Unable to receive nursing care in Corona 7th wave “The biggest nursing care crisis ever” September 2nd, 19:23
" Parents
who need nursing care are positive. I can't go to day care for 10 days and I have to care for them 24 hours a day.
"
A succession of voices.
On the other hand, from a nursing care office that dispatches helpers.
"I give up my day off every day. 'Nursing care refugees' are emerging."
Both the elderly and helpers continue to increase in the number of infected people, and there are voices of conflict that they cannot provide the nursing care they need to sustain their lives.
In the "largest nursing care crisis in history", the last thing we can rely on is the "sense of mission" and "sense of responsibility" of the people in the field.
(Sayaka Kobayashi, Reporter, Kota Iida, Social Affairs Department / Naho Yoshida, Director, Politics, Economics and International Program Department)
Heartbreaking voices from nursing homes
Around the end of July.
Reporters reporting on the field of nursing care began to hear heartbreaking voices from people working in the nursing care field.
"It's going to be a pretty big deal. There are clusters all around us. I've even heard of a facility where all the staff have tested positive.
" The users who became infected and the family members who lived with them were also infected one after another, and we made adjustments to hospitalize them, but there were no hospitals that would accept them.” (care manager
) I have been in close contact with them, and I am giving up my day off every day.There are nursing care refugees.”
With the unprecedented surge in infected people, there are also "nursing refugees" who need nursing care but cannot provide services.
Dementia, living alone, but after being found positive...
what is happening on the ground
As soon as I started interviewing, it became clear that serious things were happening everywhere.
A man in his 70s living alone in Osaka, whom I interviewed in late August.
On August 23, the man had a fever of 38 degrees and was found to be infected with Corona.
He was taken by ambulance, but the hospital he arrived at had no beds available, and his symptoms were relatively mild, so he was sent home to recuperate.
The man's nursing care level is "3", which means that he needs assistance in all aspects of his life, and he also has symptoms of dementia, such as forgetting what he did just before.
A helper visited every day and received personal assistance such as changing clothes and eating.
However, when I became positive, I was refused a visit from the office of the helper I depended on, and I ended up spending time alone at home without receiving nursing care.
The fact is that there are few helper offices that visit positive people, and it is limited to some.
instead of helper
The care manager in charge of the man contacted various offices to get someone to visit him.
What I found was a "visiting nursing" office.
I was relieved to be able to help me take medicine for a chronic disease that I couldn't take by mistake and to monitor my physical condition.
However, due to the system, "visiting nurses" cannot be asked to do the cleaning, laundry, and personal care that the helpers did, and it is said that there are still problems in terms of living.
Yukiko Kume, in-home nursing care support office "Log 03"
"I have dementia and it is difficult to live without someone's help, and I have a chronic disease and there is a risk of sudden deterioration. Also, even if you are alone, I wanted to be hospitalized because there is a risk of infecting other people if I go out of my house, but I couldn't.There are other cases like this one after another."
"Almost a sense of responsibility" That's also the limit
Under these circumstances, some businesses continue to visit positive people.
One of them is Misube no En, a home-visit care facility in Kita Ward, Tokyo.
While the surrounding businesses did not visit the positive people across the board, the "service provider" who usually works mainly in the office has continued to visit them wearing protective clothing.
Kensuke Tamura, the manager of the office, says that it is difficult to force helpers other than the person in charge to visit to face the risk of infection.
Kensuke Tamura, Manager of Misube no En, a Home-visit Nursing Care Facility: "It's
strange to ask part-time staff to wear protective clothing, so I think we have to leave it to the person's feelings and conscience to some extent. It's pretty good. I can't say that you should do it as a business order.
However, in August, employees became infected one after another and became close contacts, and in mid-August, one of the main employees was infected.
In the end, half of the 20 staff members, 10, had to rest, and the number of staff reached its limit.
In order to make it work, Ms. Tamura had no choice but to refuse visits by users with low levels of nursing care, and was forced to make a difficult choice.
Kensuke Tamura:
"If the infection spreads further, we may not be able to continue visiting people who tested positive."
Why the rapid increase in “nursing care refugees”?
the expert is
Why is the number of elderly people requiring nursing care who become corona-positive and become “nursing refugees” rapidly increasing in the 7th wave?
When I interviewed Professor Yasuhiro Yuki of Shukutoku University who is familiar with nursing care issues, he raised three points.
1. The principle of "elderly = hospitalization in principle" collapses
Elderly people are at high risk of becoming seriously ill, so it was originally said that "if you are infected, you should be hospitalized in principle".
However, with the shortage of hospital beds, that principle gradually collapsed, and after the sixth wave, the government said, ``One option is to recuperate at facilities for the elderly that offer more nursing care.'' .
Among them, there are some local governments that say, "In principle, I want you to continue recuperating in the facility."
Furthermore, as the infection spreads more than ever in the seventh wave, it is believed that not only elderly people in facilities but also elderly people who need nursing care living at home are receiving treatment at home instead of hospitalization.
2 “Visits to positive care recipients” are left to the site
For many elderly people requiring care who live at home, the long-term care insurance services that support their lives are day services and home-visit care.
However, once an individual or family member tests positive, not only can they not go to day care services, but the reality is that there are only a limited number of helpers who can visit homes where the person is positive.
▽ For helpers, many of whom do not have expertise in infection control, visiting in protective clothing is a heavy burden.
▽ There is a risk of spreading the infection because one helper visits multiple users in a day.
▽ This is because supplies such as protective clothing and test kits are expensive, and the burden on management is large.
On the other hand, there is a government subsidy that can be used to pay "danger allowances" to helpers who visit positive people, but in principle up to 320,000 yen per business establishment.
In some cases, it is not enough, and the company has issued a "hazard allowance" at its own expense.
Professor Yuki points out that in such a situation, visiting people who tested positive depends on the sense of mission and responsibility of those on the ground, who say, "Even so, we can't abandon people who need nursing care."
3 “Declining number of workers, rapid increase in demand” The balance between supply and demand collapsed
, and in the 7th wave, the unprecedented spread of infection caused the helpers to become infected one after another, and the number of workers to visit decreased.
On the other hand, day care services in the surrounding area have also closed due to the spread of the infection, and demand has surged to increase the number of home-visit nursing care instead.
In addition to spurring a serious labor shortage from the beginning, the workload has increased more than usual, and it is not possible to deal with people who have tested positive.
Professor Yasuhiro Yuki of Shukutoku University
"It seems that the number of elderly people who cannot receive nursing care services due to the rapid spread of infection is increasing."
Record-breaking number of clusters Non-positive people are becoming “nursing care refugees”
So far, we have looked at the problem of elderly people who need nursing care who are infected with COVID-19. .
The number of group infections such as clusters at facilities for the elderly (*including day services and short stays) hit a record high of 850 in the week ending August 22nd.
Since the beginning of July, it has increased more than 9 times.
Under these circumstances, in August, a total of 11 staff and users were infected at the dementia-friendly day service "Sakura" in Kamakura City, and they were forced to take six days off.
A 70-year-old man with a level of nursing care level 5, who went to work two days a week, was forced to take a heavy burden from the leave.
At the day care service, I received assistance with meals and bathing, but due to the suspension, I had to spend time at home, and my 70-year-old wife was responsible for all nursing care.
For about three weeks, the man was not allowed to take a bath because the strength of his petite wife could not support her husband's body.
Also, it was difficult for the wife to move her husband by herself, and the man was mostly bedridden until he resumed work.
The wife is worried that her husband's spending all day in bed will affect her future caregiving.
Man's wife
"If I don't go to the day care service, my muscles will weaken and I'm worried that I won't be able to walk to the toilet. If I can't walk, I won't be able to continue nursing care at home." I am afraid that
“Nursing care crisis” will continue after COVID-19
And one more thing, closed business offices face another challenge even after reopening.
Due to the decrease in income due to the closure, it is in danger of survival.
The amount of nursing care fees that come in for day care services is determined by the number of users and the number of days they are used, so revenue will decrease if the service is not used due to suspension.
"Sakura" lost more than 1 million yen in revenue due to the 6-day suspension, and the office is expected to suffer a large deficit.
Hideki Inada, the representative, hopes to keep it alive by soliciting support through donations from local people.
Day service for dementia "Sakura" Representative Hideki Inada "
I was barely moving in terms of management, so I lost my physical strength. I've been working hard and taking measures so far, but I can see the limit. I feel like I've come
"Nursing care crisis" What are the measures and necessary measures in the country?
In order to prevent the "nursing care crisis" caused by Corona, the national and local governments have taken measures to support nursing care sites.
In addition to subsidizing funds for infection control such as protective clothing, we have also provided subsidies to businesses that deal with positive people.
However, there is no subsidy system that directly compensates for the loss of income due to suspension of business.
Professor Yasuhiro Yuki of Shukutoku University points out that the current support measures are inadequate, and if things continue as they are, nursing care facilities will go bankrupt one after another, and the "nursing care crisis" may continue even after the corona is over.
In addition, he suggests that the following content be required in order to prevent people who need nursing care from being left behind at home.
Professor Yasuhiro Yuki of Shukutoku University's proposal
▽Development of accommodation and medical treatment facilities with nursing care ▽
Strengthening of financial support for home-visit nursing care offices to request helpers from temporary staffing companies
▽Compensation for the loss of income at nursing care offices due to suspension of business benefits
Don't leave it to the site
In fact, the need for support measures such as those pointed out by Professor Yuki has been pointed out every time a wave of infections comes.
Even so, the measures have not progressed sufficiently, and the situation where nursing care sites have been exhausted has been repeated.
At-home nursing care is barely supported by caregivers and family members who continue to work hard out of a sense of mission and responsibility that they cannot abandon the elderly, but there are limits to this. .
There are still many people infected with the 7th wave, but for the "now" and "future", the national and local governments should build a system that does not rely only on the "sense of mission" and "responsibility" of the field. Must-have.
I think so.
News Department Reporter
Sayaka Kobayashi
Joined in 2007
After working at the Kitakyushu and Fukuoka stations, she is currently in charge of medical care,
nursing
care, gender and children's rights.
News Department Reporter
Kota
Iida
Joined in 2009 After working at the Chiba Bureau, Akita Bureau,
and
the Network News Department, he currently belongs .
Director
Naho Yoshida Joined the station in
2013 (career)
After working in the Osaka station and the social program department, she currently belongs
.