Community topics
Author: University Line
2021-01-04 16:44
Last update date: 2021-01-04 16:44
"After she was unable to visit, there was no one to accompany her to practice walking. She was completely in bed, and the chance of walking again shouldn't be great." Since visits to the nursing home were banned, Jessie could no longer visit the home in person, and it was inconvenient to accompany her to move. , The grandmother in his nineties is practicing walking.
In addition to her grandmother's sudden deterioration in her physical condition, Jessie worriedly pointed out that she was depressed after being trapped in the hospital for nearly half a year, and her response was slower than before, and her mental and mental health was also greatly affected.
In the new crown pneumonia epidemic, the elderly are a high-risk group.
Since July 2020, there have been confirmed cases in residential homes for the elderly one after another.
The government has banned all hospital visits across the board for the massive spread of immunity, unless it is for official business or for compassionate reasons, such as the elderly in critical condition, the hospitals will make alternative arrangements.
However, some outreach doctors pointed out that life in general private institutions has always been boring and the staff has a huge workload. They can only take care of the basic needs of the elderly and have no time to care about their mental state.
The fourth wave of the epidemic is fierce. The elderly in the homes continue to be confined and their families are turned away. What should they do?
Reporter｜Editor by Han Zhuodong｜Photography by Wen Jiran｜Han Zhuodong Wen Jiran
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Related pictures: Click to learn more about the situation of homes for the elderly under the epidemic
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Jessie’s grandmother fell and injured her back at the beginning of last year. She was inconvenient to move and her family could not take care of her. She had to be admitted to a nursing home. At first, Jessie would visit her grandmother every day and practice walking with her once or twice a week.
On days without family visits, grandma would use TV to relieve her boredom.
Although she did not like life in the home, she had no complaints at the time.
However, since the Social Welfare Department promulgated a ban on visits to homes in early July 2020, grandma can no longer meet with her granddaughter Jessie. It has been nearly half a year and her mood has gone from bad to worse.
Before the epidemic, my grandmother had been receiving outreach physiotherapy services arranged by the homes. The service was under the SWD’s "Outreach Professional Services for Elderly Homes" pilot program. She trained once a week and walked with a walking frame for five minutes, gradually improving .
However, from the end of January 2020, the service was suspended until the end of May due to the severe epidemic; at the end of July, the third wave of epidemics was suspended until September; the fourth wave of epidemics recurred, and the Social Welfare Department announced again on December 2 that the plan was suspended and changed to other Mode provides training and support.
Intermittently for nearly half a year, without assistance or encouraging grandma to move her hands and feet, Jessie believes that her physical functions will gradually decline, frankly:
Grandma's chances of being able to walk shouldn't be great anymore.
The attitude of the staff has deteriorated and the elderly dare not to speak up
Unable to visit her grandmother, Jessie could only contact her through communication software to relieve her boredom, and at the same time encourage her to communicate more with her family to slow down the deterioration.
In early July 2020, the home promised to provide video calls to allow the elderly to keep in touch with their families, but the person in charge later pointed out that the wireless network of the home was not smooth and it never happened.
Jessie can only buy a smartphone on her own and ask her staff to pass it to her grandmother to ensure that she can talk to her grandmother two to three times a day to understand her physical and mental condition.
During the call, grandma often told Jessie that she was unhappy.
Trapped in the institution, unable to communicate and contact with others, most of the time facing the staff of the institution.
The grandmother also complained about the poor attitude of the staff, and seldom chatted with the elders in the institution, and her life was both restless and depressing.
Before the epidemic, Jessie visited her grandmother frequently. She thought the staff had a better attitude at the time, but the staff's attitude gradually became worse after the visit was banned:
Because the (elderly) has been trapped in bed for a long time, many things have to be done by others, and now the family cannot go, she (grandmother) lacks a lot of help.
Grandma said that caregivers were getting worse and worse, and she often said how to live like this.
For example, when the grandma asked the staff to get an extra quilt to keep warm, the staff would furiously say "very hot" and refused; another time, when the grandma dropped the quilt, the staff patted her. The grandma said that the staff had sharp eyes at the time, and they even spoke later. Intimidation: "If you complain to your family again, I will drive you away." My grandma called Jessie aggrieved in the middle of the night, and Jessie recalled that her grandma's voice trembled: "She was so terrified that her body was shaken all night, and she didn't sleep. It was very pitiful. After Jessie complained to the institution, her grandmother said she was intimidated by the staff, but Jessie was afraid that she would complain to her grandmother again, so she planned to observe the future.
During the conversation, she felt that her grandmother had no previous "elves", her memory began to deteriorate, she could not remember the date of the day, and there were fewer answers between conversations.
She used to call Jessie to tell her emotions, but now Jessie calls her.
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Increased physical problems and emotional breakdown in the elderly
However, the nursing staff in the homes are also under great pressure. At the beginning of the new crown pneumonia epidemic, Ms. Luo (pseudonym) is working as a health staff in a private nursing home in Tai Po, responsible for taking care of nearly 100 residents on the first floor. .
Ms. Luo recalled that in order to reduce the risk of infection, as early as the beginning of the epidemic, the nursing home she belonged to had completely stopped visiting services.
In March, the second wave of the epidemic broke out again. In order to reduce the contact between residents, the elderly homes directly cancelled the 30-minute exercise time for the elderly.
Exercise time has been greatly reduced. Elderly people cannot move their hands and feet, and cannot use exercise to relieve the negative emotions of being trapped in nursing homes and unable to see their family members: "If you exercise less, joints will start to harden, and physical problems will naturally increase. Cannot exercise and cannot vent. Emotions and poor moods make it easier to get sick.” Among them, pressure sores due to long-term bed rest are common.
However, the psychological condition of the elderly in residential institutions is even more worrying.
Ms. Luo recalled that an 80-year-old mother-in-law met with her family once a week before the epidemic, and she was in a good spirit and cheerful mood.
However, after prohibiting family visits, the mother-in-law was trapped in the hospital and her mood became more and more depressed, and she kept telling the staff that she missed her family.
Although the institution has arranged for her to have a video call with her family and allowed her family to accompany her when going out for follow-up consultation, the situation has not improved. She has also become taciturn, who used to talk and laugh with staff.
In September, when a staff member went to the mother-in-law’s room to deliver a meal, she found that she used nail clippers to cut her veins and kept bleeding. Ms. Luo stopped the bleeding for five minutes and still failed. She must be sent to the hospital for treatment immediately.
Ms. Luo, who had chatted with her mother-in-law in the past, believed that she mistakenly thought she was abandoned by her family:
Her eyes are so scary, she has no desire to survive, and she is empty, and she is really sad when she sees it.
In addition, Ms. Luo also found that many elderly people lost weight during the epidemic, ranging from three to four kilograms on average.
She estimated that apart from being affected by emotions, family members were unable to deliver meals to the elderly during the epidemic, and the elderly had no choice but to eat meals provided by the homes.
However, the food in the homes is light and tasteless, and there are not many choices. The elderly may not be willing to eat and their appetite is greatly affected.
Seeing that the physical and psychological effects of the elderly are greatly affected, Ms. Law also hopes to take the time to communicate with the elderly, but the actual situation does not allow it.
Ms. Luo pointed out that there are nearly a hundred elders on the first floor of the nursing home, but each floor has only one registered nurse, four health workers, seven care workers, and only one assistant on the third floor. The health workers are responsible for recording the physical condition of the elders. , Distribute medicine and treat pressure ulcers for the elderly; while the caregiver needs to deal with the elderly's daily grooming, changing clothes or diapers, feeding, etc.
As a health worker, Ms. Luo pointed out that due to the shortage of manpower, the daily workload before the epidemic was already very large; after the epidemic, the health of the elderly has deteriorated, and the health workers have to take care of more work of changing blood pressure medicines, and they cannot always get out and chat with the elderly. Let alone take care of the emotions of the elderly.
Ms. Luo witnessed an elder in a residential home hurting herself because she missed her family: "I think she has no desire for business at all." (Photo by Wen Jiran / Authorized by University Line)
The suspension of abduction physical therapy affects the rehabilitation progress of the elderly
Zeng Ji-nan, the organization officer of the General Union of Community and Residential Care Workers, agrees that the physical and mental health of the elderly in residential care homes has deteriorated after the outbreak.
He explained that in addition to the suspension of visits in general homes for the elderly, some volunteer activities, social groups, and religious visits were also cancelled. Life in the hospitals was "extremely depressing."
Many co-workers have reported to him that many elderly people with better spirits understand the situation of the epidemic at first and will try to endure them. However, when the ban on visits lasts for more than half a year, they also start to feel emotional; elderly people with lower spirits and cognitive impairment may not necessarily Understand the situation and easily become irritable due to the inability to meet with family members. For example, some elderly people will "combat" with caregivers when changing diapers and not let them help. There are also elderly people who have nothing to do during the day and stay in bed for a long time, so they cannot be at night. Fall asleep.
Under the epidemic situation, how can private institutions handle the rehabilitation of the elderly?
Zeng Jinan pointed out whether the service will continue under the epidemic situation, and the arrangements of each institution are different, because physical, professional and speech therapists are not permanent staff of the institution.
According to his understanding, due to limited resources, most private hospitals will not hire therapists to stay in the hospital, but outsource rehabilitation treatment services. Most of these services can be maintained at least once every two weeks before the outbreak of the epidemic in February, but most of them after the epidemic Service providers or institutions choose to suspend them, and some institutions do not originally provide outreach rehabilitation treatment.
During the epidemic, apart from the medical care under the Hospital Authority, fewer outreach treatment services continued to operate. In addition, the SWD’s pilot program of “Outreach Professional Services for Residential Care for the Elderly” launched in February 2019 was also suspended. Rehabilitation progress is greatly affected.
Tseng Ji-nan, the organization officer of the General Union of Community and Residential Care Workers, mentioned that outreach rehabilitation services have been suspended, hindering the rehabilitation of many elderly people.
(Photo by Wen Jiran / Authorized by University Line)
Outreach doctors: there should be no “one size fits all” visiting service
Ma Zhongyi, president of the Association of Public Medical Doctors, believes that the government should not stop all visitation services, let alone suspend rehabilitation treatment.
She explained that nearly 80% of the elderly hospitalized in Hong Kong are now in private institutions.
Different from subsidized homes with abundant manpower, abundant resources, and professional staff services, private homes have poor services. Apart from the persistent hardware and environmental problems, they also fail to provide adequate nutrition in their diets, and the home staff fail to take care of the elderly. Emotional needs, so family visits become especially important:
Frankly speaking, the life, psychological, and physical care of the nursing homes in Hong Kong are only up to the basic standards. Now (under the epidemic) even the most basic services have changed.
Ma Zhongyi pointed out that I have seen some subsidized institutions provide iPads to allow the elderly and their families to communicate via video to relieve the distress and discomfort of the elderly, but generally private institutions do not have these resources.
She also pointed out that even if the homes provide video communication tools, it is always difficult to replace relatives. For example, face-to-face communication is better for dementia treatment.
Visiting services were suspended. Without family assistance for training, speech therapy was forced to stop. Ma Zhongyi feared that the elderly with dementia might get worse. She emphasized: "Technology cannot completely replace everything."
She suggested establishing reasonable visitation rules, such as considering whether there are confirmed cases in the home, tracking the travel records of the elderly and their family members, etc. When family members visit, they must control the flow of people and arrange independent spaces to minimize risks.
She emphasized the need to pay attention to and review the overall quality of life of the elderly inpatients. She lamented:
The overall elderly service needs more humanity. In the cheapest nursing homes, I cannot feel that the elderly are treated as human beings. Now the epidemic is more like stomping on two feet.
Ma Zhongyi, a geriatrician at the United Hospital, reiterated that the quality of services in residential care homes for the elderly in Hong Kong is only up to the minimum standard. The epidemic has caused poor service changes.
(Photo by Han Zhuodong / Authorized by University Line)
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[This article was reprinted with authorization from the internship publication "University Line" of the School of Journalism and Communication of the Chinese University of Hong Kong. Original: Who will greet the elderly who have been banned for more than six months?
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New Coronary Pneumonia University Line