I refer to the editorial of Times of Malta dated May 26 entitled ‘COVID’s impact on elderly care’.
Employees living in residential homes have chosen to live in the home on a voluntary basis. They alternate for two weeks at a time and they are tested for COVID-19 every time their two-week shift is due. During their time away from the residential home, staff were also encouraged to reduce contact with others outside their household.
By living in the home for extended periods, rather than going home every day, the likelihood that staff meet outsiders and contract COVID-19, possibly remaining without symptoms and transmitting it to older residents, was reduced to a minimum. Living together has in fact reduced the risk of infection. These living-in arrangements were not imposed by any government entity but taken up by some residential homes.
Staff within government homes were also offered alternative accommodation.
In the case of homes where the government buys beds, contrary to what was stated, these homes did not lose any revenue due to the lack of new residents. The government continued to pay for those beds which remained empty after being vacated as part of the contingency plan due to COVID-19.
This in turn ensured that any empty beds remained vacant so that any suspected case could be segregated from the rest of the residents as advised by healthcare standards directorate in their guidelines for residential homes.
This was further supported by Social Care Standards Authority in a circular letter 16/20 dated April 9 which advised that these empty beds were to be left vacant as a contingency plan, to create an isolation area in each home. This same isolation area was also used by residents who returned back to the residential home, after receiving care from other institutions.
Church-run homes are also among those homes where the government buys beds (at a regular price and not on donations), and these beds, whether occupied or vacated (as above) continued to be paid. The editorial is therefore incorrect in implying that Church homes for older persons depend solely on donations.
The government’s expenditure on the buying of beds has gone up from €5 million in 2013 to €38 million in 2020- Renzo De Gabriele
The increase in expenses as a result of COVID-19 have increased for all businesses and for different areas within the government entities themselves. Privately run homes where the government buys beds are being paid to ensure regular day-to-day operations. In addition to this, during the COVID-19 period, Active Ageing and Community Care (AACC) has assisted private homes to discuss contingency plans and other issues.
Those private homes which, as a result of COVID-19 measures, requested surgical masks were also provided with an amount (at no cost to them). They are also provided on a regular basis throughout the year, with some medical consumables, such as gloves.
Not only so, but the government is already supporting private homes with health infrastructure. All health services, whether services provided at hospital, at outpatients and health centres, including pharmaceutical items on the POYC scheme are completely free.
In addition, those beds bought by AACC are also supported by various healthcare professionals provided and paid for by AACC which include incontinence nurse, infection control nurse, wound management team, OT, physios, podiatry, SLP, clinical nutrition nurse and psychotherapist. Each of the homes under AACC are also provided with a geriatrician who visit the homes on a regular basis.
When paying for occupied beds, the price per resident fluctuates so that those requiring higher levels of care are provided with better support. It is up to the private home to use that money for better resident care and not solely to make profits.
In these difficult times, all workers are experiencing higher stress levels than usual. All employees were provided support services through the Employment Support Programme or through the Richmond Foundation. All employees were also encouraged to use these services; while some private homes also provided emotional support services to their employees.
It is interesting to note that the government’s expenditure on the buying of beds has gone up from €5 million in 2013 to €38 million in 2020. That is almost an eight times increase, over a span of just seven years.
The basic pay of carers in private-run homes also have their salary pegged to reflect salaries paid within the government. Homes are encouraged to provide regular training for all staff in various areas. When the editorial refers to little job security for carers, it is incorrect as carers are in high demand as the government is buying beds very often.
With regard to the clinical psychologist, this is done on a referral basis by the doctor and sent on an outpatient basis. In addition to this, AACC also provides psychotherapy, at no extra charge to the home. This provides a safe place for residents to talk about any issues that concern them. To reduce physical contact and the risk of COVID-19, these sessions are currently being held by videoconferencing, through a tablet or a PC provided by the home.
Residential care for older persons should have at least one single room for isolation purposes, however, if a resident has an infectious disease, they would require an admission to Mater Dei Hospital for further treatment. It is to be kept in mind that residences are not hospitals but rather a place for older persons to live with adequate 24 hour support.
Renzo De Gabriele is CEO, Active Ageing and Community Care.