Imagine that you are a resident of a nursing home. Cocooned away from your family and friends since March 2020, you have lived in almost all of the care and control of nursing staff, depending on them to ensure that your rights are respected and protected. You live on an island within an island, it seems; because while the government says one thing, your retirement home is doing another.
Health Minister Stephen Donnelly has repeatedly urged nursing homes to facilitate safe window visits, but at home you have been prohibited from looking out the window at the faces you love most for hours. month.
The government has issued visitation guidelines, but does not monitor compliance or sanction your home when it refuses to comply. You need the support of the staff to use a phone or tablet and you feel unable to have private conversations.
Maybe a pressure sore gets less attention than it should and gets worse. You may have dementia and an impatient staff member yells at you, treats you brutally, or assaults you.
Perhaps your sense of dignity is lost, as you find yourself sitting in a commode, with your bedroom door open, visible to all who pass by. You are sick and scared, and although national guidelines say compassionate visits are allowed, nursing home management says you are not sick enough to deserve time with your family. How to seek help or support inside the cocoon?
These are not fictitious accounts. As a volunteer family-led advocacy group, Care Champions works with families who have shared their experiences of rights violations, abuse, neglect and unnecessary separation from residents during Covid-19.
While Tusla provides a statutory and independent response to child victims of abuse and neglect, nursing home residents lack this service when similar incidents arise.
Instead, families are tossed between multiple services trying and not seeking a satisfactory response from the state. Hiqa only investigates systemic failures, ombudsman only deals with non-clinical issues, confidential recipient’s office only supports residents of HSE nursing homes, safeguard and protection social work teams do have no legal right to enter private nursing homes, where more than 80% of residents reside.
These inherent weaknesses in our sector were well known to the government in March 2020. Stung by critics for delayed measures to protect residents of nursing homes in the first wave of Covid-19, the government has pursued a unique approach and ultimately harmful in 2020 and much of 2021 – prolonged cocooning.
The government readily acknowledged that the closures increased the risks of domestic violence and rates of child protection in private homes, but refused to recognize the risks of increased institutional abuse as retirement homes operated behind closed doors. .
Despite the harrowing stories of Dealgan House during the first wave, despite the Department of Health’s own research showing people do not know how to report abuse, despite known trends of underreporting of abuse by house staff nursing and despite successful rape prosecutions. From a resident cocooned by a staff member, the government still had no objection to the residents cocooned without a single additional safeguard in place.
The Irish Association of Social Workers advocated for a range of measures, including a family liaison service, targeted protection training to help staff recognize and specifically identify institutional abuse during cocooning and monitoring proactive protection trends. The government did not listen.
As the Dutch parliament banned general visitation bans last summer, and using visitation spaces, education and infection control measures, restored safe and managed indoor visits without any increases from the transmission of Covid-19, the Irish government has continued to frame the loss of family life for residents as an unavoidable political choice. Family visits, which are vital protective support, have been facilitated not for rights to family life, but for reasons of compassion.
As evidenced by last night, in many homes, compassion was subjective and often completely absent. Many residents have died alone, after months of preventable separation from their families, and the grief and loss group formed by Care Champions speaks to the lasting devastation experienced by grieving families.
theThe program provides a valuable opportunity for all stakeholders inside and outside of government to reflect on their role.
Where was the leadership on the risks and the response to the increase in institutional abuse during the cocooning of the National HSE Safeguarding Office? Or the safeguard of Ireland?
Why have some professional advocacy groups publicly welcomed visiting boards that offer visits on the basis of subjective compassion, rather than the family life rights enjoyed by the rest of society when the restrictions were applied? been relaxed?
There is no point in using rights-based language while welcoming paternalistic policies that infringe on rights. Why did the Nursing Home Expert Panel not make a single reference to protection in its 86 recommendations?
Why, with the exception of social workers, has there been complete professional silence on the part of medical professionals about the possibility of abuse and neglect in nursing homes, despite reports from Hiqa making state of repeated failures?
Why have families and residents themselves been left to expose these shortcomings, when registered professionals have a leadership role in every nursing home? Why don’t the resident and family councils of each household significantly contribute to the management and operation of each household?
The Workplace Relations Commission identifies social work as the primary profession in the protection of adults and social workers have demonstrated why this is the case during the pandemic.
The Irish Association of Social Workers has repeatedly informed the government of the protection risks associated with prolonged cocooning, concerns which have since been validated by the staggering 71% increase in public concerns about nursing home care reported to Hiqa in 2020.
Social workers offered solutions and campaigned for political action. They, like Care Champions, encountered deafening political silence.
Care Champions and the IASW are now jointly calling for legislative and regulatory reform, the introduction of an independent safeguard ‘one-stop-shop’, legal protection of visitation rights, a public inquiry into the deaths that have occurred and the experiences of surviving residents and for a fundamental reform of our nursing home sector.
The Care Champions are clear: nothing will change until the law changes. It is also clear that political action will only take place with sufficient media attention and sufficient public pressure.
- Majella Beattie is President of Care Champions, a family rights advocacy group