testing staff who are self-isolating with coronavirus symptoms has improved over recent days, according to care home staff. Questions have been raised over the reliability of the tests. Some staff who had been off were told that while they test negative for Covid-19, the results may not be accurate. Health experts, on the other hand, are standing over the rigour of the testing regime and are confident the results are accurate in the vast majority of cases.
This afternoon, Health Minister Robin Swann said there were outbreaks of Covid-19 in care homes across the North. The Andersonstown News believes six of those homes are in Belfast.
This story was updated at 17:53 on Tuesday 7 April
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