Alone and fragile facing the coronavirus (3/3): Do not "let slip" the elderly

"Today, we have to make decisions. We don't know if they will be good or bad," says Nicolas Bresse. Faced with the coronavirus pandemic, this manager of a home for the elderly in Cher is worried about the consequences of the Covid-19 pandemic for its residents. He and his teams are faced with a double problem: preventing the spread of the coronavirus in the residence, but also preventing the confinement from causing the loss of autonomy for the elderly.

Joined by France 24, Nicolas Bresse believes that the epidemic could have been roughly anticipated by its structure:

"During the first phase of the epidemic, we managed to stock up by working with local pharmacies. We were therefore properly equipped with hydroalcoholic gel and we had enough masks. Now, we have endowments from the ARS [ Regional Health Agency] ", he explains, proud of the functioning of its structure, a Marpa [Home and residence for the elderly] and its team.

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The Marpas welcome people who are capable of autonomy. They constitute a network of 200 structures in France. That of Val d'Arnon, in Cher (central France) thus welcomes 21 residents who each have their own accommodation, but who benefit from services such as accompaniment, laundry as well as meals taken in community.

A small structure that made it possible to respond to the epidemic

Unlike an Ehpad [Accommodation facility for dependent elderly people], "we are not at all a medical structure. We do not have caregivers on site. Our residents are still independent, but they need to be in collective to feel secure and break the loneliness, "explains Nicolas Bresse. "It is also a support promoting good aging. Liberal nurses' offices and home helpers intervene for all personal care."

The manager believes that being a "small structure" has made it possible to react better to the arrival of the coronavirus. He was able to take the necessary measures without upsetting the little habits of the residents despite the confinement:

"Usually, we are six people working permanently here. We now take care of a large part of the cleaning and washing ourselves, in order to avoid the comings and goings. We limited the exchanges with families and the arrival of professionals. The personnel who come from the outside are equipped at best. We had anticipated and we are now tending towards a vacuum, "he lists.

"Our role is to reassure. And many have realized how dangerous this virus is for them," he explains. "The coronavirus has slightly changed the dynamics of the place. In the absence of family visits, residents have less personal space. They turn more to other residents to compensate."

Letters to break the isolation

One of the objectives of the Marpa is to allow the elderly to keep a place in society. Usually, this involves the organization of entertainment by outside speakers or visits by primary school students. The coronavirus having broken this, the Marpa du Val d'Arnon has circumvented the problem thanks to the couriers:

"A person sent us a card telling us that they were thinking of us during this complicated period. We didn't know them. The idea was nice. I put this on my personal Facebook account. The post was shared , so much so that other letters have started pouring in, "says Nicolas Bresse, smiling.

As you know, I do not work with grandpas and grandmothers who are confined and who risk dying away from isolation. . . Today ...

"We have received about twenty letters. Someone is taking care of their reception, they are then posted for everyone. It breaks the isolation," he analyzes. "The idea is to occupy the minds of the elderly to prevent anxiety from arising."

Nicolas Bresse also hopes to be able to help his residents stay in touch with their families by helping them use the webcam and smartphones for videoconference calls. He also notes that the crisis has cemented local solidarity. Families and local actors offer voluntary help in this situation. An example: the nursery owner has flowered all around the building to brighten up the structure's daily life.

Isolation in a single room, a false good idea

An announcement by the Ministry of Health, however, put a blow to the morale of this incurable "optimist", as he defines himself. Olivier Véran, on March 28, asked Ehpad-type establishments to move towards individual isolation for each of their residents in order to go further in protecting the elderly against the coronavirus.

For Nicolas Bresse, this obvious health solution also presents risks for the long term: "We are certainly facing a health crisis, but we risk having a traumatic crisis once this has happened. They will have survived but will have lost their autonomy. We will have degraded our old people. If they let go, they will regress. From there, it will be impossible to find the mechanisms of yesteryear, "said the social worker. "Someone who is not walked everyday, he will not start walking again in two months if he has spent all this time without walking. Someone in cognitive degeneration, if we do not continue with him offer exchanges, links, a rhythm, it will be out of phase and let itself slide, "explains the manager. "And to let oneself slip, in an old character, it is death, nothing else," he warns.

"This is what makes this crisis so complicated for workers. The whole objective in normal times is to project ourselves to keep a course. There, we are no longer in project mode, we are in daily mode and it is the worst for our residents, for us, for everyone, "he sighs as his Marpa finally has to settle for room confinement.

A team that can handle the shock

Fortunately, to help its residents pass this test, Nicolas Bresse can count on his team.

"We must salute the work of the teams. There is a huge workload and they are mobilized. In this kind of situation, the teams unite and we all move forward together for the well-being of the residents", praises he. "In the long run, it will be difficult to escape wear and tear. But for the moment, we are advancing in stages."

Because chasing the optimism of Nicolas Bresse, he returns to the gallop: "Everything is turned upside down, but we will get there! We must remain mobilized, positive and invested to reinvent ourselves", he exclaims in conclusion , already exhilarated.

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