The Covid-19 pandemic has been a challenging time for everyone, but especially for people living in care homes, their families and the staff. Our Professional and Practice Development Team and Helpline Nurses have put together some information to help you support the person you love and care for.
What is the government guidance about visiting in a care home?
National guidance around care home visits has changed as lockdown eases.
There is slightly different guidance in England, Scotland,Wales and Northern Ireland, so it is advisable to check with the guidance where you live, as well as with the care home before visiting to establish what restrictions and arrangements they have in place.
Can I visit?
Yes. You can discuss with the care home manager how the home is meeting the regional and local care home visiting guidance. This will include how many daily visitors are allowed for each resident and the testing regime, in addition to the Personal Protective Equipment (PPE) you should wear.
Ask the care home manager about their visiting policy in cases of an outbreak or not. Some examples of questions you can ask include: how long and how often you can visit; how many people there should be during the visit; if they have a designated visiting area (inside or outside); if you can do an ‘in room’ or ‘through the screen’ visit; and what infection control precautions you will have to take.
Do I need to have had a vaccination before I can visit?
You do not have to have been vaccinated against Covid 19, although it is strongly recommended that all visitors and residents take up the opportunity when they are contacted by the national vaccination programme.
Can I visit my loved one even though they are on the Shielded Patient List?
You can still visit in the same way as other residents. Following the precautions and wearing the appropriate personal protective equipment will protect the safety of you and your relative.
I’m not the ‘named/designated’ person – does this mean I can’t visit?
This will depend upon the region that you live in as well as your care home policy. However, all guidance advises that residents can receive more and different types of visitors.
Can I visit if there is an outbreak in the care home?
Yes, but only in exceptional situations. This would include residents who are approaching the end of their life or residents who may be very distressed or disorientated. Another exception that would be made in the event of an outbreak would be that essential care givers/partners should carry on visiting.
I haven’t seen my loved one for a long time – what might I expect?
It is important to prepare for this visit as it is likely to be quite emotional. Take time to think about expectations. You might be hoping for a big reunion and need to prepare for the possibility that your loved one may struggle to recognise you, struggle to cope with their emotions or be having a ‘bad’ day.
Such situations are likely to be extremely upsetting unless you have a strategy in place for managing this. Being prepared with an activity, a special time to reminisce about or a favourite song to listen to together can help connect you both.
Do also consider the likelihood of your loved one having deteriorated mentally and physically since you last saw them and how this will make both of you feel. It may help if you ask the care home manager to advise you if they think this is the case beforehand.
How can I communicate with them after such a long period?
Whether you are wearing PPE or are behind a protective screen, some tips for communicating include speaking loudly, clearly and in short sentences. Use your body language to communicate affection, such as ‘miming a hug’ or ‘blowing kisses.’ If your loved one has difficulty in accepting staff or visitors wearing masks or face coverings, talk to the home about an individual comprehensive risk assessment to look at alternatives, such as visors or clear face coverings.
It is possible that your loved one may become upset during your visit. Listen to why they are upset. If it feels right, apologise for why you have not been able to visit by reminding them that a virus is going round, and reassure them of your love, care and affection. Bring in gifts and mementos, which can be cleaned with sanitiser, to help keep in touch, and include the family; for example, grandchildren’s drawings, photographs of friends and relatives, and cards with short written notes. You could take a photo during the visit, and ask the care home staff to display this clearly in the person’s room.
Regardless of how your visit went, make sure that you have someone to speak to afterwards, such as a friend, Admiral Nurse or member of the care home staff.
Will we be able touch each other?
It is advisable to keep close contact to a minimum. Handholding and hugging can increase the risk of transmission, particularly when you haven’t been vaccinated.
What types of visits are there?
This will vary depending upon where you live and the local policy. However, all national guidance advises increased types of visiting including indoor, garden, screen, and, in some cases, out of care home visits.
Indoor visiting (excluding exceptional circumstances) may be denied whilst there is a local outbreak in the region or home. This may be very frustrating and distressing but having regular and open conversations with the care home team is important, as well as how you can remain in touch with your loved one and receive updates about their care and wellbeing. If you are feeling distressed and need support, then the Admiral Nurse Dementia Helpline can help you work through these feelings and plan a course of action.
The home will also confirm what gifts you can bring in, and if they have to be cleaned with sanitiser before being given.
What is an ‘out of care home visit?’
Spending time out of the care home has always been an important part of life for many people living in residential care, and residents leave their care home for a range of reasons. These might include to attend work or education, attend medical appointments and to spend time with friends and family.
Depending upon the activity, infection control precautions and the risk of infection, residents may be advised to self-isolate on their return to the care home.
How can I make the most of ‘outdoor’ visits?
It is important not to under-estimate the value of being outside with eachother. Taking your loved one for a walk or in the wheelchair is a very important aspect of their care. Being outside is known to improve emotional well-being and promote a sense of calm and peace. Enjoying the smells of flowers, noticing the changing seasons, listening to birdsong, and watching out for wildlife can be very therapeutic. Sharing food and drink together can increase bonding so think about taking a picnic with suitable finger foods or a flask of a favourite beverage.
How do I stay in contact with my loved one?
Staying in contact might not feel the same as before the coronavirus outbreak.
For some people, particularly families who are caring from a distance, using video calls such as Skype, Zoom or FaceTime will be successful and enjoyable. Check out if the home has Wi-Fi and how much help your loved one needs to use such technology. Perhaps suggest a regular time of the day and add in other family members to the call, if this won’t overwhelm your relative. There are also other things you can do if conversation proves challenging, such as a virtual cuppa together, reading a favourite story or newspaper, or perhaps just sharing family news.
Not everyone likes video calls, so other methods might be more helpful. You could arrange a regular phone call, using simple and short sentences. Send letters, postcards, or emails regularly to your loved one, with news, photos or messages, and discuss with the staff about helping your loved one to read them. Include small reminders of who is in photos and where it was taken, so the care home staff can discuss and share it with them.
Check with the care home if you can bring somethingthat has a lovely scent or feels soft, such as a new pair of pyjamas or scarf spritzed with a favourite perfume. These can be evocative to the senses and provide stimulation. You could send an audio story book, music CD, or recording of you reading a story. Ask staff to build a photo or life story (see link to our resources on this) board in your relative’s room and send relevant items to add to it.
Staying in contact works both ways. Discuss with the home how your loved one can contact you, or share news of their day. Ask the care home staff if they can take and send you photos of what your loved one has been doing, or when they receive your letters or gifts, or maybe help write you a letter, postcard or email.
How can I continue to contribute to the care of my loved one?
Discuss with the care home how you can contribute and be informed of any changes to your loved one’s care, particularly if there is deterioration in your relative. This might include asking when the next care plan review is due, so you can be involved. Check that the home still has the correct emergency numbers for you, particularly if you hold Lasting Power of Attorney (Health and Welfare), and if there is any advance care planning in place, (please see our resources on this) so if there is a change in your loved one’s condition, you will be consulted.
I am not happy with the care that my loved one is receiving: what do I do?
It may be helpful to make a list of your concerns and consider if they are related to the coronavirus social distancing requirements or something else. Arrange to speak to the home manager, saying what you want to discuss with them and why. Ask for a plan of action from your meeting, so that you can work together to support your loved one.
My relative is dying in a care home. I need to be there for them but I’m not sure how I can be
Discuss with the home their end of life visiting procedures, as well as how and when they will update you about your loved one’s condition. Speak to the home about what you think is important at this time. Perhaps there is a particular type of music your loved one would enjoy listening to, or a favourite night dress or blanket. Maybe the smell of your perfume or aftershave on the bed spread or your picture by the bed will be a comforting reminder of you when you are unable to be there.
You may feel feelings of loss, grief and bereavement during this time. This is normal, but you might find it helpful to discuss and share with a friend or family member how you are feeling. Our Admiral Nurse Dementia Helpline is also there for you to discuss any feelings of grief you are experiencing.
Find out more about our campaigning work during the coronavirus pandemic here.