Primary and Community Care

I have been a nurse since 1986, mainly working in end of life or dementia care. I have had a variety of roles in the hospital, care home, community and hospice settings. I have been a family carer (alongside my brother and sister) since 2002.

Chaired by BGS Past President Dr Eileen Burns, the five nation care home meeting gave participants an opportunity to share their experiences of managing COVID in care home settings and to compare what worked well and what didn’t.

On the 20th March the usual discussion, laughter, sounds of people coming and going, and noises of normal life fell eerily silent. We had gone into a national state of ‘lock down’. I had always avoided using the phrase if we had needed to close our care home to visitors previously, but now it actually felt appropriate.  We were locked down and locked in.

There has been a significant focus on UK care homes following COVID-19. Care homes have had to quickly adapt their working practices, to keep their residents and staff safe. Approximately 400,000 older people are currently living in UK care homes.

Lister House Care Home nestles against the beautiful North Yorkshire landscape, just on the outskirts of the historic small city of Ripon.

Earlier this year health and social care organisations across Newcastle upon Tyne (Collaborative Newcastle) were focused on how to respond to the COVID-19 pandemic. 

In this blog I write as a care home nurse with hindsight, reliving my shift in mid-March, when I could hear the ‘hooves of the apocalyptic horses’ approaching as coronavirus took hold. I have not worked there since, as I have instead been caring for my husband who is shielding. 

Earlier this week I wrote about ongoing and sometimes over-polarised debates within British geriatric medicine, BGS membership, and government policy around community versus acute hospital care for older people with frailty who require skilled assessment and treatment.

As the COVID-19 pandemic enters its fifth month there is increasing focus within the UK on care home deaths. Latest figures show almost 5000 deaths were registered in the week ending 10 April, double the number a month prior.

We are in exceptional times, and people are providing care in extraordinary ways. On the 30th January 2020, the World Health Organisation (WHO) announced that the COVID-19 (Coronavirus) outbreak was a Public Health Emergency of International Concern.

Getting older and having dementia increases the risk of health problems and can make it hard for people to keep their mouth and teeth clean. As a result, more oral health problems occur. 

In my experience I have found three types of doctors; Those who work very fast, very slow or somewhere in the middle. This is obvious and logical as human behaviour is divided on the basis of a normal distribution, with most being average.

Titled “Investment and Evolution” and sporting the NHS flagship blue and white livery it made many bold statements. First up, the extortionate premiums in indemnity coverage that GPs face will end, thanks to state backed indemnity. Nice.

Palliative care is relevant across the illness trajectory for people living and dying with chronic progressive conditions, aiming to improve quality of life and enable a peaceful death. With an ageing population, an increased proportion of older people will need to access care and support in a long term care facility.