Just imagine what it is like looking at life through the eyes of someone living with dementia. Sometimes it is confusing, sometimes stressful, sometimes good, and so much more. Add the components of a pandemic Covid Virus and life changes into the mix and life changes.
People can live well with dementia, especially if the there is order and routine in their lives, however, the pandemic has catapulted elements of disorder into their lives. Indeed, the prefix dis – appears to be used often, affecting their mental health-dis-order, dis-tancing, dis-comfort and dis-stress.
So how have government directives and regulatory infection control procedures impacted on the lives of people living with dementia? People living with dementia may require added support as their lives are thrown into turmoil, for example support with their activities of daily living and personal care, having their hair washed and styled by a hairdresser, suddenly there is no hairdresser, she has stopped visiting, people who supporting them are wearing extra gowns, masks and visors . How frightening this must be? The people who cared and supported them previously, are now unrecognisable. Lowered cognitive ability may not have the means of recognition or reconciliation with the fact that carers wearing appropriate PPE is to protect them. Personally, I find it disconcerting walking around in a world of mask wearers. It unsettles me. So how must this be perceived by some with distorted cognitive ability.? It is difficult to recognise the person that they are used to feel comfortable safe and secure with and this must cause anxiety in distress
The Social Care Institute of clinical of excellence have advised to do the following when working when wearing masks
- Have your name and picture clearly displayed on your person
- Explain why you are wearing masks in a clear, calm and open voice.
Generally, healthcare must surely have impacted elderly and vulnerable adults. Community nurses’ visits reduced if they were able to visit at all, thus chronic condition monitoring such as leg ulceration will be reduced and perhaps daily dressings. As we all know elderly people will suffer with co-morbidities that need supervision and healthcare management. The only accessibility to see a GP will be by a telephone call or zoom. Can a true holistic assessment be deemed by one of these methods.? These chronic illnesses need to be regularly monitored, treated and assessed, therefore not only is the mental health of a person living with dementia been impacted by Covid, but also their physical status is at risk and will not have been managed with efficacy as pre-covid. The risk of contracting general infection is also raised but may be slower to diagnose and treat in a vulnerable adult. Challenges of regular testing have also been problematical. Tragically many people have died of Covid of weakened physical states both at home and in care homes. . One has to question whether it was Covid that led to these deaths (Some premature) or existing chronic illnesses.
In a recent survey from Alzheimer’s UK it was stated that “confusion and depression was exacerbated for those living with dementia during the pandemic. As carers were doffing masks which in itself is confusing people were also denied visits from loved ones from enforced restrictive visits. How can it be explained logically that their loved ones must talk to them in a garden or through a window. Indeed, some care homes have come up with innovative ideas to assist in meetings between loved ones but for a person living with dementia, the lack of physical closeness, not able to hold a hand, having the comfort of a hug or even having an engaging conversation with their families and friends must be devastating and they may not be able to comprehend the reason why this is happening. Man is a social, tribal animal and seeks out physical contact, therefore for having it enforceably removed must have negative effects. However, many care homes have gone the extra mile and set up zoom calls, facetime calls and meeting pods and whilst it does not replace the real thing it is helpful. Again, people living in their own homes have been impacted with possible reduced care visits. The lack of social contact can only lead to feelings of depression and isolation. Touch is an inherent human need and yet people living with dementia have been forcibly denied this from relatives. The impact on families has been catastrophic. They cannot socialise with their loved ones. They do not know how their loved ones are really feeling. There are tragic reports of people dying and their loved ones have been unable to see them and say things that they would have wished or even say goodbye. This, surely cannot be right? Families are left bereft and have not had closure. I personally spoke to a carer who had lost her mother and was unable to say goodbye and minimal attendees at the funeral were allowed. Social distancing is having a devastating effect mental health and is yet to be measured. With this second wave of Covid measures have become more draconian. One understands that this is to protect lives and the NHS from becoming overwhelmed, however the cost is extremely high. Man is a social animal and lives in packs.
Assistive technology has helped in reducing isolation and it is the future, especially if the pandemic continues, but the answer cannot rely on machinery alone. There is evidence that social distancing is causing increased depression, stress and anxiety, reduction in mobility, and heightened levels of confusion which can only lead to people living with dementia having an even more loss of self-identity. It also needs to be considered the cases of the unpaid carer. Sons and daughters have had to put their lives on hold, pause their careers, juggle family and work, feel isolated as their social life has been curtailed, and maybe even feelings of resentment and they may even question themselves by saying “I didn’t ask for this”
Whilst I understand that government is in a very difficult position in order to keep everybody safe, I would suggest that the elderly and the vulnerable, especially those living with dementia and their families have paid far too great a cost, both physically and emotionally. It is time for government to rethink a strategy that lifts the blanket lock down to the elderly and after 7 months with no date in sight should look at supporting alternatives. Furthermore there has to be consistency in care homes to have a one hat fits all lockdown policy.
SABINA KELLY RN Ba(Hons) Bsc(Hons)