- The Minister of Health, Olivier Véran, announced Sunday evening the resumption of family visits within the Ehpad.
- They had been banned since the beginning of March, for fear that the Covid-19 would enter these establishments to the vulnerable public. But for many residents confined to rooms, the isolation and deprivation of the family became too difficult to bear.
- According to Romain Gizolme, director of AD-PA, this new step, "very important", must be accompanied by a resumption of activities.
The news was awaited by many elderly people and families. The Minister of Health, Olivier Véran, announced Sunday the reinstatement this Monday of family visits in the Ehpad. Recalling that to date, "45% of Ehpad have reported at least one positive Covid case in the territory", he said that the decision to reorganize visits had been taken after consultation with "learned societies" and "representatives organizations of these institutions for the elderly ”.
"We have together developed new recommendations that will allow from Monday the organization of visiting rights for families towards their frail elders" residing in Ehpad, "in extremely limited conditions," said the minister. "There will be eye contact," but "a continued impossibility of going to touch the person, of being in physical contact," he added. Olivier Véran also announced that the Ehpad test campaign, announced a fortnight ago, had started. "This week, 50,000 tests have been scheduled and carried out in nursing homes," he said.
AD-PA, the Association of Directors for the Service of the Elderly, welcomed the government's decision on Sunday, "very encouraging, given the necessary extension of the confinement over the coming weeks". "It is very important for our residents, for whom this confinement is very difficult, to be able to receive the visit of their loved ones again", explains Romain Gizolme, director of AD-PA to 20 Minutes , who is now advocating for " a resumption of activities and social life times, which the residents lack ”.
How to ensure the safe resumption of visits to nursing homes?
We are waiting to see if the Ministry of Health has specific recommendations. But already, Olivier Véran's announcements give some details. Everything will be done in strict compliance with barrier measures, hand hygiene, wearing a mask and minimum distances between each person. To facilitate this safe recovery, we limit visits to two people from the resident's family.
As for the place, it will depend on the layout of each structure, it can be organized in the gardens of the establishments, or in specially fitted out spaces. What is certain is that it will be up to each structure to determine the conditions allowing a secure resumption of visits, taking into account in particular local specificities: if it is a region where the virus is still actively circulating, or if Covid-19 cases are confirmed within the facility. In this case, the logistics are not the same either if you have one case or if you have dozens.
With regard to the length of visits, it seems to me - and this is only my personal opinion - that it should be modeled on ordinary law measures. If each individual has the freedom to walk for an hour a day, the duration of visits to a loved one in an Ehpad should be an hour, no less, no more.
Will family visits to residents with Covid-19 also be possible?
In recent weeks, the only exception to the ban on visits has concerned residents at the end of their lives, with a highly regulated system to allow loved ones to say goodbye to their parent or grandparent and accompany them in their last moments .
Today, with a specialized and ultra-secure protocol, we will allow relatives to come and see a resident even if he is a Covid-19 carrier. This will be done under more stringent conditions, probably in the accommodation of the sick resident, with the wearing of a mask for everyone, perhaps with a restriction to one person and over a given time.
It is possible today and has not been for the past few weeks. The fact that the Ehpad are now better supplied with protective equipment will allow us to provide masks to our residents so that they can see their families.
On the psychological level, we can imagine how the resumption of visits will have a beneficial effect on the well-being of residents…
It's obvious ! It is very difficult for them to endure this distance from their loved ones. It is all the more difficult for those who have hearing or vision problems, or certain Alzheimer-type pathologies, to communicate by telephone or Skype. Especially since it is a generation that is mostly not used to these communication channels. From now on, being able to see and talk to each other "in real life", even at 1 meter or 1.50 meters and without touching each other, will change everything. The contact, the looks and the smiles will be there. Inevitably, the return of relatives will do a lot of moral good.
Since the beginning of containment, and even before since the government has prohibited Ehpad visits from March 11, the AD-PA advocates that a balance be found between protecting the physical health of residents - as well as people dependent elderly people who are followed at home - and their psychological well-being. This is also the meaning of the recommendations of the National Consultative Ethics Committee (CCNE), which stresses that specific containment measures in nursing homes can have deleterious effects on the mental health of residents, and recalls the importance of " respect for human dignity, which also includes the right to maintain a social bond for dependent persons ”.
Because we know that the conditions of this confinement are more difficult for our seniors to live with, that there is, with this vulnerable population, a risk of "slip syndrome". It results in a depressive disorder, a significant loss of autonomy and desire to live. Hence the importance of restoring the link with families. This is decisive for the residents' health, and for their acceptance of the confinement, which will still last at least several weeks.
In many nursing homes, residents are confined to their rooms. Are there also plans to make this form of containment more flexible in containment? Is screening a strategic tool in this case?
Screening has become widespread in nursing homes in recent days, and is no longer limited to screening for the first suspected cases of Covid-19. Testing everyone allows, within each establishment, to have visibility and to implement very individualized measures. Whether on the strategy to adopt if one or more residents test positive, or on the greater latitude that can be agreed when no case is detected.
For the past few days, the physiotherapists have been able to exercise again, and resume the exercises to preserve walking autonomy. The resumption of family visits is a capital first step, but today we must go further, and organize the resumption of social life in nursing homes, always in compliance with the barrier measures. In recent weeks, the days have been particularly long for residents who have no visits, no more activities and are isolated in their rooms. It is a time of deep boredom. And unfortunately, staff who are already overworked in normal times have even less time to devote to them. The relational aspect has been reduced to a minimum, and it is not sustainable over time. This is why it is necessary to bring back volunteers and animators in our structures, by setting up specific arrangements, activities in small groups: again offering bond and entertainment to the residents.
This recovery requires significant logistics. What means are provided in the establishments? But also for all those who work from home?
Olivier Véran praised the commitment of professionals in the sector, but now it will be necessary to strengthen the logistics, because all this requires more resources, especially human. Having a better supply of masks in recent days already allows you to resume visits and activities safely. This also allows a resumption of professional activity of staff working at home and who, for lack of sufficient supply of protective equipment in recent weeks, have been forced to restrict their essential activity.
Then, if people, particularly partially unemployed, wish to help nursing homes, they can report to the health reserve. Any help to improve the well-being of our residents and teams will be invaluable. We have also set up a free psychological and logistical support platform on the AD-PA website for staff who support dependent elderly people on a daily basis, whether they work in nursing homes or at home.
Finally, it should not be forgotten that the support sector for dependent elderly people has been going through a deep crisis for many years, with a chronic lack of human and material resources. It is a sector that operates on a just-in-time basis throughout the year. This situation is aggravated in times of crisis and cannot be resolved while we are in the midst of a pandemic.
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- The elderly
- epidemic
- Covid 19
- Ehpad
- Health
- Coronavirus