It is recognised that the impact of COVID-19 on society in general and especially those living in long term residential care facilities has been considerable. Residential settings are people’s homes as well as places where health and social care are provided. The introduction of physical distancing, isolation and restricted contact with family and loved ones has changed the usual dynamic of social interaction. During these times there has been a particular emphasis on retaining a holistic view of the wellbeing of residents, remaining person-centred, being cognisant of their rights as citizens, and being vigilant that in seeking to shield them from infection that these rights are not infringed upon in to an extent, or in a manner, that is disproportionate.
However, it is important to recall that people living in long-term residential care (LTRC) facilities are particularly vulnerable populations in the context of Covid-19 and have been identified by the World Health Organisation (WHO) to be at a higher risk of being susceptible to infection from this disease and for subsequent adverse outcomes.
The actions and measures we have taken in Ireland to support long term residential care facilities and their residents have evolved on foot of epidemiological data and guidance from the WHO and the European Centre for Disease Prevention and Control (ECDC). These measures have been both society wide as well as focused specifically on residential facilities. Advice from the National Public Health Emergency Team (NPHET) focused on all LTRC settings and its recommended actions were relevant for all residential care services - older people, disability and mental health settings.
As the disease is becoming more suppressed in the community the National Public Health Emergency has advised that the gradual reintroduction of usual activities while taking public health precautions should commence. This advice is reflected in the latest Cocooning and visiting guidance. Detail of this guidance is set out by the Health Protection Surveillance Centre at: https://www.hpsc.ie.
The Department of Health is very much aware of how difficult the current restrictions on visiting are for residents and their families. Families are encouraged to talk to the support staff at the person’s residence, to make arrangements for visits and other activities that can be facilitated within the current public health guidance. While it is appropriate in line with the public health cocooning guidance for activities outside the home to commence, it is important to balance the risk involved in prolonged periods of time outside the home. These risks will continue to be reviewed in line with the disease progression and guidelines will be updated.