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There's a lot of scaremongering going around about nursing homes.
Claims that residents are being "left to die".
A few points on that...
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Claims that residents are being "left to die".
A few points on that...
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The first is that there clearly *are* issues. The purpose of this thread isn't to claim there isn't.
I know of one nursing home where families were only informed of an outbreak after they saw a Facebook post about a resident who died of COVID-19!!
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I know of one nursing home where families were only informed of an outbreak after they saw a Facebook post about a resident who died of COVID-19!!
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There are 550 private nursing homes in Ireland, representing 80% of all nursing homes. So only 20% are public sector.
Some are going to handle this well, others won't.
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Some are going to handle this well, others won't.
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Nursing home outbreaks are taking place in most European countries. Covered well in detail here by @Care2much18
Ireland isn't unique in having outbreaks. But, that's not to say there aren't practices that could be improved on.
https://twitter.com/Care2much18/status/1248750138199347200
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Ireland isn't unique in having outbreaks. But, that's not to say there aren't practices that could be improved on.
https://twitter.com/Care2much18/status/1248750138199347200
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PPE is now being provided (if it wasn't already) and staff will be temperature checked.
Good moves. We'll debate whether it should have happened earlier. Some nursing homes will have already been doing this. Remember, 550 different private homes.
5/ https://www.rte.ie/news/coronavirus/2020/0404/1128463-covid19-coronavirus-ireland/
Good moves. We'll debate whether it should have happened earlier. Some nursing homes will have already been doing this. Remember, 550 different private homes.
5/ https://www.rte.ie/news/coronavirus/2020/0404/1128463-covid19-coronavirus-ireland/
The circulation of this particular slide is what prompted me to write this thread.
First point says that management of cases will take place in the nursing home itself.
It's being interpreted as "leaving them to die" in nursing homes.
That's not the case.
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First point says that management of cases will take place in the nursing home itself.
It's being interpreted as "leaving them to die" in nursing homes.
That's not the case.
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The first mistake is believing that nursing homes don't provide healthcare (even though "nursing" is in the name).
Residents are the most frail members of society. They're there because they can't look after themselves. Staff are trained to deal with all kinds of illness.
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Residents are the most frail members of society. They're there because they can't look after themselves. Staff are trained to deal with all kinds of illness.
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Nursing home staff are the ones most familiar with the conditions of their residents. They know their comorbidities, they look after their medication, they know the residents personally. They are well placed to look after a resident who catches COVID-19.
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But sadly those efforts come up against the realities of nursing homes.
20% of nursing home residents die within the first 3 months of admission, and the average resident lives for 30 months.
9/ https://www.irishtimes.com/news/health/study-reveals-nursing-home-death-rate-1.747254
20% of nursing home residents die within the first 3 months of admission, and the average resident lives for 30 months.
9/ https://www.irishtimes.com/news/health/study-reveals-nursing-home-death-rate-1.747254
My point here again is that these people are incredibly frail.
My point isn't "they would have died anyway" as some believe is at play here.
The HSE clarified this morning that hospital admission is *not* being refused to nursing home residents.
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My point isn't "they would have died anyway" as some believe is at play here.
The HSE clarified this morning that hospital admission is *not* being refused to nursing home residents.
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Again, the big fear is residents are "being left to die" in nursing homes.
I counter that by repeating - nursing homes provide healthcare on site.
The new supports for nursing homes include oxygen supplies.
11/ https://www.irishexaminer.com/breakingnews/ireland/harris-commits-to-provide-covid-19-financial-support-and-ppe-to-nursing-homes-991097.html
I counter that by repeating - nursing homes provide healthcare on site.
The new supports for nursing homes include oxygen supplies.
11/ https://www.irishexaminer.com/breakingnews/ireland/harris-commits-to-provide-covid-19-financial-support-and-ppe-to-nursing-homes-991097.html
But nursing homes don't have ventilators?
What about ICU care?
The experience from other countries is changing the approach to ICU care.
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What about ICU care?
The experience from other countries is changing the approach to ICU care.
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In Italy, they found that putting the most frail and elderly patients on life support had poor outcomes.
The first minute of this video discusses it.
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The first minute of this video discusses it.
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"care specialists have learned a hard lesson from Italy that the numbers who benefit from ICU and ventilation are lower than first thought"
"people with extensive underlying illness and people who are older tend to do less well"
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"people with extensive underlying illness and people who are older tend to do less well"
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Is the number of nursing home residents who would *benefit* from ventilation zero?
Of course not.
Is it a low number.
Probably.
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Of course not.
Is it a low number.
Probably.
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So let's be careful when we see scaremongering posts about nursing homes.
They are being looked after by the people who know them best and they now have PPE and oxygen to fight this virus.
And if more help is needed, then it should be provided!
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They are being looked after by the people who know them best and they now have PPE and oxygen to fight this virus.
And if more help is needed, then it should be provided!
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